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Revealed: Pharmacies paid average of £48 a month for CPCS

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Contractors have six months to submit their claims for a completed referral to NHSBSA

Community pharmacies in England that signed up to provide the CPCS were paid an average of just under £48 a month for offering the service in its first six months.

A total of £3,043,823.51 was paid to the 10,629 pharmacies that were registered to deliver the Community Pharmacist Consultation Service (CPCS) as of May 31, NHS Business Services Authority (NHSBSA) said in response to a freedom of information (FOI) request by C+D.

This means that pharmacies were paid an average of approximately £47.73 a month for the claims they submitted for each referral they completed between October 29 – when the service was launched – and the end of April, working on the basis that pharmacies can start to claim and be paid for each month's consultations at the beginning of the following month.

Contractors have six months to submit their claims for a completed referral to NHSBSA, which means the £3m figure may not be reflective of the total number of CPCS consultations completed by contractors between October and April.

Pharmacists could start claiming for their CPCS referrals from December, which included consultations carried out between October 29 and the end of November.

The sum paid to pharmacies in the service's first six months does not include the payments made to them for early sign-ups to the service, NHSBSA said.

Through those incentives, pharmacies registering to provide the service by December 1 last year and January 15 received a supplement of £900 and £600 respectively.

Claiming the £14 CPCS fee

Contractors can claim a consultation fee of £14 for each completed urgent medicines supply or minor illness referral they make under the service – but no payment can be claimed if the pharmacist cannot make “any contact with the referred patient”, according to the CPCS service specification.

NHSBSA can accept claims from contractors “within six months of completion of a referral”, although claims made later than this will not be processed, NHS England and Improvement (NHSE&I) wrote in the service specification.

An Association of Independent Multiple pharmacies (AIMp) spokesperson told C+D yesterday (August 13) that the organisation believes the £14 fee is “unfortunately not sufficient and, in some cases, it is loss-making considering the time the pharmacist puts in”.

“A high percentage of CPCS [referrals] use up pharmacists’ time but are ultimately found not to qualify for payment,” they added.

But pharmacist Andre Yeung, who helped to formulate the pilot that inspired the service, told C+D yesterday that the £14 fee “still feels about right for the moment, based on what I know about these consultations”.

He would be “surprised if community pharmacies still get paid by volume” in the future, he added. Instead, he thinks the service “will go to a flat fee”, which contractors will receive quarterly or yearly, “for being a high-quality CPCS provider”.

An “opportunity”

The service is an “opportunity for community pharmacy to show its ability to deliver a high quality acute national service that patients and NHS systems really benefit from”, Mr Yeung said, a view that is also shared by the Company Chemists’ Association (CCA).

A spokesperson from the CCA told C+D yesterday that while there were fewer referrals from NHS 111 to community pharmacies during the COVID-19 pandemic, “pharmacy teams worked tirelessly… to ensure the demand for the supply of vital medicines continued to [be] met both safely and effectively, while providing advice and reassurance to the public”. 

“CPCS shows the vital role that community pharmacy has in supporting patients and taking pressure off the wider NHS,” they added.

“We need fair funding for contractors to continue their vital role, particularly as the NHS prepares for the potential double whammy of winter pressures and COVID-19”.

As of May 18, more than 300,000 patients with a minor illness or in need of urgent medicines supply were referred to community pharmacy in just over six months since the launch of the CPCS service, C+D reported in June.

Community pharmacies handled 127,070 of these referrals between February and April, when the COVID-19 pandemic started taking its toll on the UK.

32 Comments
Question: 
What do you make of the figure paid to contractors?

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

So £48 per month to replace MUR? This was obviously the plan all along. Replace a service which most pharmacies could do and control with one which pharmacies have no control over and is far less likely to be used anyway, make the paperwork such a massive ball-ache that no-one wants to be bothered and it's a winner on the DoH side.

A.S. Singh, Community pharmacist

I know gardeners that earn more than what we were paid in the same amount of time it takes to do the paperwork.

O J, Community pharmacist

Thats it, I am becoming a gardener now. A.S Singh you got any bushes to trim?

Freelance Chemist, Pre-reg Pharmacist

I do too

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I'm starting my horticultural qualification in September - truth, I'm not bulling here!

David Holdsworth, Community pharmacist

The PharmOutcomes claim form to claim fee is awful and takes 15 minutes to complete after all the previous work checking SCR etc. to enable a referral t TY o be completed. Process has potential but needs to be simplified.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

They won't simplify it though because then, everyone will do their claims and it'll cost more. The whole thing, like EPS, is set up to be as awkward as possible without it being TOO obvious, so a significant number of claims slip through the net.

Watto 59, Community pharmacist

The PSNC were told months ago by plenty of contractors this would be the outcome but they chose to save face by continuing the pretence to have acheived something significant by polishing this turd.  It was obvious to anyone with a brain cell that it would soon prove to be an irrelevance.

Hannah Darling, Community pharmacist

Of the 3 referrals I have had in the past 6 months, none have been claimable. My Saturday locum has done a few emergency supplies via CPCS but I have had two children with suspected coronavirus referred to me (thanks so much). I'm not sure what the 111 call handlers expect community pharmacists to be able to do. I suspect they see us as an easy catch-all referral.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Probably catch-all in more ways than one given your coronakids referrals

Locum Pharmacist, Locum pharmacist

Utterly pathetic.What more can I say.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

No more needs to be said.

Chris Locum, Locum pharmacist

I thought I was missing the glorious imagined clinical future during my time. It seems not. The Government is offering hollow praise to our faces while spitting behind our financial backs.

With real-world service remuneration like this, the imaginary extra funding (offered as an advance) will have little chance of it being returned. Pharmacy teams are going to face challenging autumn and winter activity.

Tony Schofield, Community pharmacist

The service favours those working out of hours. Very little can be done during conventional hours. Money taken from contractors already under pressure and repaid in ways they cannot access. We need the acute care element in fast or this joke of a transition to "clinical services" will achieve the expected closures faster than attrition 

Freelance Chemist, Pre-reg Pharmacist

So you saying we should all be working 24/7 to make £48 per month lol

Freelance Chemist, Pre-reg Pharmacist

I wish you all the luck in the world with your "clinical services". If these figures isn't a wake up call, your all like sheep to the slaughter!!

O J, Community pharmacist

Emergency community pharmacy locum late in republic of Ireland €80/hour.

Freelance Chemist, Pre-reg Pharmacist

An here we are being asked to work for £15ph!!

Mr Anon, Community pharmacist

The service is not suitable for the current pharmacy business model. Our pharmacy has had maybe 3 referrals in the last 3 months, 2 of which we couldn't do because they were both for emergency supplies and weren't suitable to supply (NHS111 was referring patients to us for an emergency supply for medication which isn't on repeat and haven't had for more then 6 months). 

Also, the actual referral system seems flawed. In areas like cities where there are several pharmacies close by, there is bound to be some pharmacies that lose out possibly because of an inferior location compared to competitors (at least on paper anyway).

Instead of CPCS, how about a paid for delivery service? Then additions of more services to ease NHS burden. If the NHS was willing to pay for deliveries, it would then be easier to combat online pharmacies who provide no face to face services at all. There will never be a sustainable model where distant selling pharmacies and online pharmacies or hub and spoke do all dispensing and then brick and mortar pharmacies perform services exclusively. Unless the government literally wants a handful of pharmacies per city.

Pharmacy may as well just take over from NHS111. Pharmacy 111. We handle everything over the phone (minor ailments, advice etc) and refer to everyone else. We could be the new admin profession. I mean, we've been managing workloads and patient repeats for so long we're already trained surely ;)

 

 

Freelance Chemist, Pre-reg Pharmacist

What would be the benefit of pharmacy doing this.......They seem to be doing a good job with unqualified staff and getting away with paying them peanuts?

Leon The Apothecary, Student

I think a paid delivery service should be quintessential for pharmacy. However, I also think why would they fund it when online pharmacies have to do it for free?

Also, Amazon Pharmacy India just opened up recently.

Freelance Chemist, Pre-reg Pharmacist

Are you clueless? Why on Earth would the Gov pay for something if they no morons will do it for free???

Mr Anon, Community pharmacist

.

O J, Community pharmacist

What! £48 per month. I think that's absolutely disgrace. Wasting valuable tax payers money on Farmers.
This lot can do it for free.
I think DoH should cut this funding and spare it to the very hard working and respectful GPs.
:)

Freelance Chemist, Pre-reg Pharmacist

Haha OJ!!

The fees are a disgrace !!

O J, Community pharmacist

Pet biscuits cost more

Freelance Chemist, Pre-reg Pharmacist

I'm not surprised by that OJ! Animals get treated better than our "profession". 

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

So true - even pheasants being blasted out of the sky by chinless people who look like horses get a closed season.

Leon The Apothecary, Student

I feel this statement is lacking a few key caveats, that I would like to respectfully challenge.

1) Does this average include pharmacies with no engagement with CPCS at all, significantly lowing the average, and giving a misleading representation?

2) What was the distribution of CPCS claims? Are there some significant differences between cities, towns, and regions? Could this then be an indication of referrals not happening?

3) Are we also taking into account those that self-refer? Whilst not producing any income for a pharmacy, it may show a need for self-referrals to be included within the service?

4) What were the outcomes of the referrals? How many referrals were deemed unsuitable, and for what reason? Again, this would highlight weaknesses in the suitability and capability of the service, and ask questions like "Would having a Pharmacist Prescriber improve the service?"

Personally, I feel Ms Fiore has only superficially scratched the surface here, and I would be keen to see her investigate much deeper into CPCS.

Another Pharmacist, Community pharmacist

Another cost effective service! Potentially a whole heap of work for little reward.

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