NHS England could expand number of minor illnesses covered by pharmacist consultations

If the community pharmacist consultation service proves successful, it could be expanded to cover a wider range of symptoms and minor illness categories, Ed Waller, director of primary care strategy at NHS England, has said.

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NHS England is considering expanding the number of minor illnesses covered by the community pharmacist consultation service (CPCS), if it is successful, an NHS England official has said.

Ed Waller, director of primary care strategy at NHS England, told the Association of Independent Multiple Pharmacies conference on 23 January 2020 that it would also look at developing a referral pathway for urgent medicine supplies between 999 and community pharmacy.

Waller told delegates that, to date, 93% of community pharmacies had signed up to offer the CPCS, receiving 132,922 referrals from NHS 111 since its launch in October 2019.

Of these referrals, 44% (58,768) had been for minor illnesses, with pharmacies in the North West receiving the most referrals (24,153) overall.

The CPCS covers patient referrals from NHS 111 to community pharmacy only, with ongoing pilot projects trialling referrals between community pharmacy and GP practices, and NHS 111 online for urgent medicine supply.

Waller said the “next steps” for the CPCS “are to pilot [referrals] from A&E” as well as NHS 111 online for minor illnesses.

He added that NHS England also plans “to think about the future, if the CPCS is successful” — this could potentially include extending “the number of symptoms and potential minor illness categories [covered by the service, which] would be a debate about clinical safety”.

A slide presented by Waller also suggested that NHS England is “working with the NHS Integrated Urgent Care team to develop a referral mechanism from 999 services”. However, no further details were provided.

Andre Yeung, a community pharmacist based in Newcastle, who led the digital minor illness referral service pilot in the North East of England that fed into the CPCS, said: “There are most certainly other conditions that could be referred to community pharmacists, but some of the barriers to this work are standardised access to equipment and medicines in the pharmacy.”

“An example of this would be urinary tract infections (UTIs) where we could, with a relatively simple pathway, some equipment and medicines, take referrals for patients who report uncomplicated UTI-like symptoms,” he added.

He told The Pharmaceutical Journal that the advantages of such an addition “would be assessment and treatment of patients closer to home, access on weekends and evenings and access more quickly than they may experience through the GP appointment system”.

Prior to the launch of the CPCS in October 2019, pharmacists expressed concern over the number of referrals they would receive.

However, Waller told the audience: “I don’t think there is any other way of operating this model other than allowing the patient to choose which pharmacy they want to go to — whether it be location, opening hours, having had good service there in the past — when they are referred to pharmacy for their issues.

“I understand that makes that difficult as a pharmacist to predict the volumes you might get, but it doesn’t mean it’s entirely out of your hands to shape how many of those people might be choosing to come your way,” he added.

The CPCS was announced in the ‘community pharmacy contractual framework for 2019/2020 to 2023/2024’ which also set out a range of clinical pilot projects which are expected to be launched throughout the length of the contract.

Waller said a cardiovascular disease-checking pilot project, which is scheduled to start before the end of March 2020, would be introduced in three clinical commissioning groups initially.

Meanwhile a point-of-care testing pilot programme, also announced as part of the contract, would focus on patients with sore throat symptoms from “spring 2020”.

Last updated
The Pharmaceutical Journal, NHS England could expand number of minor illnesses covered by pharmacist consultations;Online:DOI:10.1211/PJ.2020.20207626

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