In October last year, the government implemented a new NHS Community Pharmacist Consultation Service following a successful pilot programme in several areas across the UK. Now, after the September 2020 meeting, there have been a few changes. The PSNC agreed to proposals to implement the general practice referrals service into the CPCS this autumn and it is now officially live.
The decision to start general practice referrals followed negotiations with NHS England and NHS Improvement (NHSE&I) where they ran a pilot of this service as part of the Pharmacy Integration Programme with the aid of the Pharmacy Integration Fund (PhIF).
You can access the NHSE&I case study on the pilot in Avon for a greater understanding of how it all works. There’s also a detailed VirtualOutcomes article explaining the initial programme launch, processes and benefits.
More On The Pharmacy Integration Fund (PhIF)
The PhIF aims at supporting the development of clinical pharmacy practice in a wider range of primary care settings. This would result in a more integrated and effective pathway for NHS primary care patients. More specifically, the PhIF wants to achieve greater use of community pharmacy, pharmacists and pharmacy technicians integrated into local care models.
In essence, this fund will help transform how pharmacists and community pharmacies will operate within the NHS. According to NHS England, the three key areas for the operational delivery of the Five Year Forward View are as follows:
- Improving care and quality
- Improving health and wellbeing
- Closing the finance and efficiency gap
Putting The GP Referrals And The Community Pharmacist Consultation Service (CPCS) In Action
As mentioned earlier, the next phase to include GP referrals has been completed and it will engage general practices across England. The GP Referrals service will offer tremendous support when making referrals of community pharmacy patients for minor illness consultations. This not only involves providing better patient care but also helping community pharmacy teams offer a more all-round service.
Simon Dukes, CEO of PSNC, said: “The commencement of this additional referral route into the CPCS will represent a significant milestone in the implementation of the service developments agreed in the 5-Year Community Pharmacy Contractual Framework.”
In light of Covid-19, patients being referred to the Community Pharmacist Consultation Service is encouraged to phone the pharmacy and speak to the pharmacist. Unless there is a clinical need to visit the pharmacy, the pharmacist can provide telephonic consultation, as required by the service specification. In this instance, the pharmacy can claim a fee for providing the service.
Steps In The Community Pharmacist Consultation Service
It’s important to remember that the Community Pharmacist Consultation Service is based on referrals from NHS 111 only. Here, a call advisor assesses the patient’s situation and will refer them for a consultation with a community pharmacist. This replaces the need to book an urgent GP appointment for what could be a minor illness or condition.
It involves sending a formal electronic patient referral to a nominated community pharmacy. From there, once the patient has been referred, the pharmacist will have a private consultation with the patient. Pharmacists will have access to various support materials to offer advice on minor illnesses and general health and well-being.
Pharmacists will use the NICE Clinical Knowledge Summaries to assess symptoms and offer advice and treatment if required. If a pharmacist can’t assist, there is an option to escalate patients to a GP or out of hours services.
Was The Avon LPC Pilot Programme A Success?
The Avon LPC owned the programme implementation as part of a strategic initiative with NHS England and Bristol, North Somerset and South Gloucestershire CCG. Since July 2019, the Avon LPC area has delivered more than 6,500 referrals from over 50 GPs and 130 pharmacies.
The success of this initiative is due to Avon LPC not only training community pharmacy teams but also GP teams. Contrary to popular belief, this programme is aimed at seriously ill and co-morbid patients with many middle-aged patients and people with children.
Considering 11% of patients had a condition for less than 24 hours and 89% had it for two to three days, it’s reassuring that these patients had common conditions for some time and that the referral system worked.
Conclusion
The NHS Community Pharmacist Consultation Service (CPCS) is an advanced service that aims at reducing pressure on the primary and urgent care system. This is particularly important for A&E (Accident and Emergency) and GP out of hours. The service will help support the integration of community pharmacy into the urgent care system.
Following the proposed changes to the Community Pharmacist Consultation Service, Simon Dukes said this. “The success of this addition to the service will be built on the development of strong relationships between community pharmacy and GP colleagues, but this will also build the platform for longer-term relationships between the two professions and that has to be a good thing.”
With the addition of GP referrals, the CPCS becomes an even greater asset for patients, pharmacies, GPs and the NHS. It has now gone live and to help pharmacies deliver the service successfully, VirtualOutcomes will make the appropriate online courses available in due time.
Whether as part of a pharmacy’s LPC licence or a pay per view course, the training material will be comprehensive. It is set to include three modules, i.e. Pharmacy Training Course, Implementation Module and GP Practice Training Course.
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