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Is the community pharmacist consultation service really delivering?

The recent debate about GP contract changes in England has distracted us from the problems with the community pharmacist consultation service (CPCS), warns Adrian Zacher

As the headlines proclaim, GPs will be able to provide an appropriate response the first time a patient makes contact from May 2023.

When unwell, it would seem a reasonable and appropriate response to seek help. And few would disagree that primary care is unwell.

Read more: ‘Chaos’: GPs to ‘signpost’ patients to pharmacies from tomorrow

One of community pharmacy’s roles is to consider if a prescription is appropriate. Therefore, it would seem reasonable for the sector to question this proposed prescription for primary care’s malaise.

Over the last six months, I have been a consumer of NHS care with my Mum following her stroke. It has been eye-opening. Sometimes brilliant. Sometimes not so much. In short, a mixed bag.

However, what was consistently awful were the processes – or the apparent lack of them. It made me wonder if the NHS's processes were outdated, inappropriate or simply not being implemented.

Read more: Only two-thirds of GPs referring to pharmacies via CPCS, minister reveals

I would argue that primary care does not need new prescriptions from on high with diktats to do this and that. Instead, the focus should be on implementing and developing the processes that currently exist.

In my view, we have all the pieces of the puzzle, but have not put them together properly. Consider the CPCS. Regrettably, the service misses the point. It’s fundamentally flawed.

According to section 5 of the CPCS advanced service specification, “patient access to the CPCS is via NHS 111/integrated urgent care clinical assessment service, or by referral from general practice or other authorised healthcare provider – [such as] 999 providers”. Huh? How does that make any sense? Don’t we want the patient to go to the pharmacist first? You know, Pharmacy First – the clue is in the name.

Read more: PSNC ‘still awaiting news’ on Pharmacy First service amid October launch hints

Should I, as a reasonably intelligent human being, go directly to a community pharmacist, because I heed government advice to see a my pharmacist first? Or should I understand that GP appointments are hard to come by, with waits of over two weeks to see a doctor if media reports are to be believed?

Or should I recognise that the community pharmacist can help me, either there and then or by signposting me appropriately? That said, the pharmacist doesn't get paid to do this. How can that be right?

I am staggered that the CPCS is not integrated into GP websites when general practice appointments for the day have all been taken. The 'find a pharmacy' near you passive referral service on GP webpages is outrageous.

When GP appointments are fully booked and their websites signpost a 'find a pharmacy' option that is not under the CPCS then the community pharmacy doesn't get paid. This surely only adds insult to injury? Without funding, it’s an exploitation of the goodwill and caring nature of community pharmacists.

To me, what appears a relatively simple web integration with the CPCS seems obvious – so clearly I'm missing something.

Read more: The jury's out on the community pharmacist consultation service

Currently, the CPCS provides a way for both the GP and community pharmacist to get paid. In what I would call the CPCS 2.0, I would only pay the community pharmacist. Spend the money saved by increasing capacity on the frontline healthcare professional – namely the community pharmacist.

If the CPCS was made to work along with read/write access to electronic health records, it could get patients promptly seen by a healthcare professional and free up GP appointments for those with more complex needs, remunerate community pharmacists and take the pressure off the rest of the NHS.

What’s not to like?


Adrian Zacher is CEO of The British Society of Pharmacy Sleep Services

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