‘Three clicks more than we want ’: GPs refuse to make Pharmacy First referrals

One pharmacy missed out on 10 consultation referrals in one day after GPs failed to formally refer patients to the Pharmacy First service, C+D has learned.  

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“If they're not formally referred and [don't] fall under a clinical pathway…you're not getting paid for that time”

GPs informally suggesting patients use Pharmacy First rather than booking them an appointment using the referral system is costing pharmacies vital consultation fees, contractors told C+D yesterday (March 21).

When a GP makes a referral, “regardless of whether the patient falls into one of the clinical pathways” pharmacies will “get paid for seeing the patient”, Imaan Healthcare operations director Saghir Ahmed told C+D. 

But “if they're not formally referred and the patient doesn't fall under a clinical pathway…you're not getting paid for that time,” he said. 

Read more: ‘A lot of failures’: Less than 40% of Pharmacy First consultations secure fee

“That means less work being spent on something else [and] it all has a knock-on effect”, he added.

Community Pharmacy Sandwell and Walsall services lead Sukhy Somal also told C+D that she knew of one pharmacy that has received 10 informal Pharmacy First referrals from GPs “in one day”.

“The pharmacists had to start saying ‘I'm really sorry, but you've got to go to the surgery and get them to send a referral so I can book you an appointment,’” she said.

Read more: Most common Pharmacy First conditions revealed

Somal said that she’s had to train GPs on “how to do [Pharmacy First] referrals”.

She added that “once they see how easy it is”, they say “is that all - we know how to do that” and that they “didn't realise it was that easy”.

But one anonymous contractor told C+D that GPs had told them that the three clicks needed to make an online Pharmacy First referral were “three clicks more than [they] want to do”.

Read more: UPDATED: Pharmacy First fee claim deadline delayed again over IT issues

Somal added that pharmacists in her area have said that few walk-in consultations meet the gateway criteria to secure a fee.

Pharmacy manager of Touchwood Pharmacy in Walsall Gary Mason reported that only around four in 10 “walk-in referrals pass the gateway point”, she said.

GPs “already refer patients” to pharmacies

Meanwhile, pharmacy minister Andrea Leadsom said in parliament this week (March 20) that NHS England (NHSE) “has further engaged with GP representatives during the development and launch of Pharmacy First”.

The comment came in response to a question from Labour MP for York Central Rachael Maskell who asked what steps she was “taking to help ensure GPs are trained to engage with Pharmacy First”.

Read more: Pharmacy First threatens independents with ‘financial deficit’, warns NPA chief

Dame Andrea said that “GPs and their teams already refer patients to community pharmacies for a wide range of services”.

Pharmacy First is “built on the existing community pharmacist consultation service (CPCS),” she added.

Pharmacy First chaos

It comes as the National Pharmacy Association (NPA) warned earlier this month that issues with Pharmacy First tech could leave contractors “out of pocket” by “thousands of pounds”.

And NPA chief Paul Rees said that the new service threatens independents with a “financial deficit”.

Read more: Contractors ‘still getting nowhere’ a week on from Pharmacy First IT crash

Pharmacies have also reported experiencing long Pharmacy First consultations, most of which do not reach the gateway criteria for payment and disgruntled patients “yelling and throwing items” at pharmacists due to unclear messaging over the service.

New data has shown this week that a sore throat was the most common reason to offer a Pharmacy First consultation in the first month of the new service

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Kate Bowie

Read more by Kate Bowie

Kate Bowie joined C+D as a digital reporter in August 2023 after graduating from a master’s in journalism at City, University of London. She began covering the primary care beat at the end of 2022, when she carried out several health investigations focused on staffing issues, NHS funding and health inequalities.

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