Pharmacies could receive 275,000 extra minor ailments service referrals annually

Additional symptoms have been included for referral to the 'Community pharmacist consultation service' after a review of the NHS 111 referral pathway.

Community pharmacies in England could receive 275,000 additional referrals each year from NHS 111 after more minor illness symptoms were included for referral to the ‘Community pharmacist consultation service’ (CPCS), the Pharmaceutical Services Negotiating Committee (PSNC) has said.

In a statement on its website, published on 14 January 2022, the PSNC said a review of NHS referral algorithms “was conducted by an expert group of integrated urgent care clinicians and pharmacists” and introduces “three new condition types (scratches and grazes, teething, sinusitis) and incorporates general health information requests”.

“Referrals will also be made for some conditions which are already well managed by the CPCS, but that have been previously triaged as having higher acuity requirements depending on the patient’s declared history,” the statement said, adding that these conditions include diarrhoea, vomiting, cough, cold and flu.

“While the volume of referrals to pharmacies [is] always dependent on overall NHS 111 call volumes, based on data from 2021, this review could generate 275,000 additional referral opportunities annually.”

The PSNC added that there are “no planned changes to the service specification” following the review.

The service specification for the CPCS currently lists 37 “possible symptom groups identified for referral to a community pharmacist”, including athlete’s foot, headache and sore throat.

According to data available from NHS Business Services Authority, published monthly, community pharmacies made 487,991 claims for funding through the CPCS between January 2021 and October 2021, across both the GP and NHS 111 referral routes.

NHS England began piloting a third referral route into community pharmacy from urgent and emergency care on 1 November 2021, which pharmacy representatives said would “make greater use of the clinical expertise of community pharmacists”.

Thorrun Govind, chair of the Royal Pharmaceutical Society’s English Pharmacy Board, told The Pharmaceutical Journal: “It is positive to see this ongoing discussion with the NHS on how to maximise the benefits of CPCS referrals for patient care, which was a key finding of our workshop with the Royal College of GPs, British Medical Association and pharmacy teams.

“We know there’s potential to evolve CPCS even further and we’ve welcomed the commitment from ministers to explore a ‘Pharmacy First’ approach, so people can go directly to their pharmacy for a minor ailment.”

In October 2021, health secretary Sajid Javid said he was looking into creating a national pharmacy minor ailments service in England — similar to the ‘Pharmacy First’ service in Scotland.

Under the NHS ‘Pharmacy First’ scheme, launched across Scotland in July 2020, community pharmacies can offer free advice, treatment and referrals to patients presenting with minor conditions and prescribe treatment for certain conditions.

The CPCS launched in England in October 2019, replacing the ‘NHS urgent medicine supply advanced service’ and ‘Digital minor illness referral service’ pilots.

However, the service has so far failed to bring in the promised levels of funding. It had been expected to bring in around £4m in 2019/2020 and £9m in 2020/2021, with pharmacists paid £14 per consultation; however, low uptake meant the projected funding levels were not reached.

Data published on 28 October 2021 by NHS Business Services Authority show that community pharmacies earned just £1.9m through the CPCS in 2019/2020 and £5.3m in 2020/2021.

Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, said: “We clearly need all CPCS coming into our pharmacies to be directed through the formal system so our members are paid for the services they give.

“At present, far too many CPCS type patients are being referred to pharmacies outside of the formal system so they do not receive the CPCS fee for managing these.”

Read more: Learning resources on minor ailments

Last updated
The Pharmaceutical Journal, PJ, January 2022, Vol 308, No 7957;308(7957)::DOI:10.1211/PJ.2022.1.124071

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