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Impact of a pilot NHS-funded sore throat test and treat service in community pharmacies on provision and quality of patient care
  1. Efi Mantzourani1,2,
  2. Andrew Evans3,
  3. Rebecca Cannings-John4,
  4. Haroon Ahmed5,
  5. Kerenza Hood4,
  6. Nicholas Reid1,6,
  7. Robin Howe7,
  8. Emma Williams2,
  9. Cheryl Way8
  1. 1School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
  2. 2Primary Care, Information and Communications Technology, NHS Wales Informatics Service, Cardiff, UK
  3. 3Health and Social Services Group, Welsh Government, Cardiff, UK
  4. 4Centre for Trials Research, Cardiff University, Cardiff, South Glamorgan, UK
  5. 5Division of Population Medicine, Cardiff University, Cardiff, South Glamorgan, UK
  6. 6Health Protection Division, Public Health Wales, Cardiff, UK
  7. 7Microbiology, Public Health Wales, Cardiff, UK
  8. 8Clinical Informatics, NHS Wales Informatics Service, Cardiff, UK
  1. Correspondence to Dr Efi Mantzourani; MantzouraniE1{at}


Objective A National Health Service (NHS)-funded sore throat test and treat (STTT) service was introduced in selected pharmacies in two local health boards in Wales, as an extension to the national pharmacy common ailment scheme. The aim of this study was to evaluate the impact of STTT on provision and quality of patient care, namely antibiotic use, patient safety and general practitioner (GP) consultation rates.

Methods Secondary analyses of STTT consultation data to describe service outcomes, and routine data to explore changes in antibiotic prescribing and the prevalence of complications. Data were also collected from one GP practice to explore the feasibility of measuring changes in sore throat consultation rates in general practice.

Results Less than 20% of 1725 consultations resulted in antibiotic supply. The availability of STTT was associated with greater reductions in prescriptions for phenoxymethylpenicillin than in areas where STTT was not available (−3.8% and −3.4%, difference 0.4%). When pharmacy supplies were included, the reductions in the supply of the antibiotic were similar. No increase in the monthly number of incidents of quinsy was detected, and patients were appropriately referred to other healthcare professionals during pharmacy consultations. GP consultation rates since introduction of STTT were found to be lower than the equivalent monthly average since 2014.

Conclusions Data from the first 5 months of the STTT service suggest that it may have a role in safely rebalancing uncomplicated sore throat management from general practice to community pharmacies while continuing to promote antibiotic stewardship.

  • antibiotic management
  • community pharmacy services
  • evaluation methodology
  • general practice
  • health services research

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  • Contributors EM, AE, EW and CW conceptualised the study. EM, AE, RC-J, HA and KH developed the methodology. EM supervised the study, was responsible for project administration, and managing the study, coordinated data collection and led the initial manuscript preparation and final submission. EM, AE and RC-J completed the data analysis. NR and RH reviewed the data under the lens of public health. All authors were involved in data triangulation and interpretation and reviewing versions of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Three of the authors (EW, CW, EM) are pharmacists and were involved in the development of the service specification and all other aspects of the running of the STTT service pilot.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement De-identified original data can be shared upon reasonable request.

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