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NHSE&I warns GPs against 'informal' CPCS referrals to pharmacies

Some GP practices are bypassing the formal Community Pharmacist Consultation Service (CPCS) referral route for minor illnesses by “informally directing” patients to community pharmacies, NHSE&I has flagged.

GP practices seem to be doing this to “prioritise delivery of COVID-19 booster vaccinations”, NHS England and NHS Improvement (NHSE&I) wrote yesterday (December 20)  in its weekly primary care bulletin.

The bulletin highlighted that health providers in England had delivered 1.5 million booster jabs over the weekend, bringing the total to a “record-busting” 1.7 million.

NHSE&I GP and medical director for primary care Nikki Kanani and Ali Sparke, director for dentistry, community pharmacy, optometry and the NHS standard contract, recognised that both general practice and community pharmacy are “trying to do their very best for patients”.

But they cautioned GP practices that referring patients into community pharmacy informally “may result in some patients not accessing the care they need” and can hinder pharmacy teams “from identifying patients that need to directly speak to the pharmacist at this very busy time”.


Pharmacies “inundated” by walk-ins


CEO of the Association of Independent Multiple pharmacies (AIMp) Leyla Hannbeck told C+D today (December 21) that she had alerted NHSE&I to the issue in an email last week and was “pleased” to see it highlighted in its latest bulletin. 

“Many independent pharmacies from across England – from one-branch pharmacies to pharmacies [with several branches] – contacted me last week and sent me examples of where this was happening,” Dr Hannbeck stated.

She asked NHSE&I to take action, as pharmacy teams already “under immense pressure” were being “inundated by patients walking in because they were instructed by some GP surgeries to do so”.

Dr Hannbeck enclosed an example of a message that appears to have been sent by a GP practice to patients, which states that practices were “reducing some of their daily services to prioritise the delivery of COVID-19 booster vaccinations” and that fewer appointments would be available for “non-urgent matters”.

While patients’ appointments would be clinically triaged, patients “may be asked to consider other options of care”, such as “attending local pharmacies”, according to the note.

Dr Hannbeck communicated to NHSE&I that some GPs signed to the CPCS were informally referring patients to pharmacies in “at least in eight regions, from Yorkshire to North West and London”, she told C+D.


GPs want to make referrals to pharmacies


However, Amit Patel – chief executive officer at Pharmacy London, Merton, Sutton and Wandsworth local pharmaceutical committee (LPC) and Croydon LPC – told C+D today that this issue had not been flagged by his members.

“We are seeing a large demand from general practice to use this service and have had over 250 GP staff attend our events to learn more about how they can be involved,” Mr Patel said.

He believes the issue with the service might lie with the fact that it was “commissioned without any infrastructure or GP workforce development attached”. His LPCs in south west London have been busy negotiating an IT system for the service and ensuring standard operating procedures are in place, he told C+D.

But he said it is “unrealistic” to expect GP referrals to pharmacies from day one. In addition, he argued that for the past eight years, GPs have got used to informally signposting patients to pharmacies, “which bears no responsibility on the practice”.

“This was essentially a way to send patients to community pharmacy with no responsibility, but now the conversation has changed as the value of a formal referral is a lot more to both the system and the patient,” he added.

NHSE&I revealed in October that only 800 GP practices had already signed up to refer patients to pharmacies via the CPCS service, despite the GP pathway of the service being enabled from November 1 last year.

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