Meetings with DH fail to boost NHS 111 pharmacy referrals
Exclusive NHS 111 referral rates to pharmacy are still shockingly low, despite the RPS, PSNC and NPA having raised the issue with the DH seven times in the past 18 months, an FOI request by C+D has revealed.
NHS 111 is still referring less than 3 per cent of callers to pharmacies, despite pharmacy representatives holding several meetings with the government to try to boost the profession's role in the helpline service, a C+D investigation has found.
The Royal Pharmaceutical Society (RPS), PSNC and NPA between them met with the Department of Health (DH) seven times between August 2011 and December 2012 to try to boost patient referrals to community pharmacy, C+D's freedom of information request revealed.
The pharmacy bodies highlighted the low referral rates to pharmacy on two separate occasions and suggested that pharmacists could play a greater role in helping with specialist medicine enquiries and minor injuries.
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"I'm waiting for NHS 111 to break and then they'll come running to us, because the NHS can't cope with the amount of referrals [to more expensive providers]" Nick Hunter Nottinghamshire LPC |
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But referrals to pharmacy and dental services have shown minimal increase since the first meeting, having risen from 2 per cent of calls in August 2011 to just 3 per cent in December 2012, according to government figures. Total calls to the service rocketed from 35,463 in August 2011 to more than 240,000 by December 2012, as the number of areas in England that operated NHS 111 grew from four to 15. |
‘Frustrating' NHS 111 service fails to acknowledge
pharmacyReferral rates to pharmacy were very low and a lot more could be done to make use of the profession, the RPS, PSNC and NPA said in a joint statement to C+D.
"For many conditions, community pharmacies could offer patients a quick and efficient resolution to their problems at a lower cost to the NHS than would be available from other providers," they said.
The DH had conducted an analysis of NHS 111 data to determine how to boost referrals to pharmacy, the organisations said. Ensuring the directory of services – a database of all local health providers used by call handlers – was kept up to date was one of the main recommendations.
But Nottinghamshire LPC chief officer Nick Hunter, whose area was one of the first four sites to pilot NHS 111 in August 2011 said he was still "arguing and raising issues".
"The fundamental problem with NHS 111 is that, in order to achieve its objective of the patient accessing what they want from the NHS at the first point of contact, patients have to access it at a higher level than perhaps they would normally," he said.
"It may seem like something we can treat in pharmacies perfectly easily – a minor ailment like a headache – and that might end up being referred to a GP, out-of-hours or A&E because it may be seen as a risk of a brain tumour," Mr Hunter said.
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"I've got to the point really where I'm waiting for NHS 111 to break and then they'll come running to us, because the NHS can't cope with the amount of referrals [to more expensive providers]," he argued. His concerns were echoed by Croydon LPC secretary Andrew McCoig who said less than 1 per cent of calls were referred to pharmacy in his area, despite the service launching locally in March last year. The local team would "desperately" like more authority to direct people appropriately, he said. At the time of the NHS 111 launch in October 2011, former health secretary Andrew Lansley said the service would be an "important step in modernising the NHS". The DH did not respond to C+D's requests for comment. Impact of NHS 111NHS 111 failed to cut use of emergency services in the four areas where it was first piloted, a University of Sheffield analysis found. The analysis of the service, published in August last year, found there had been no significant change in the number of emergency calls or attendances in County Durham and Darlington, Luton, Lincolnshire and Nottingham. Those involved in designing and implementing the service also expressed doubts over its impact on the emergency and urgent care system, although an expert panel of clinicians judged that, overall, callers were referred to the right place first time. And, despite nearly three quarters of users being very satisfied with NHS 111, the report estimated there was only a 21 per cent chance the service would generate cost savings for the health service. The report's authors recommended that NHS 111 improved its pathways – paying particular attention to emergency ambulance referrals – and looked to gain better integration with other local services. |
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NHS 111: how the pharmacy meetings with the DH unfoldedAugust 8, 2011 NPA discusses directory of services with DH and highlights that advanced pharmacist prescribers are "very important" members of the directory. The NPA also offers to help with the marketing of the service. October 3, 2011 RPS discusses how pharmacists can get involved in NHS 111, and suggests callers could speak to a pharmacist for specialist medicine enquiries October 26, 2011 NPA, RPS and PSNC discuss low number of referrals to pharmacies and the need for a "co-ordinated message" on NHS 111 December 7, 2011 PSNC and RPS discuss referring callers with minor injuries to pharmacies and PSNC arranges further meeting to share its specific queries and concerns. May 15, 2012 NPA attends NHS 111 stakeholder meeting June 12, 2012 PSNC highlights "specific concerns" from members about conditions not being included in pharmacy profile. DH says it is best to refer to a GP if there's any doubt over whether a pharmacist can help, as the service aims to signpost patients to the right care first time. December 4, 2012 NPA joins telephone briefing on NHS 111 |
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What health issues could be referred to pharmacy from NHS 111? Comment below or email us at [email protected] You can also find C+D on Twitter, LinkedIn and Facebook |
