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CPCS referrals from GPs still a ‘slow burner’ due to COVID pressures, say LPCs

The number of practices involved in the Community Pharmacist Consultation Service (CPCS) is now slowly increasing, but factors including the COVID-19 booster programme and poor IT systems are hampering progress, LPC chiefs have told C+D.

While some local pharmaceutical committee (LPC) chiefs told C+D they have seen an improved number of GP referrals following the introduction of incentives, others believe that increased focus on providing booster jabs is now slowing down the rollout of this pathway.

C+D reported in October that only 800 GP practices had signed up to refer patients to pharmacies under the service, despite the GP pathway of the CPCS being enabled from November 1 2020.

NHS England and NHS Improvement (NHSE&I) had called for GP practices to sign up to the CPCS service by December 1, 2021 in a bid to improve access to GP appointments.

Practices would only be able to access a share of the GP winter access fund on the condition they signed up to the GP CPCS, it specified at the time.

A  spokesperson for NHSE&I told C+D yesterday (January 5) that it does not yet have an update on whether the number of GP practices signed up to make referrals under the CPCS increased following the financial incentive.


Winter access fund’s impact on referrals


Michael Lennox, chief executive officer at Community Pharmacy Somerset, told C+D last month that his LPC’s experience of CPCS so far has been “really positive”.

Following the incentives introduced by NHSE&I with the GP winter access fund, Community Pharmacy Somerset has seen its “best ever week and a series of best ever days to date” of CPCS referrals, he added.

Meanwhile Simon Hay, the service and engagement officer at North Staffordshire and Stoke on Trent LPC, told C+D that while “the number of practices showing interest in the service increased with the announcement of the winter [access] fund”, with over 300 practices now “live” across the Midlands, this “also coincided with a lot of work that the LPC, integrated care system and clinical commissioning groups (CCGs) had been doing”.

The number of GP practices and primary care networks (PCNs) engaging with the CPCS is increasing in West Yorkshire, too, the LPC's chief executive officer Ruth Buchan told C+D.

However, the COVID-19 booster programme, alongside the “usual winter pressure” could have had an impact on GP CPCS referrals, she suggested.


COVID-19 booster programme slowing progress


Meanwhile, in Devon, around a third of practices had received training to go live with CPCS as of last month, with around half of these making referrals since August 2021, Devon LPC chief officer Sue Taylor told C+D.

“We have seen some increase in the number of referrals over the past few months, but it is very much a slow burner compared with other integrated care systems in the south west,” she said.  

“Now that the system needs to focus on the COVID-19 vaccination booster programme, I am not sure when we will see a noticeable increase in the number of referrals – although [we are] expecting some further resources to be put into dedicated project management resources in the new year.”


“Lack of interoperability” between practice and pharmacy IT systems hampering progress 


Nick Hunter, chief officer for Doncaster, Rotherham and Nottinghamshire LPCs, told C+D that despite “a lot of general interest” from practices, CPCS referrals are “still quite slow [in] building”.

He added: “The lack of interoperability between practice and pharmacy systems has hampered progress, along with any dedicated NHSE&I resource to support implementation.”

While he understands this issue is currently being addressed, he said, practices, PCNs and the CCG will only be able to “significantly increase activity” once this is complete.

Meanwhile, for Dudley LPC, it was decided that “just two GP surgeries in just two of the six PCNs would go ‘live’ first with GP CPCS”, the LPC's chief officer Stephen Noble told C+D yesterday (January 5).

He added: “We are fortunate in that we will be using 'Patient Connect' from PharmOutcomes, which runs off GPs’ EMIS systems, rather than referrals coming in by NHS mail.”

GP CPCS referrals also remain “very low” in south east London. Raj Matharu, Pharmacy London chair and chief officer at Bexley, Bromley and Greenwich LPC, told C+D that south east London could have seen “a rapid expansion” of the service, had pharmacies been able to “secure EMIS/Patient Access in July and if the Omicron variant had not emerged”.


Pharmacies still seeing informal GP referrals


Last month, NHSE&I warned that some GP practices are bypassing the formal CPCS referral route for minor illnesses by “informally directing” patients to community pharmacies instead, which “may result in some patients not accessing the care they need”.

Ms Buchan told C+D yesterday that this practice has been highlighted in West Yorkshire too.

She added: “Our West Yorkshire NHSE&I team have sent out messaging to encourage CPCS use rather than just make informal referrals.”


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