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Emergency supply and SCR issues: week one of NHS 111 referral service

One pharmacist is "surprised" at how few minor ailment referrals they have received from NHS 111, while another had SCR issues in the first week of the service, they have told C+D.

Almost three quarters (8,649) of the 11,600 pharmacies in England have so far signed up to deliver the Community Pharmacist Consultation Service (CPCS), which went live last week (October 29), and sees pharmacies receive £14 for each consultation they complete following an NHS 111 referral for minor illnesses and urgent medicines supply.

Pharmacists previously told C+D that they feared they would not have enough time or staff to deliver the service, which was introduced to make pharmacy the "first port of call" for low acuity conditions.

But how did the first week of referrals go?

Mostly emergency medicine referrals

Martin Bennett, managing director at Wicker Pharmacy in Sheffield, was "surprised" that his pharmacy did not receive any minor illness queries, having handled nine CPCS referrals – all for emergency medicines since the service launched.

But this figure is not unusual, he believes, as the pharmacy – which participated in the NHS Urgent Medicine Supply Advanced Service (NUMSAS) – used to receive 10 emergency supply requests a week through that pilot.

One CPCS referral concerned the supply of an inhaler, which a patient transferring between GP practices could not get prescribed in time, he told C+D this morning (November 4).

The challenge in that case, Mr Bennett said, was contacting the patient.

"After 24 hours, we had left a message on an answer machine and got no reply. So we closed the consultation," which then removes the request from PharmOutcomes, he explained.

But when the patient called back 20 minutes later, and after he unsuccessfully tried to retrieve the consultation request on PharmOutcomes, Mr Bennett had to contact NHS 111 to reopen the consultation to be able to help the patient.

Seeking permission to access SCR

Hull-based pharmacy manager Laura Buckley said her pharmacy has handled four CPCS referrals so far; three being for an emergency supply and one for a minor illness.

Those needing an emergency supply believed the NHS 111 operator had sent a prescription to the pharmacy, Ms Buckley claimed, which proved to be "time consuming" to then explain this was not the case once she spoke to the patient.

Seeking a patient's permission to access their summary care record (SCR) – a requirement under the CPCS – also proved time consuming when it came to handling an emergency supply request for a care home patient.

"I was speaking to a representative and I asked if there was any reason why the lady couldn’t give me permission [to access her SCR]. [When I was transferred to her] at first, she said no. After explaining the issue to her over the phone, I got permission to access her records, but that took about 35 minutes,” Ms Buckley explained.

"According to the SCR, one medication had been stopped, so I then couldn’t emergency supply it," she added.

However, the minor ailment referral was easier to deal with and was potentially life-saving, she explained.

"The minor ailment was a skin rash. Prior to examination the rash could have potentially been shingles. Thankfully in this case I identified it as contact dermatitis and treated it with an over-the-counter product."

"Straightforward supply"

A superintendent pharmacist based in east London who wished to remain anonymous also received a couple of CPCS referrals for emergency supplies and, as Ms Buckley experienced, found one patient was "misinformed", as he thought he could collect his medicine from the pharmacy.

"The second one was very straightforward," the pharmacist explained. The patient came in, participated in the consultation and the pharmacist was able to supply prednisolone to treat their asthma symptoms.

Have you received many referrals from NHS 111 as part of the CPCS?

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