AR134 Pharmacy First Online: Managing Common Minor Ailments in Community Pharmacy

Aims / objectives

By the end of this course, participants will be able to:

• Conduct structured consultations based on presenting symptoms
• Recognise differential diagnoses for common presentations
• Apply red flag criteria to ensure safe and effective patient care
• Identify when escalation or referral is needed
• Understand and apply PGD criteria appropriately
• Document consultations according to professional and legal standards
• Communicate effectively with patients and other healthcare professionals

Course programme

Welcome & Programme Overview

• Overview of the Pharmacy First service and seven nationally commissioned conditions
• Understanding the symptom-led approach
• Recognising red flags and knowing when to escalate or refer

Essentials of Symptom-Led History Taking

• Conducting a structured history: uncovering patterns, symptoms, and patient concerns
• Focused questions to identify key symptoms and risk factors
• Recognising red flags that may suggest serious underlying conditions
• Interactive activity: Practice history-taking and red flag identification

Clinical Examination Techniques Within Scope of Practice

• ENT and neck lymph node examination techniques
• Assessing visual clues, hygiene issues, and other physical signs relevant to patient complaints
• Recognising when a physical examination is unnecessary or outside the pharmacist's scope
• Knowing when to escalate care or refer

Condition 1: Sinusitis (12+ years)

• History taking: Key questions regarding facial pain, nasal discharge, fever, and congestion
• Examination: Inspection and palpation of the sinuses, assessing for tenderness or swelling
• Signs and symptoms: Common indicators of viral vs bacterial infection
• Differential diagnoses: Conditions that may present with similar symptoms
• Management: Self-care advice, treatment options, and when to refer for further evaluation

Condition 2: Sore Throat (5+ years)

• History taking: Questions to identify throat pain, fever, and difficulty swallowing
• Examination: Lymph node assessment and throat inspection
• Signs and symptoms: Differentiating between viral, bacterial, and other causes of sore throat
• Differential diagnoses: Considerations like viral pharyngitis, tonsillitis, or post-nasal drip
• Management: FeverPAIN and Centor scoring, self-care, and when to escalate care for bacterial infections

Condition 3: Earache (1–17 years)

• History taking: Key questions and red flag review
• Examination: Otoscopic examination and palpation of the tragus and mastoid area
• Signs and symptoms: otitis media vs otitis externa
• Differential diagnoses: a wider perspective
• Management: Treatment pathways for common ear infections and when to refer

Condition 4: Infected Insect Bites (1+ years)

• History taking: Questions regarding bite location, symptoms of infection, and any history of allergies
• Examination: Visual inspection of the bite, surrounding skin, and possible systemic involvement
• Signs and symptoms: Localised swelling, erythema, pus formation, or systemic symptoms like fever
• Differential diagnoses: Conditions that may mimic an infected bite
• Management: Treatment recommendations, red flag escalation, and preventative advic

Condition 5: Impetigo (1+ years)

• History taking: Assessing the appearance of the rash and associated symptoms such as itching or pain
• Examination: Visual inspection of the skin and identifying the key characteristics.
• Signs and symptoms: Clear signs of bacterial infection and possible complications
• Differential diagnoses: Conditions like eczema or contact dermatitis that may present similarly
• Management: Treatments, PGD criteria, and when to refer

Condition 6: Shingles (18+ years)

• History taking: Key questions such as dermatomal pain, past history, and immune status
• Examination: Inspection of the skin.
• Signs and symptoms: Classic signs of shingles and red flags.
• Differential diagnoses; it’s not always shingles.
• Management: initial and long-term treatment

Condition 7: UTIs in Women (16–64 years)

• History taking: Symptom-focused questions and the broader picture.
• Examination: What sort is required?
• Signs and symptoms: Key features of a UTI and recognition of red flags for complications
• Differential diagnoses: Could it be interstitial cystitis, a vaginal infection or??
• Management: treatment, self-care advice, and safety-netting

Safe Referral Pathways & Record-Keeping

• Understanding when and how to escalate care, ensuring patient safety
• Best practices for documentation and using structured templates
• Recording consultations to meet professional and legal standards

Interactive Exercise

Clinical Decision-Making in Practice

• Dedicated session on applying structured clinical reasoning
• Tools for managing diagnostic uncertainty and balancing risk
 • Discussion of real-world case examples where clinical judgment was key

Embedding Pharmacy First in Daily Practice
 • Implementing Pharmacy First services in community pharmacy settings
• Managing walk-in and appointment-based consultations
 • Real-world troubleshooting and patient communication tips

Final Q&A & Key Takeaways

Led by

TBA