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More than 300,000 CPCS referrals in six months since launch

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Community pharmacies handled 127,070 CPCS referrals between February and April
Community pharmacies handled 127,070 CPCS referrals between February and April

More than 300,000 patients with a minor illness or in need of urgent medicines supply have been referred to community pharmacy through the CPCS since its launch six months ago.

As of May 18, 295,256 patients had been referred to a community pharmacist by NHS 111 under the Community Pharmacist Consultation Service (CPCS) – which launched on October 29 – NHS England and Improvement (NHSE&I) told C+D last month (May 22).

Of these, 128, 575 (44%) referrals were made for patients with minor illness needs, while 166,681 (56%) had called NHS 111 with an urgent medication request, according to data NHSE&I shared with C+D.

The total number of CPCS referrals goes up to 307,142 once NHS 111 online referrals are added to the mix. As many as 11,886 referrals have been made through the NHS 111 online service since it began to be trialled in October last year. Of these, 8,399, were made after the service was officially rolled out at the end of March.

COVID-19 and CPCS

Between February and April, when the COVID-19 pandemic started taking its toll on the UK, community pharmacies handled 127,070 CPCS referrals.

While facing new challenges including difficulty sourcing personal protective equipment and increased demand for medicines home delivery, community pharmacies in England dealt with 55,441 minor illness concerns and 71,629 requests for urgent medicines supply. As of the end of April, the most common symptoms generating a CPCS referral included “sore throat and/or hoarse voice”, “lower back pain”, “headache” and “wrist, hand or finger pain or swelling”.

Commenting on the latest CPCS figures, the Pharmaceutical Services Negotiating Committee (PSNC) CEO Simon Dukes told C+D yesterday (June 2): “Throughout the COVID-19 pandemic, the CPCS has continued to support patients needing urgent supplies of prescription medicines or help to manage minor conditions.

“This has been a phenomenally busy period for all pharmacies. Helping large numbers of patients to manage minor conditions or to access vital medicines without needing to see a GP or another healthcare professional has been just one of many critical roles played by the sector.” 

An NHS spokesperson told C+D yesterday that the CPCS is “delivering benefits for tens of thousands of patients and has been playing a particularly important role as the NHS responds to the greatest health emergency in its 72-year history”.

Phone consultations

NHSE&I told C+D that it updated the NHS Pathways algorithms on March 24 to ensure that patients with COVID-19 symptoms were directed to the NHS 111 COVID Clinical Assessment Service and not to pharmacies. This allowed call handlers to continue to send patients with non-COVID-19 symptoms to pharmacies where clinically appropriate, the national commissioner said.

NHS 111 call operators highlight to patients the importance of contacting the pharmacy by phone as part of the CPCS referral process, NHSE&I said, adding that this message was “strengthened” in early March.

Chief pharmaceutical officer for England Keith Ridge said in a letter to pharmacies on March 19 that they should consider contacting the patient via phone once a CPCS referral has been received. If appropriate, the referral can then be completed over the phone, according to the letter.

Pharmacies who registered to offer the CPCS service as of or after March 23 were not made live for the service. However, the registration process resumed on June 1 and “once a pharmacy registration has been processed this will be communicated”, NHSE&I said in a COVID-19 primary care bulletin published last month (May 18).

Meanwhile, CPCS referrals from GP practices to community pharmacy – which are being piloted across England and were expected to be rolled out nationally “as early as April”, according to the Community Pharmacy Contractual Framework – were not extended due to COVID-19. This followed negotiations between the Department of Health and Social Care and PSNC.

38 Comments
Question: 
Have you dealt with many CPCS referrals during the pandemic?

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I'll bow to your experience, but the fact that I've only done two since the launch when I used to do four or five MUR a day (until consulting rooms were ruled out of bounds) just goes to show that it's saving the government rather a lot. Theres around 11000 pharmacies in England, in six months thats a ballpark figure of 200 MUR each (under the old rules) which is 2,200,000 MUR at 25 quid a pop which is 55 million quid. 300,000 CPCS at £14 a go is 4.2 million. That's a pretty tasty saving which is the entire point of the exercise - remove money from dispensing, an essential service, come up with a spurious advanced service, let it run for a few years then replace it with an even more spurious and lower paid one and Bob's your uncle, Fanny's your aunt, you strip 50 million quid from the pharmacy pot. Thats four and a half grand per pharmacy saved in six months, lets call it ten grand per pharmacy per annum. You can see why they've done it, can't you?

mark straughton, Pharmaceutical Adviser

Exactly, even back of a fag packet maths shows it's a massive saving for the government but more importantly they know that community pharmacy is not in a position to maximise the service; which is a further saving on top. Each pharmacy needs to consider it's own situation. Until it was pulled pharmacies could only achieve 400MURS per year that we're reimbursed. This CPCS and the previous NUMSAS is some thing that can be pushed to increase revenue with no ceiling.

Just as an example, I once offered one of my locums a few years back an incentive to earn £10 for every flu jab and MUR that we're done per patient. Over the 3 days he earned over £200 extra and all the paperwork was done and complete appropriately (said he earned himself a day off). These services can be done. The problem is that pharmacist don't want to do them on top of their already pressured role with no reimbursement or incentive. Most contractors now rely on these extra services as theyve removed from the dispensing and, quite rightly so, employed pharmacists don't have the capacity to meet the targets.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I have to disagree about the amount that can be earned from this service - we are reliant upon referrals from a third party and while we COULD refer every 'I forgot to order my meds' query to 111, that would, especially at the moment, be an inappropriate use of that service.

Just to say, by the way, that locum only did 20ish MUR or flu over 3 days which isn't hard, the paperwork for both is easy (I'm assuming he didn't have to do the end of month part) and while your offer was very generous (I once did EIGHT MUR in a day to earn myself the princely sum of £5 - thankyou small northern multiple beginning with'W') it's very much the exception not the norm.

I think, reading between the lines, we roughly agree that MUR and NMS are crap, dispensing fees are a joke and pharmacy is going to hell in a handcart. Just the little disagreement over CPCS - I can cope with that!

mark straughton, Pharmaceutical Adviser

Exactly, I can cope with that too. It's good to come across someone who can see and is reaching the bright, obvious light as the way out of the cesspit of community pharmacy. These crappy CPCS and all the other useless services don't counter the steep downtrend of the profession. Community Pharmacy RIP.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I reached the 'Pharmacy is dying the death of a thousand cuts' conclusion years ago but it's taken until now for me to get my act together. As soon as covid is on the way out and firms are recruiting again, I am so gone you won't see my dust for dust. I've grown to loathe pharmacy with a passion and I'm living for the day when I can wave it the two fingered salute of goodbye.

mark straughton, Pharmaceutical Adviser

Good man! It's a tough decision to fully commit to and brave to make the jump. But well done! I can always see myself in pharmacy in some capacity so long as there's a shift and you earn £200+ for the day and it's not a stressful pharmacy. It's a great feeling knowing that pharmacy is not your whole career and really takes the stress away.

N O, Pharmaceutical Adviser

"""More than 300,000 CPCS referrals in six months since launch"""

How many actually atteneded and how many resulted in claims ??????

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

And I wonder how many, a few months ago, were for persistent dry coughs and resulted in coronavirus spread?

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