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National pharmacy NHS 111 referral service to launch on October 29

Pharmacies can sign up to provide the NHS 111 referral service from today
Pharmacies can sign up to provide the NHS 111 referral service from today

Pharmacies across England will receive £14 for each consultation resulting from a referral from NHS 111 under a new advanced service launching at the end of October.

Pharmacies in England can from today (September 2) register their interest in providing the Community Pharmacist Consultation Service (CPCS), which will see them receive referrals from NHS 111 from October 29 for minor illnesses – such as rashes, constipation and vaginal discharge – and urgent medicines supply.

The advanced service follows on from two pilots – the Digital Minor Illness Referral Service (DMIRS) and the NHS Urgent Medicine Supply Advanced Service (NUMSAS) – and aims to establish community pharmacy as the “first port of call” for low acuity conditions, as well as reduce demand on urgent care services, NHS England said.

Pharmacies must meet a set of requirements (see below) to provide the service and will receive £14 for every consultation completed – either over the phone or face-to-face – following a referral from NHS 111.

As set out in the five-year funding contract in July, pharmacies signing up to provide the CPCS by December 1 will receive a £900 “transitional payment”, and those who do so by January 15 will get £600.

How will the service work?

Under the CPCS, an NHS 111 advisor will refer a patient to a participating pharmacy via a dedicated IT system – which pharmacies must check at regular intervals – and advise them to call the pharmacy, so a pharmacist can assess their need for an urgent medicine supply, NHS England explained.

The consultation can be conducted entirely over the phone in certain circumstances, such as if a patient does not need to pick up a prescription. However, the pharmacist may deem it necessary to invite the patient to attend a face-to-face consultation before making an emergency supply, it added.

As well as emergency supplies, referrals may lead to pharmacists giving advice, providing over-the-counter medicines, referring patients to locally commissioned pharmacy services, or to other appropriate services and healthcare professionals, NHS England said.

The service must not be actively promoted to the public and should not be used as a replacement for the normal repeat prescription ordering and dispensing processes, the commissioning body stressed.

Service requirements

Pharmacies participating in the service must have a consultation room and from April 2020 be able to access the CPCS IT system from the room. Pharmacists delivering the consultations must have access to the summary care record and the pharmacy’s shared NHS mail inbox.

Contractors must have standard operating procedures in place to support the running of the service and “be satisfied that all pharmacy staff involved in the provision of the service are competent to do so, including any locum staff”, NHS England said.

It will initially fund a CPCS IT system to manage the referrals and log the outcomes. However, by 2021 contractors will be expected to have decided on the IT system they wish to use to continue to deliver the service.

New pharmacy service for winter

Commenting on the launch of the CPCS, NHS England’s deputy chief pharmaceutical officer Bruce Warner said: “We want community pharmacies to start registering for the consultation service, so we have it up and running across the country for the benefit of patients this winter.”

The CPCS represents a “major step change” for the NHS and “fully uses the clinical skills and expertise local pharmacists have to offer”, he added.

From October 29, pharmacies signed up to provide the CPCS will only receive referrals from NHS 111, but NHS England expects to add additional “strands” to the service –such as GP and urgent care referrals – following pilots, it said.

Pharmacies can sign up to the service –and claim their £900 transitional payment – on the NHS Business Services Authority website.

Read C+D's editor's initial take on the new advanced service

18 Comments
Question: 
Will you sign up to deliver the referral service?

Caroline Jones, Locum pharmacist

I hope the 111 staff will be better trained as I find their referrals a nightmare with requests persistently sent through for CDs, wrong strengths and doses of drugs, wrongly spelt drugs eg mirtazapine for metformin! This is before our regular opiate abusers seek to manipulate 111 for an extra weekend supply of their favourite codeine or dihydrocodeine. The time I have wasted on poor NUMSAS requests is not covered by the fee - not that the poor pharmacist who takes all the trouble and responsibility sees a penny for it. 

Sanjay Mistry (Pharmacybox), Community pharmacist

Each consultation with documetnation will take about 20minutes as I have heard from others working in 111 already. So three an hour £42 but who is there to do the other pharmacy duties? locum costs /additional staff - whats the true value?  Definetely a step in the right direction but we need to negotiate a lot better.

How High?, Community pharmacist

Great. More services........ Yummy!

Just what we need, another raft of training to complete and DoCs to print, forms for patients, SLAs and PGDs to sign off, claims to be made.

And right in the middle of the flu jab season when our teams are stetched beyond breaking point after years of chronic underinvestment and management teams trying to get all staff down to the NMW.

Super. Smashing. Lovely........... 

Farmer Cyst, Community pharmacist

Has any thought been given to us disinterested locums who can barely be bothered to put our trousers on let alone do six hours of poorly written, vague online quizzes only to be given the right to fill in 7 pages of info to offer a 'service' that would be completely hassle and further-education free if the punter would just pay for it (i.e. the myriad of tiresome EHC services)

 

The sheer level of ballache in registering for most of these things definitely isn't meant for people who do 6 hours worth of Saturday monrings a month, I can tell you. 

N O, Pharmaceutical Adviser

""Has any thought been given to us disinterested locums""

Just to remind you, it is because of the moaning and groaning of this category of Pharmacists that lead to scrapping of MURs and has been now introduced with a different set of more paperwork related SERVICE.

So as they say, always think before you wish for something!!

Lucky Ex-Locum, Superintendent Pharmacist

Cobblers is it down to moaning and groaning pharmacists. Try working at the coalface rather than 'advising' then you may be able to see beyond the end of your own nose and into the real world.

Lucky Ex-Locum, Superintendent Pharmacist

MURs were utterly worthless. That's why they got scrapped.

N O, Pharmaceutical Adviser

May be for some lazy sods, who wanted to just show their presence in the Pharmacy, sign the RP register, check some scripts and submit their invoice at the end of the day.

Ultimately, whichever way you think, the MURs did provide a good source of income for the Pharmacy Owner to manage the cashflow and keep jobs and wages secure. 

Now what? Stupid services with no idea, more redtape, more time with patients, more paper work and less pay. 

Let me see how many of these sods will call the CPCS -- non clinical, worthless etc etc. 

Lucky Ex-Locum, Superintendent Pharmacist

I meant worthless in terms of worth to patients which was supposed to be the idea. I know how much money was attached to them, which was the entire problem.

N O, Pharmaceutical Adviser

"""" I know how much money was attached to them, which was the entire problem.""""

This is the problem. Unless the Pharmacist makes the most of the MUR and gives value to the patient nothing will be worth it. You want more pay (rates) but you don't want to do more work (which you think is not worth) and moan that contractrors are making money.

Welcome to the new contract. More stupid services for much less pay and more workload. How do you think any contractor will be willing to pay higher rates?

Lucky Ex-Locum, Superintendent Pharmacist

Look at the name - EX-locum. Pay rates are no longer a concern of mine.

The worthlessness of MURs was because a) we didn't have the time to do them properly, b) they were used as a stick to beat employee pharmacists c)the only ones that were actually WORTH doing and the patient got something out of were for people that had complex regimes that, due to the time constraints, were avoided like the plague, and if you say that you have never avoided an MUR because it was too big and complicated, you are a liar. 

Pharmacists have ALWAYS given value to the patient since the year dot. We do NOT need pharmaceutical advisers telling us our worth.

A.S. Singh, Community pharmacist

Is this service before or after the 'free cholesterol and blood pressure check' according  to the bbc. In fairness if the paperwork for this particular service is less tedious then NUMSAS, this might be quite good. But for community pharmacy sake and the staff that go with it: Doh stop spreading rubbish to the BBC 

Charles Whitfield Bott, Pharmacist Director

I will register, but they need to have a think about cut off times. At the moment because we are open 9-12 on a sat am I can not get a numsas referal after 10am. If I use the online referal service for the patient this them becomes 11.30, but the message transfers within seconds, so why the cut off. You would think a simple opening times warning would be enough.

The same happens during the week.

If this new service is the same 40h contracts will suffer and the 100hs and supermarkets will be the ones who get the referals, no matter were the patients wants to go.

Snake Plissken, Student

“The service must not be actively promoted to the public and should not be used as a replacement for the normal repeat prescription ordering and dispensing processes, the commissioning body stressed”. 

Emergency Supply service repackaged as this?!

 

Bob Dunkley, Locum pharmacist

Yes, very good, I hope there is some training for this, and not like NUMSAS where you have to pick it up as you go along. A website where you can ‘play’ with the system before going live would be a good start.

 

James Waldron, Editorial

Hi Bob,

Good question. My understanding is that training modules and some face-to-face sessions will be available from CPPE.

Regards,

James Waldron, C+D Editor

Caroline Jones, Locum pharmacist

The CPPE courses are poorly constructed at the best of times with half the link sections either not working or redundant. So if you are pinning your hopes on their 'training' course, then heaven help us.

Anne Cole, Hospital pharmacist

Caroline Jones, you can send any comments, feedback or reports of links not working in CPPE programmes to: [email protected]

All CPPE programmes are reviewed and updated every 8 months to comply with governance and quality requirements. If any links are found to be not working in between these reviews CPPE would appreciate your help in bringing this to their attention. Thanks

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