This call is backed by health secretary Sajid Javid, who wrote in the Daily Mail today (October 14) that he wants every practice to use the CPCS, “so our brilliant community pharmacists can do more in terms of prescribing”.
Mr Javid also revealed that he wants the NHS and the Department of Health and Social Care (DH) to work together on a ‘Pharmacy First’ scheme for England, building on the existing pilot schemes and the equivalent service in Scotland.
The push for more GP practices to sign up to the CPCS is one of the measures set out in the NHS England and NHS Improvement (NHSE&I) and DH blueprint for improving access to GP appointments, which was also published today.
As part of it, the national commissioner made a £250 million winter access fund available to improve access to “urgent, same day primary care” and increase the NHS’s resilience during the winter months.
Local systems will be able to “determine the optimal use of the funding” based on their needs, and the funding is “not designed as a ‘pass-through’ payment to individual practices”, NHSE&I specified.
Make use of pharmacies through CPCS
The blueprint document acknowledges the role community pharmacy can play in alleviating pressures on GPs, specifically through the CPCS – which sees pharmacists offer advice and treatment on minor illnesses.
However, only 800 GP practices have already signed up to refer patients to pharmacies via the service, according to the document. This is despite the GP pathway of the CPCS being enabled from November 1 last year.
“NHSE&I is providing support through a nationally procured resource that will help practices use the new service. All practices are encouraged to sign up by December 1, 2021,” NHSE&I wrote.
Local systems are expected to support all GP practices to “sign up and make full use of general practice referrals” to pharmacies, “to divert demand and improve patient experience”.
Practices will only be able to access a share of the winter fund if they sign-up to the GP CPCS, the national commissioner specified.
Incentives to boost CPCS referrals
Implementation of the GP CPCS pathway has been notoriously slow, with pharmacists reporting a low rate of GP referrals this year and the Pharmaceutical Services Negotiating Committee (PSNC) calling for incentives to be introduced in the GP contract to encourage practices’ engagement with the service.
NHSE&I said in its document published today that the primary care network (PCN) Investment and Impact Fund offers an incentive to PCNs to “develop plans to implement CPCS or increase their current referral rate”.
The commissioner also revealed that it will work with the DH to consider how to further expand the role of pharmacists in the supply of medication, having referred to its ongoing pilot on the supply of contraception from pharmacies.
Commenting on the support package, PSNC director of NHS services Alastair Buxton said clinical commissioning groups and integrated care systems should use the winter access fund “to commission additional local services from community pharmacy, including services to augment the CPCS, such as patient group directions (PGDs)”.
“[These] are already being used successfully in several areas of the country to increase access to treatment, without the need to refer patients back to their GP,” Mr Buxton added.
“Pharmacy First” for England?
PSNC welcomed Mr Javid’s intentions to explore a bigger role for community pharmacy via the introduction of a “Pharmacy First” service. It added that it will discuss details with the DH and use this opportunity to “expand pharmacies’ role and to press for adequate funding for the walk-in advice that pharmacies are offering on a daily basis”.
Under the Scottish Pharmacy First service, which launched on July 29 last year, pharmacists can offer free advice, treatment or supply of medicines for certain conditions – supported by national PGDs.
Royal Pharmaceutical Society chair of the English pharmacy board Thorrun Govind said the organisation expects the NHS and the DH to work with professional bodies and others to understand how the CPCS service can be expanded to “include services such as supplying medicines without the need to visit a GP”.
“Community pharmacy will be central to supporting the NHS recovery, including through increasing use of pharmacist independent prescribers and commissioning innovative services to enhance patient care, safety and better manage demand across the NHS.
“Funding for implementation, education and training will be key to making this a success and I look forward to working with the government and the NHS to make this happen,” Ms Govind added.
