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NHS 111 operators got 'detailed' training ahead of referral service

NHS England: Further training sessions are planned in the lead up to Christmas
NHS England: Further training sessions are planned in the lead up to Christmas

NHS 111 call handlers received “detailed” training ahead of the launch of the pharmacy referral service, NHS England has told C+D in response to pharmacist concerns.

The “detailed training plans” put in place before the Community Pharmacist Consultation Service (CPCS) launched on October 29 included “a combination of approaches” to ensure call handlers could access the training across their 24-hour shift patterns, NHS England told C+D earlier this month (November 8).

NHS 111 providers were asked to facilitate a 30-minute briefing for all their staff, during which the call advisors were shown an animation of the CPCS and a video explaining the role of a community pharmacist, the commissioning body added.

They also received instructions on how to select the right “directory of services template”, which includes pharmacy service information to help operators refer patients to the right healthcare provider, NHS England added.

Pharmacist concerns

A week into the CPCS, C+D readers shared their concerns around the preparedness of NHS 111 call handlers for the national advanced service, claiming that patients were “misinformed” that their prescription would be passed to the pharmacy, ready for them to collect their medicines on the spot.

While NHS England does not mandate the training that NHS 111 call handlers receive, each NHS 111 provider organisation was offered an NHS CPCS workshop in September and October, delivered by the national directory of services team and the national pharmacy integration team, and attended by a local community pharmacy representative, the commissioning body told C+D.

During these sessions, supervisors and frontline staff briefed NHS 111 call advisors, while support staff attended to cascade any briefings, NHS England said.

Further training sessions are planned to support call advisors in the run-up to Christmas and new year, the commissioning body added.

12 Comments
Question: 
What has your experience of the service been like so far?

Joan Richardson, Locum pharmacist

18 month old child with constipation - prescribed Movicol by GP and had taken for 1 week with little result.  Child in a lot of pain and now running a temperature which may of course have been due to a separate issue.  Referred to pharmacy because this is "just" constipation.

Kevin Western, Community pharmacist

If, as we were told there vwere huge numbers of calls to nhs 111 for minor ailments that should be handled by Pharmacists, where are they? I have had one so far, for vaginal blistering(!) what are they doing with the rest?

I understand many will go to 100 hour Pharmacies but, as usual I suspect Pharmacy is being left out because we arent GPs or Nurses... what do we know about it? we run shops...

Thats the training element that needs sorting. I hope someone is reviewing the decisions being made to sort out why the service isnt happening properly. If not it will never change.

Watto 59, Community pharmacist

Only received one so far and that was one more than I expected.  Inappropriate referral for an emergency supply of pexofenidine 120mg (sic.) for a non regular patient.  She had enough Fexofenadine for about a  week but had some difficulty contacting her surgery for a further supply as they were "always engaged".

Watto 59, Community pharmacist

Only received one so far and that was one more than I expected.  Inappropriate referral for an emergency supply of pexofenidine 120mg (sic.) for a non regular patient.  She had enough Fexofenadine for about a  week but had some difficulty contacting her surgery for a further supply as they were always engaged

.

Chris Locum, Locum pharmacist

So well trained they can send someone who left the UK ten years ago and therefore has no registered GP.

A Long Serving Pharmacist, Community pharmacist

The only referral I've had so far was for an Emergency Supply of Tramadol because the patient (not one of our regulars) would have had to wait until 4pm for the GP to sign her Rx. It was 10am! No training for the 111 team about Emergency Supplies of CDs not being allowed. Also this patient had already contacted her surgery and been promised a prescription within a reasonable time frame. Misuse of the service and misdirection by 111  

Angela Channing, Community pharmacist

My colleague had one for MST tabs!! only a fully controlled CD!

No problem said 111 just go to the pharmacy. Result : patient kicked off because "they said..."  blah blah blah. Surely their systems have been configured to flash up when it's CD 2 or 3 and cannot be given as an E.S. ? 

What a dog's breakfast. But did we really expect it to run smoothly. Does no-one ever learn? They spring these things upon us with a couple of weeks' notice, and apparently the paperwork is horrendous! 

As usual I think we have brought it on ourselves, there are too many young pharmacists (and maybe older, lazy???!) who don't like to/ or don't want to do an Emergency supply, or are too scared to.  Scenario I dealt with last week: Regular customer of over 40yrs! Repeat ETP not arrived by Saturday morning. Asks newly qualified by 1 yr, please may I borrow ?(i.e. have an E.S. to get me through until Monday morning) Answer: No!  Why? regular patient, regular meds for yrs, non-abuseable, small quantity required. Are they taught nothing about evaluating risk vs benefit these days? Patient rationed her meds until Mon morning and spent all day Sunday in bed feeling rather ill and alarmed. So perhaps it is these types of ridiculous scenarios where there is a genuine request and can be dealt with in ten muniutes. I often wonder is it because the under 30s have lost the ability to hold a biro and write a few lines in a book, as I was told in one shop. " No MrX. the regular chap never does E.S. because he can't be bothered to write them in the book! " 

A.S. Singh, Community pharmacist

Pharmacists are in the perfect position to handle and triage NHS 111 calls.

The problem is that the NHS know this and would rather spend £20,000 per hour on a huge unqualified team than a bunch of pharmacists costing £1000 per hour, for example

Farhat Ahmed, Locum pharmacist

All NHS 111 operators have been trained, what a load of codswallop, West Midlands Ambulance Service have taken over NHS 111 on the 5th November, in the midlands, and the remit is to have the staff  trained by the 29th November. So, as per usual, NHS England do not have a clue.

Joan Richardson, Locum pharmacist

Training = read the spec and then attempt to deal with the IT mess that is PharmOutcomes!  In other words nothing at all as yet - the first training in this area is in January and 40 miles away from here!

I quite happily provided the previous NUMSAS service on several occasions - the paperwork was a bit of a pain but a check sheet from the PSNC website helped.  This time - total confusion!

N O, Pharmaceutical Adviser

Why are they complicatiing a simple service? All you have to do is a National Urgent medicines Supply service (which exists in places like Cornwall during holidays) and spread the awareness that people should approach the Pharmacy first then be directed to proper healthcare professional if the Pharmacist can't help. No need of all the unecessary 111 calls > referrals > confusion > more phone calls > Chaos.

The URM service runs so smooth. Less paperwork, less beurocracy and both parties are happy at the end of the service provision.

Adam Spencer, Community pharmacist

As a pharmacist I can say I received Little or no training.all I received was angry customers who just wanted their meds

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