By Debra Spencer. GP Business Partner, Birchwood Medical Practice.
Connexus PCN serves around 50,000 patients and was one of the pilot sites for the GP referrals into the Community Pharmacist Consultation Service (CPCS).
One thing that really made the pilot work was the great attitude and relationship between the GPs and the pharmacists. The service has given our GPs time to focus on more complex cases that have more in-depth complications. Most people that we refer to the pharmacy, around 85%, are dealt with by the pharmacist, either with advice, guidance and an over-the-counter medicine in the pharmacy or by onward referral to another provider. There is a dedicated professional line in the practice that pharmacists can use if the person needs to be seen by the GP that day. But pharmacists don’t usually refer back to the GP. For example, we had one person who had an injury that the pharmacist correctly referred on to A&E. This saved time, improved access for the patient as they were seen a lot quicker than if they had waited for a GP appointment and then been told to go to A&E.
This service helps to improve access to primary care by using the pharmacy network. GPs and receptionists in our practice recognise pharmacists as highly skilled clinicians and the confidence they have in the pharmacy profession is reflected by the way they speak to patients, promoting the role of pharmacists. We have a skilled reception team and they feel empowered to support the patient by being able to offer this service. The introduction message on our practice telephone notifies patients that they could be referred to a community pharmacist or another clinician who is not a GP, so the expectations are set early on.
We have also included the provision of some medicines via a Patient Group Direction (PGD) for conditions such as UTIs and impetigo, as part of this service. This is funded via local funding and might be something other PCNs want to explore with their LPC as it further increases capacity in GP practices.
The referral process itself is no more difficult than booking an appointment. The receptionist enters data around symptoms, duration of symptoms and other information onto a referral form in exactly the same way they would as if they were booking a GP appointment. So, the number of clicks needed to refer the person to the pharmacist is the same as if the receptionist were booking an appointment with the GP. Receptionists have said that the fact they can get the patient an appointment on same day outweighs any issues electronically. And the overall outcome is that GP time has been saved.
There is also a fear factor that people who don’t normally pay for prescriptions will be unwilling to pay for a medicine supplied by the pharmacy, or they simply cannot afford to. Connexus PCN sits within one of the most deprived areas in Bristol and getting people easy access to medication is a key issue. We need to continue to tackle health inequalities within these communities by encouraging greater collaboration across multidisciplinary teams within Primary Care Networks, helping to provide more accessible healthcare for all.
Working together is crucial. As we’ve seen during COVID-19, ensuring that pharmacists can support GPs is effective in dealing with the increased pressures posed by the pandemic. CPCS will further help community pharmacists to develop new skills that will enable them to work closer with GPs and other health professionals in delivering urgent care within general practice.
For more information on the NHS CPCS, visit the RPS and NHS England websites.