The Community Pharmacist Consultation Service (CPCS) was launched with much fanfare in October 2019. NHS England and NHS Improvement (NHSE&I) deputy chief pharmaceutical officer Bruce Warner heralded the introduction of the service as a “major step change” for the NHS.
However, the CPCS made more of a timid shuffle into the world of pharmacy. Pharmacies were quick to sign up to the new service, with more than 10,000 doing so within three weeks of its launch. But contractors told C+D that within the first month of the rollout they had only received a handful of referrals.
Now, over 16 months into the service, it’s fair to say that the volume of CPCS referrals hasn’t massively improved. This month, the Company Chemists’ Association (CCA) revealed that big multiple branches receive, on average, fewer than three CPCS referrals per week. Other pharmacists have recently reported receiving as few as one referral per week.
The rollout of GP referrals under CPCS has been especially slow. Pharmaceutical Services Negotiating Committee director of NHS services, Alastair Buxton, attributed this to the pandemic, which he said is “distracting many general practices from considering the implementation of the pathway”. Would the introduction of “incentives” encourage more GP practices to formally refer patients to pharmacies under the CPCS, as suggested by PSNC?
Rolling out a new service during a pandemic can’t have been a walk in the park for NHS chiefs. But COVID-19 is here to stay to a greater or lesser degree over the coming years. The CPCS could be the key to pharmacy reducing pressures on other parts of the NHS struggling to cope with the impact of the virus.
60k claims over one year
My C+D investigation revealed that pharmacies claimed for just 60,316 CPCS referrals between December 1, 2019 – the first month they could claim – and November 30, 2020, according to the NHS Business Service Authority (NHS BSA). Contractors were paid just over £6 million for these consultations.
It’s worth noting that contractors have six months to submit their claims for a completed referral to the NHS BSA, meaning the actual number of CPCS consultations completed over the time period may be higher. But while 60,000 consultations will doubtless have helped patients, it equates to fewer than six consultations per pharmacy in England over one year.
Several pharmacists have flagged that they continue to receive “inappropriate” CPCS referrals. This means that pharmacists may end up dealing with patients in need of urgent care. Some pharmacists raised concerns over the training that NHS 111 call handlers receive to be able to refer patients to the most appropriate healthcare professionals.
An NHS spokesperson told me that “health advisors don’t independently make the decision to refer a patient to a pharmacist”. Are we therefore supposed to deduce that it is NHS Pathways – NHS 111’s tool for triaging patients – that needs a revision?
Pharmacists can’t afford to waste time dealing with inappropriate referrals. One contractor said it takes their pharmacists 20 minutes on average to complete a CPCS referral, for which they believe the £14 fee “does not represent a professional payment for our pharmacists’ professional time”.
It might be too soon to establish whether CPCS will pay dividends in the future. However, the testimonies shared by pharmacists show that there’s a long way to go before the service can fulfil its potential of becoming a vital piece of the NHS puzzle.
Valeria Fiore is C+D deputy news editor
Every day this week – March 15-19 – C+D has been 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.