Do we need to rethink the role of private healthcare in patient access to medication?

Timely patient access to medication has become an acute problem in the UK healthcare system, with patients often caught in a tug-of-war between an overburdened NHS and the high costs of traditional healthcare. Shockingly, spending on primary care has actually fallen in recent years (8.9% in 2015/16 to 8.1% in 2021/22), despite 40% of GP appointments being focused on minor health conditions. The impact of this is acutely felt by patients requiring support for minor and longer term ailments.

As the current system falters under the weight of inefficient processes and systemic barriers, this is not just a matter of convenience and patient detriment, but also continues to exacerbate the NHS’s incumbent challenges. GPs are swamped by demand, emergency care wait times are on the rise, and private care is a financial stretch for many.

Present barriers to medication access are numerous and complex. It’s often a postcode lottery, where the quality and pace of care is compromised by an NHS funding model that prioritises cost-saving over optimal patient outcomes. Financial pressures mean that patients can be prescribed the most affordable formula, rather than the most suitable, only scaling to something more costly later down the line as a result – and hence requiring numerous appointments or prescriptions.

As a former A&E doctor who has witnessed the impact of these issues on both patients and the quality of public health services first hand, I believe we need to act now to change this situation before it becomes totally unmanageable. Before its impact on, you guessed it, the least wealthy patients, is too deep to be rectified. In this piece, I want to look at why accessing medication for minor conditions is so hard right now, and where the solutions could lie – including adopting a holistic bureaucratic approach, breaking down the barriers for private sector providers to ease the pressure, and creating a hybrid, technology-driven third way solution to minor illness prescriptions.

The problem with accessing medication for minor conditions

Take, for example, the market for ‘spare’ medication, such as asthma inhalers. We have all, in our time, lost wallets, phones, keys, and other important personal items. Inhalers are no exception and are an important piece of kit that many individuals have to take with them on every excursion. Many people aren’t organised enough to rely on keeping one inhaler safe forever, and yet the process for a second still requires a GP visit and long-winded prescription process. Many are willing to pay a small price to have a spare.

Patients in the UK can also today wait anything up to three to four weeks before getting an appointment for non-urgent health issues. That means that people either don’t see their GP for minor health complaints and the conditions get worse, in cases such as acne, or they choose to self-manage and finally go to the doctor when the impact of these previously minor conditions has worsened significantly, thereby impacting both the patient’s health and NHS resources. Often, you will also see non-urgent patients in A&E because of the difficulty experienced in getting regular appointments, and research shows that 25% of A&E visits are for minor health issues.

The technology story

We’ve seen many other industries with ailing structures transformed by technological innovations and mobile-friendly improvements. Twenty years ago, many of us would never have imagined booking a holiday using solely our mobile devices, or managing huge financial transactions without even speaking to an operator. We’re not twenty years behind in terms of healthcare technology - far from it - but it can’t be denied that the flaws in both NHS software and its approach to data access and management are very much one of the root causes of limited patient access to medication and healthcare. It would be simple to suggest that if we can put down a deposit for a house via a banking app, we should be able to manage our health with the same digital savvy. But the current infrastructure presents significant hurdles that private healthcare providers have to jump to reach that level of service.

On the NHS side, and as a former A&E professional, I have seen the suffocating bureaucracy that all too often stifles innovation, responsiveness and, most importantly, patient access. From using outdated systems for test results, to managing issues with electronic prescriptions and discharge letters, to the difficulties ambulances face in accessing patient health records in emergency situations, there’s a long way to go, and there’s a lot to do. With a huge geographical disparity in terms of data access and systems management, many private practitioners have struggled to manage patient access and encountered multiple issues trying to work directly with NHS services.

The longer we ignore the call for a systemic overhaul, the more entrenched these issues become. We need to explore how technology can be used better to fuel a model that offers affordability, accessibility, and efficiency. It’s here that digital services and AI enter onto the stage to ease the burden on strained systems.

The urgency to scale the right alternative solutions and reduce the burden on primary care

The potential of tech-driven solutions lies in their ability to streamline experiences – improving access without compromising on the quality of care.

The recent troubles of video call GP solutions like Babylon and Push Doctor underline a crucial lesson, though: we need to look at the healthcare model itself and how it serves the ideal patient profile. It’s not just about convenience, but an underlying financial and care delivery model that balances patient needs with system capacity. Private healthcare providers, such as online pharmacies, have the potential to relieve pressure from the NHS by managing recurring prescriptions and minor ailment treatments, thus allowing the NHS to focus on more complex care needs.

Other organisations have a part to play, too. For example, cosmetics companies could offer prescriptions for acne, eczema, and psoriasis. Similarly, companies and insurers tailored for over 50s often offer tailored services alongside healthcare related to menopause, erectile dysfunction, and regular health screenings. The e-pharmacy market is growing rapidly, meaning that private medication catalogues can grow equally rapidly in terms of volume of treatments.

The tides have also started to turn with the introduction of the CPCS (The NHS Community Pharmacist Consultation Service, a national Advanced Service to refer patients requiring low acuity advice, treatment, and urgent repeat prescriptions to community pharmacies). Here, the NHS tried to empower pharmacies to see patients, but again hands were bound by funding restrictions and demand. Pharmacies were only paid if a complex and time consuming process was followed involving NHS 111 validation and referral.

We are, however, seeing this being driven forward more effectively with the roll-out of the Pharmacy First service - an NHS service to get treatment for up to seven conditions. The challenge now is that this needs scaling to nearer 200 conditions to fully meet the needs of patients with minor conditions.

In this context, the healthcare system needs innovation that mirrors the Pharmacy First service's vision, but which goes further. An approach that caters for minor conditions, aligns with the convenience of modern technology, and respects the economic constraints of today's patient without prohibitive costs or lengthy wait times.

What’s next?

The advent of AI and technology holds the potential to make this possible. With the capability to support patient self-management and alleviate the administrative load on healthcare professionals, technology can streamline the path to treatment for routine and minor conditions, preserving resources for more complex care. This middle ground wouldn’t be a replacement for the NHS or traditional private care, but an accessible tier made up of pharmacies and private companies that complements both, reducing the system's overall strain and improving patient outcomes. What’s next is a union of public interest, private innovation, and legislative support designed to create a holistic ecosystem – ensuring that no patient falls through the gaps and that every individual can access the care and medication they need when they need it.