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Are pharmacists ready to deliver next week’s NHS 111 referral service?

Rekha Shah: Feedback from CPPE training was superb

Pharmacies in England will start receiving NHS 111 referrals as part of the Community Pharmacist Consultation Service (CPCS) from next Tuesday (October 29). So are they ready?

The CPCS – introduced as part of the five-year funding contract in England, with the stated aim of establishing community pharmacy as the “first port of call” for low acuity conditions – will see pharmacies paid £14 for every phone or face-to-face consultation completed.

Less than a week away from the launch date, how have pharmacists prepared for the service?


The Centre for Pharmacy Postgraduate Education (CPPE) – tasked by NHS England with training pharmacists to deliver the service – is delivering one-day workshops across England, as well as e-learning modules.

There are 2,500 places available up to March for pharmacists, NHS England told C+D.

Rekha Shah, CEO of Kensington Chelsea and Westminster local pharmaceutical committee (LPC), said some contractors in her area attended the CPPE training last weekend “and the feedback from that is superb”.

“Some of the things they covered included red flags – what to look out for. It made them really think about how they are going to manage those patients,” she says.

Those who could not attend “formal training” were able to learn from colleagues at a contractor meeting the LPC held the following day, she adds.

She feels that pharmacy teams in her area are ready to offer the service, as they gained experience from the NHS Urgent Medicine Supply Advanced Service (NUMSAS) and the Digital Minor Illness Referral Service (DMIRS) pilots.

“Similar to a minor illness service”

Lisa McGowan, pharmacy manager at the Well Pharmacy at Collum Lane Clinic in Ashby, Leicestershire also feels ready to deliver the service from next week. She expects it to be similar to the minor illness service the branch already offers.

She participated in CPCS training organised by Community Pharmacy Humber. However, she knows other pharmacists who do not feel ready for the service, which she suggested might be due to a lack of mandatory training.

“With most patient group directions, there’s something that you need to do to deliver the service”, while “there isn’t anything like that for this particular service”, she says.

Pharmacists are used to receiving training and information to “prove that they can do the service”, Ms McGowan added.

“Coming in quite quickly”

An anonymous locum pharmacist based in Kent told C+D they believe the service has been introduced “quite quickly”.

They claimed it has mostly been contractors who have benefited from existing training, while locums “are just going to turn up and they're going to be hit with this new service that they're expected to do, which they're not going to know how to do”.

All the relevant training in their area is also scheduled to start in December, one month after the service launches, they said.

Figuring out the elements

Amish Patel, pharmacist and owner of Hodgson Pharmacy in Kent, has completed all the recommended CPPE training and now needs to understand how the service will work in practice.

“All of the most time-consuming stuff, I’ve done,” he told C+D. “Now I need to figure out the logistical stuff.”

James Wood, CEO of Community Pharmacy Surrey and Sussex, said pharmacy teams in his area feel ready to offer the service from “a clinical perspective”.

But they are still preparing for the different elements of the service, he added.

There is also a “small cohort of pharmacists who feel that they need a bit of a refresh or more confidence around delivering aspects of the service”, Mr Wood added, which is why the organisation has arranged for another training date with CPPE.

A weekly CPCS implementation group has been set up with other local health organisations, “led by LPCs across Surrey, Sussex and Kent”.

The group has representatives from the local NHS England and NHS 111 providers, the directory of service leads and “all the key stakeholders to deal with urgent care”, he said.

“It’s got all of us together with a view to making sure that we help pharmacists, pharmacies and other parts of the system, making sure we’re all aligned in terms of our readiness to go live,” Mr Wood added.

Over 1,000 Lloydspharmacy branches signed up

Meanwhile, Lloydspharmacy is working “closely with its store teams to make sure they are confident and ready to deliver the CPCS”.

So far “over 1,000” of its pharmacies have signed up to deliver the service, and it “expects to have all teams up and running ahead of the launch”, it told C+D today.

“We understand how important it is to help our employees understand what it means for them and how it will benefit our customers and patients,” the multiple added.

Each pharmacy has been supported with a set of standard operating procedures and a CPCS toolkit, “to help them understand how it works and what they need to do”.

Are you ready to offer the CPCS?

Gabriela Peterlin, Locum pharmacist

The notice about the service came for many of us late. It seems to be done hastily. Lots of ‘paperwork’ for already overbusy pharmacists, hardly able to perform their regular pharmacist tasks. With pharmacies understaffed out of regular hours who will perform this service in case there is no space for it? Diagnosis, even basic, requires time. What is 111 for then? It was supposed to cover patients our of hours. My impression is that new pilots are created by some teams who probably need to display new activities, rather than making our profession easier and more managable. 

Leon The Apothecary, Student

Is it just NHS 111 that can make referrals? I was thinking that there are a number of other health professionals who could make use of such a service as well. If the intention is to make Pharmacy First, let's do it properly.

Prafulkumar Soneji, Locum pharmacist

NHS 111 is the start. Referrals from GPs, A & E, OOH etc are to be phased in over next few months....this is my understanding of CPCF.

N O, Pharmaceutical Adviser

""Only hoping for the success of this service purely based on the anticipation that some really clinical service with a good remuneration and less paperwork will follow, MAY BE!!!""

Having said that, if we believe what PSNC says -- If the money allotted to these services is unused, then the money will be redistributed equally among all Pharmacies, then I hope this service fails miserably. Damn with future services, if they are eaqually frustrating and favor a few, atleast for the next Five years we will get back part of the unspent money.

Caroline Jones, Locum pharmacist

Again we've been shafted!!! Another, potentially useful scheme, rushed in with little or poor CPPE training and excessive paperwork. Also concerned about the quality of the people at 111 who triage this service who seem to operate from a tick box list rather than any clinical experience. Where exactly will the responsibility for mistaken diagnosis/referrals lie?... squarely with the pharmacist. Will our insurances cover it? Cos we all know the multiples will skate on any responsibility with the GPhC. Also when will we get a system that actually pays the pharmacist PROVIDING the service and taking the RESPONSIBILTY a fee instead of it all going to the multiples ??? At least then we could afford better training and increased insurance premiums not to mention increasing GPhC fees (who again seem to be asleep on the job when it comes to ensuring standards of training for these new services).

Leon The Apothecary, Student

Paperwork seems to be as standard with any other patient-facing professionals these days, I'd actually argue the issue is how we handle it in pharmacy; we need streamlined systems that make it easy to fill out forms, autopopulate data when possible, and reduce what we enter to the absolute minimum requirement.

There are some good examples out there that we could emulate.

Benie I, Locum pharmacist

Stay tuned Caroline, let's see what happens in the coming weeks once the service goes live.

Benie I, Locum pharmacist

Will be interesting to see how employers make this a target chasing exercise.

Leon The Apothecary, Student

I doubt it could be made into any meaningful KPI considering pharmacy has no way of easily influencing uptake.

Farmer Cyst, Community pharmacist

Do 50 a month or I report you to the GPhC for that dispensing error you made 9 years ago.


Don't worry about the stress bro - I used to manage a Dixons I know about professional standards.

Career Miss Take, Locum pharmacist

What training ? At least a podcast would help!

Benie I, Locum pharmacist

Best username on here !!

It’s hard to plan for a service when you have no idea how many referrals you will receive in a day and how long they will take. I was getting patients using the NUMAS scheme come in 5-10 minutes after getting off the phone to 111 with only an email notification I hadn’t had chance to read.

At least MURs could be planned to an extent.

How High?, Community pharmacist

No, Nobody is ready. Staff cutbacks mean pharmacists still spend all day checking, chasing MURs and giving flu jabs. Locally there are ENT+, emergency upply, EHC, supervised consumption, UTI, infected skin and eczema local enhanced services. All of which have to be signed up for using the DoC system, paperwork completed and all claimed during the consultation straight onto Pharmoutcomes. All at the same time as dealing dozens of queries around stock issues. And have a look at Appendix D. Swelling itch? Rectal Pain? Tiredness? Who the hell agreed to this at a time when all the employers are cutting back on staff due to flat funding and that being the only cost they can actually control..... It's an utter joke!

Benie I, Locum pharmacist

Coming months should be fun filled.....

N O, Pharmaceutical Adviser

"""Pharmacies in England will start receiving NHS 111 referrals as part of the Community Pharmacist Consultation Service (CPCS) from next Tuesday (October 29). So are they ready?""""

As if there are millions of patients waiting in que for the Pharmacy to open in the morning!!!

Are we ready?? Yes. Spent whole weekend and the week so far just going through the enormous pages of documents.
Already providing Minor ailments and Urgent Medicines supply over few years now (Locally Commissioned Service) But never had to do so much paperwork.
Only hoping for the success of this service purely based on the anticipation that some really clinical service with a good remuneration and less paperwork will follow, MAY BE!!!

Gabriela Peterlin, Locum pharmacist

Like with all services, soon the articles will follow about the discontinuation of it. Such waste of everybody’s time. 

Stephen Walker, Community pharmacist

Lisa works at Well Pharmacy, Ashby SCUNTHORPE not Leicestershire as the article states. Accuracy in reporting would help debate. Ashby is a nice place and the pharmacy is great,have worked there as a locum.

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