Community Pharmacist Consultation Service
Community Pharmacist Consultation Service
The NHS Community Pharmacist Consultation Service (CPCS) will launch on 29th October 2019 as an Advanced Service.
The CPCS will take referrals to community pharmacy from NHS 111 initially, with a rise in scale with referrals from other parts of the NHS to follow. The CPCS will relieve pressure on the wider NHS by connecting patients with community pharmacy, which should be their first port of call and can deliver a swift, convenient and effective service to meet their needs.
The CPCS provides the opportunity for community pharmacy to play a bigger role than ever this winter as an integral part of the NHS urgent care system. This will continue to be supported by the NHS Help Us Help You Pharmacy Advice campaign.
Click on a heading below for more information.
The service specification and Directions
CPCS service specification
Prior to this final version of the service specification being published, a draft version was published on the NHSBSA website. A small number of changes were made to the text during the NHSE&I internal governance process. The only substantive change from a community pharmacy perspective was for references to annual reviews of Standard Operating Procedures and Business Continuity Plans to be amended to regular reviews.
The service specification contains three forms within its annexes; standalone versions of these forms can be downloaded via the links below:
The Department of Health and Social Care (DHCS) has drafted amendments to the Secretary of State Directions which will provide the legal basis for commissioning the service; these will be published in the Drug Tariff in due course.
Toolkit for pharmacy teams
A draft version of the NHSE&I toolkit to support pharmacy teams to provide the service has been published on the NHSBSA website; the final version will be published by NHSE&I once it has completed its journey through their internal governance process.
The toolkit (and a template SOP – see below) have been written by members of the Urgent Care Delivery and Implementation Group, which was set up by PSNC and NHSE&I to support rollout of the service. The group includes representatives from the NHS, DHSC, pharmacy contractors and the National Pharmacy Association.
The toolkit contains patient flow diagrams for the two aspects of the service; standalone versions of these diagrams are available via the link below.
Template Standard Operating Procedure
Pharmacy contractors providing the CPCS must have a Standard Operating Procedure (SOP) in place for the service. A template SOP has been written by members of the Urgent Care Delivery and Implementation Group. Contractors can amend and adopt this SOP for use in their pharmacy if they wish.
The launch date for the NHS Community Pharmacist Consultation Service (CPCS) has been set as 29th October 2019.
CPCS replaces the NHS Urgent Medicines Supply Advanced Service (NUMSAS) and the Digital Minor Illness Referral Service pilots. These services will continue to be commissioned until 28th October 2019, with the DoS entries for them being deleted thereafter. If a pharmacy registers to provide CPCS, new DoS entries for the service will be created which will become active on 29th October 2019, at the point the service goes live. All these changes to DoS will be managed by the DoS team and there is no need for pharmacy contractors to take any action in relation to this.
Registering to provide the service
Pharmacy contractors can now register to provide the service via the NHSBSA Manage Your Service (MYS) portal. This includes claiming the Transition payment supplement, which will be £900 for those who register by 1st December 2019.
Pharmacy contractors that have not previously registered for access to MYS should follow PSNC’s guidance on registering.
Before registering to provide the CPCS, pharmacy contractors should read the service specification to ensure they will be able to meet all the service requirements from 29th October 2019.
When registering to provide the service on the MYS portal, contractors will need to make the following declaration:
- I am registering to provide the Community Pharmacist Consultation Service from this pharmacy.
- I confirm that I have read the service specification and will be able to comply with its requirements and deal appropriately with any CPCS referrals from the service commencement date (29th October 2019).
- I am claiming the CPCS Transition payment and understand that I am committing to provide the CPCS until 31st March 2020, unless exceptional circumstances prevent the pharmacy from providing the service. Where I withdraw from service provision prior to 31st March 2020 and NHS England do not believe exceptional circumstances apply, they may reclaim all or part of the CPCS Transition payment.
Multiple pharmacy contractors that would like to register more than one pharmacy to provide the service can email the NHSBSA MYS team (email@example.com) to discuss how to bulk register pharmacies
Funding for the CPCS will include an initial supplement to the Transition payment for contractors that register to provide the service before the below deadlines:
- Register by 1st December 2019 – £900 supplement
- Register by 15th January 2020 – £600 supplement.
No supplement will be paid for registrations after 15th January 2020.
The supplement to the Transition payment will be paid, following a claim by the contractor, as follows:
- For claims (£900) up to and including 31st October, these will be paid in the December Schedule of Payments (Payment date 31st December, in relation to October prescription claims);
- For claims (£900) from 1st November up to and including the end of the day on Sunday 1st December, these will be paid in the January Schedule of Payments (Payment date 31st January, in relation to November prescription claims); and
- For claims (£600) from 2nd December up to and including the end of the day on Wednesday 15th January, these will be paid in the February Schedule of Payments (Payment date 28th February, in relation to December prescription claims).
When a pharmacy provides the service, they can claim a £14 fee per completed consultation.
This payment model will be reviewed for 2021/22 onwards, depending on factors such as volume of service.
The anticipated funding profile for the initial (NHS 111 referral) service is:
|£4 million||£9 million||£13 million||£16 million||£19 million|
IT requirements and support
The service specification requires that from 1st April 2020, the pharmacy must have IT equipment accessible within the consultation room to allow contemporaneous records of the CPCS consultations to be made within the CPCS IT system (see below). As with the provision of all community pharmacy IT hardware, the provision of IT equipment in the consultation room is for the pharmacy contractor to arrange. The costs of IT equipment were included in PSNC’s assessment of costs of providing the service which has informed the agreement on the funding for the CPCS, which includes a £900 supplement to the Transition payment if contractors register to provide the service by 1st December 2019.
NHSE&I intend to use the Pharmacy Integration Fund (PhIF) to procure IT functionality (“the CPCS IT system” referenced in the service specification) to support the service in 2019/20 and 2020/21. This system will receive the ITK (Interoperability Toolkit) referral messages from NHS 111, allow the maintenance of clinical records of service provision, send post-event messages to patients’ GP practices, support payment claims to be made to the NHSBSA and provide data to support service management and evaluation. Currently only two pharmacy IT systems have the capability to receive ITK messages (Sonar Informatics and PharmOutcomes).
During 2019/20 and 2020/21, contractors providing the service must use the CPCS IT system made available to them by NHSE&I. Work is ongoing to procure IT systems to meet this requirement ahead of the service commencement date and NHSE&I will provide further information when it is available.
The decision that NHSE&I would lead on commissioning this IT support, as opposed to the normal situation of contractors purchasing the IT support themselves, was driven by the relatively short time in which to get the service implemented ahead of the winter period of peak activity for primary and urgent care services and the need for data to be available to the NHS from all pharmacies providing the service to support implementation of the service and its evaluation.
From April 2021, contractors providing the CPCS will need to procure their own CPCS IT system. By that time, we hope that other pharmacy IT suppliers, including PMR system vendors, will have been able to develop support for the CPCS, so that community pharmacy contractors have a choice of potential IT solutions to support the provision of the service. The future cost of providing the service, including IT system costs, will be something that PSNC will discuss with NHSE&I in the annual reviews of the CPCF, which have been agreed as part of the 5-year settlement.
Learning and development resources
The Centre for Pharmacy Postgraduate Education (CPPE) has a range of training resources which can be used by pharmacists to prepare to provide the CPCS, including a self-assessment framework which helps you to identify gaps in your knowledge. It is recommended that pharmacists use this framework to plan their learning ahead of providing the service.
Further information is available on the CPPE website.
As announced in the 5-year CPCF agreement, NHSE&I and Health Education England (HEE) will work to deploy PhIF funding in support of the CPCS, offering opportunities for continuing development of pharmacists’ skills. These will be made available in parallel with the service rollout. HEE are planning this with stakeholders, building on the CPD already delivered in some of the DMIRS pilot areas.
The new CPD offer will aim to enhance the efficiency of pharmacists to undertake effective consultations, communications and clinical assessments. With a particular focus on identifying red flags, referring appropriately to the wider NHS network, if needed and effective patient follow-up, the CPD will ensure patient care continues to be as safe as possible.
In mid-September, PSNC and NHSE&I held a joint webinar for pharmacy teams and others interested in learning more about the service and how to implement it; nearly 500 people tuned in on the night and 98% of people responding to the feedback survey found it useful.
If you missed the webinar, you can watch the on-demand version.
Resources for LPCs
LPCs have a very important role to play in supporting the implementation of CPCS in their area. A list of potential roles that LPCs could take to support implementation has been developed by PSNC, with input from members of the Urgent Care Delivery and Implementation Group.
Organising a contractor event on the CPCS
Many LPCs are planning to organise local events focused on the CPCS for pharmacy contractors and their teams. The following template presentation can be modified as appropriate and used in such events.
PSNC template presentation on the CPCS (PowerPoint) (last updated 18/9/19)
Further resources to support LPCs will be published here as they are developed by PSNC.
Information for patients
The service specification requires that the CPCS is not actively promoted to patients by contractors or the NHS. However, the use of community pharmacy as the first port of call for advice on the management of minor illness will continue to be promoted by the NHS Help Us Help You Pharmacy Advice campaign.
During consultations for minor illness, pharmacists may provide the patient with printed information about their condition or recommended treatment or direct them to a website containing this information. The NHS website (NHS.UK) provides high quality information on a wide range of conditions and commonly used medicines:
Frequently Asked Questions (FAQs)
FAQs are answered on the CPCS FAQ page of the website.
Further development of the service
Development of the CPCS will take place over the five-year period of the revised CPCF.
The piloting of DMIRS and NUMSAS through the Pharmacy Integration Fund (PhIF) has enabled NHSE&I to introduce a well tried, tested, safe and sustainable service into the CPCF. It has also enabled the demonstration of the value that community pharmacy can add. They want to build on this model to ensure that any further services are fully evaluated before their introduction at a national scale.
In 2019/20 the CPCS will take referrals from NHS 111, but over the course of the five years of the CPCF agreement, this is expected to expand to include referrals from GP practices, NHS 111 online, urgent treatment centres and possibly A&E. Each phase will be piloted first using funding from the PhIF, with roll out subject to successful evaluation. The potential volume of referrals is not certain at this stage, but the GP Forward View suggested that around 20 million appointments in general practice alone do not require a GP.