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Pharmacy sector cashes just over £6m in first year of CPCS referrals

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NPA: COVID might be reason behind the lower-than-expected income
NPA: COVID might be reason behind the lower-than-expected income

More than £6 million was paid to pharmacy owners who were signed up to the Community Pharmacist Consultation Service (CPCS) in 2019-2020, C+D can reveal.

Contractors made 60,316 claims to the NHS Business Service Authority (NHS BSA) between December 1, 2019 – the first month from which pharmacies could start claiming for CPCS referrals – and November 30, 2020.

This amounted to a total of £6,000,941.19 being paid to the sector in this period, NHS BSA said in response to a freedom of information (FOI) request by C+D.

Some 10,934 community pharmacies were signed up to the CPCS between October 29, 2019 – when the service was launched – and October 29 last year, according to the NHS BSA data.

Pharmacy minister Jo Churchill said in a Westminster Hall debate last week (March 11) that the community pharmacies signed up to the CPCS have dealt with more than 750,000 referrals since the service launched.

Contractors have six months to submit their claims for a completed referral to the NHS BSA, which means the £6m figure may not be reflective of the total number of CPCS consultations completed in the first 12 months of the service.

Around £46 per month per pharmacy

If the total CPCS income for the first year of the service were to be divided by 10,934 – the number of pharmacies that were signed up to the service as of October 29 last year – it would result in an average monthly payment of just short of £46 per pharmacy.

However, the NHS BSA said “this number covers all pharmacies who were signed up to the service at any point in this time period”.

“Some community pharmacies were initially registered in September 2019 and some may have ceased, changed or de-registered before October 29, 2020,” according to the NHS BSA.

Rollout during pandemic “a challenge”

Commenting on the £6m CPCS figure, a National Pharmacy Association spokesperson told C+D that the rollout of the CPCS “has been a challenge” due to the COVID-19 pandemic.

This “would explain why the income is less than the sector would have hoped for, but it is more important than ever to support primary care and our patients”, they said.

“We hope that NHS England and NHS Improvement will increase investment within the sector to allow community pharmacy, as a member of the NHS family, to continue to help patients and ease the strain on the health service,” the spokesperson added.

C+D reported last year that between February and April, when the COVID-19 pandemic started taking its toll on the UK, community pharmacies handled 127,070 CPCS referrals.

“Structural problems”

Commenting on the first year of the CPCS, the Association of Independent Multiple Pharmacies CEO Dr Leyla Hannbeck told C+D that there are “structural problems with the service”.

“When the CPCS was introduced our members embraced it as they saw this as a valuable service for patients,” she said.

“However, detailed analysis of the CPCS by one of our members [a chain of pharmacies] shows that the average CPCS consultation takes a pharmacist 20 minutes, which does not cover the professional fee.”

The analysis of the pharmacy chain also shows that “20% of all CPCS [referrals] attempted turn out to be not claimable”, she added, and of these, 33% are unclaimable “because the patient is not contactable”, while 5% are inappropriate referrals.

The analysis, which was shared with C+D, revealed that the independent pharmacy chain reported a profit of just £4,913 from the CPCS across its tens of branches in over nine months.

CPCS benefits “across the system”

Andre Yeung, one of the architects behind the pilot that inspired the CPCS, told C+D that the service is “still growing”.

However, “it will become a much bigger aspect of what community pharmacy does and will underpin our ambitions with independent prescribing and digital connectivity with our health and social care partners”, he added.

“For me, the benefits of the rolling out of NHS 111 referrals to community pharmacy and GP referrals to [the sector] are already being felt across the system,” Mr Yeung said.

CPCS payment data sourced from NHSBSA DPC Database, NHSBSA Copyright 2021

Every day this week – March 15-19 – C+D will be analysing the Community Pharmacist Consultation Service (CPCS) a year into its launch. Read all the coverage in the dedicated hub and join the conversation on the C+D Community.

14 Comments
Question: 
How many CPCS referrals did your pharmacy receive in the first 12 months of the service?

Bob Dunkley, Locum pharmacist

When will the devisers of these grand schemes learn that the general public, by and large, do not want to consult a pharmacist  - they want to see a fully paid up member of the GMC, ie a Doctor, however trivial the complaint. The derisory amount paid out to contractors for the CPCS bears this out.

A.S. Singh, Community pharmacist

£450 per year per pharmacy (£6m/12.5k pharmacies in UK)

about £1.30 per day. Not even worth getting out of bed for that

A LOCUM, Community pharmacist

totally agree with previous comments , a service which started out so enthusiastically has become a nightmare .We do not have a second pharmacist whilst we are in our rooms for 20 minutes , we have limited diagnostic tools unless we buy our own , we disappoint the public as they think we can write them prescriptions,if only we could become prescribers in the community using  a relevent course  opposed those inaccesible prescribers in gp surgeries and hospitals 

Watto 59, Pharmacy owner/ Proprietor

Not sure it was greeted entusiastically by the many who predicted this would be the outcome.

 

anti-depressed Pharmacist, Manager

The service is a failure because the people doing the referral (NHS 111) are poorly trained. I have had many patients demanding I dispense schedule 3 medication because they believe the referral for an emergency supply is a prescription.

 

I also had one patient believe she was being referred to a GP to have her symptoms diagnosed and then a prescription being written so she did not have to pay for the medication.

 

To me it just feels like NHS 111 want to unload their work pressure rather than the NHS as a whole.

P M, Community pharmacist

my head hurts

Uma Patel, Community pharmacist

Most GP’s and Practise Pharmacists I have talked to are not bothered or haven’t heard of it. There is no incentive for the GP’s. It is far easier for them to tell the patient   ‘go to the chemist’

C A, Community pharmacist

I'm so glad that NHSE gave us this wonderful new service to replace the MURs - which in a 12 month peroid pharmacies were being paid £61,245,380 for according to the PSNC. So CPCS is 10% as "profitable" as MURs. The accountants at the DoH must be chuffed.

Dave Downham, Manager

These numbers do not add up - if £6m was paid out for just over 60,000 claims, that suggests that average cost of drugs provided on a CPCS was (£6,000,941/60,316 claims - £14) = £85.49, which would be handy. And that's assuming that all consultations lead to dispensing. 

Also, if there's been over 750,000 referrals and only 60,000 claims, that's a hell of a difference.

(Apologies if I'm jumping the gun and anticipating future articles this week...)

C A, Community pharmacist

Your math is bang on but your notation is off - 

[Amount paid - Fees]/Claims = Average cost of drugs

[£6000941 - (60,316*£14)]/60316 = £85.49

Yes something is up with that information - if there had been 750,000 referrals, even allowing for 40% drop rate (which seems generous from the info above) the fees paid would be £6.3 million plus the cost of any drugs provided via Urgent Supply.

Dave Downham, Manager

6= 2 × 3!

C A, Community pharmacist

What?
2 x 3! = 12

Dave Downham, Manager

Chapeau, CA, chapeau!

Kevin Western, Community pharmacist

so, 750000 referrrals, across 10000 sites = 75 each over  12 months... - just over 6 a month, and if 20% require work but arent then claimable thats down to 5 a month plus extra work.... hardly a mind blowing advance in services...or finances. once again an arm of the NHS (The 111 service)  that doesnt see Pharmacy as a healthcare provider.

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