Community Pharmacist Consultation Service
Community Pharmacist Consultation Service
The NHS Community Pharmacist Consultation Service (CPCS) launched on 29th October 2019 as an Advanced Service.
The CPCS takes referrals to community pharmacy from NHS 111 (and NHS 111 online for requests for urgent supply), but there are plans for referrals to be taken from other parts of the NHS in time. The CPCS aims to 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 within the urgent care system.
COVID-19 update: patients being referred to the CPCS are now being told to phone the pharmacy and to speak to the pharmacist. Unless there is a clinical need for the patient to be seen in the pharmacy, the pharmacist can provide a consultation by telephone, as is provided for in the service specification. If the consultation is conducted in this manner, the pharmacy is eligible to claim the fee for provision of the service.
Click on a heading below for more information.
Changes to the CPCS - GP referrals
At its September 2020 meeting, PSNC agreed proposals that general practice referrals into the CPCS should commence this autumn.
This decision follows recent negotiations with NHS England and NHS Improvement (NHSE&I), who have been running a pilot of the service as part of the Pharmacy Integration Programme.
Work is now underway to plan the roll out of the service, which will engage general practices across England, supporting them to make referrals of patients to community pharmacists for minor illness consultations.
Commenting on the announcement, made at the 2020 Local Pharmaceutical Committee Conference, Simon Dukes, PSNC CEO said:
“The commencement of this additional referral route into the CPCS will represent a significant milestone in the implementation of the service developments agreed in the 5-Year Community Pharmacy Contractual Framework.
“The success of this addition to the service will be built on the development of strong relationships between community pharmacy and GP colleagues, but this will also build the platform for longer-term relationships between the two professions and that has to be a good thing.”
Further information on the rollout plans will be published in due course.
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:
Amendments to the Secretary of State Directions provide the legal basis for commissioning the service.
Toolkit for pharmacy teams
The NHSE&I toolkit to support pharmacy teams to provide the service can be downloaded via the following link:
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.
Registering to provide the service
Pharmacy contractors can register to provide the service via the NHSBSA Manage Your Service (MYS) portal.
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.
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.
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.
Service funding and payment claims
Funding for the CPCS included an initial supplement to the Transition payment for contractors that registered to provide the service before the below deadlines:
- Registered by 1st December 2019 – £900 supplement
- Registered by 15th January 2020 – £600 supplement.
The supplement to the Transition payment will be paid, following registration for the service, as follows:
- For registrations (£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 registrations (£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|
Claiming payment for the service
All payments must be claimed via the NHSBSA Manage Your Service (MYS) portal; no paper-based claims process is available for the service. The CPCS IT system (Sonar or PharmOutcomes) will be able to pre-populate claim information in MYS each month, so that the contractor then just needs to login to MYS at the start of the following month to confirm that the information is correct and to submit the claim.
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.
The CPCS IT system
NHSE&I have used 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.
Two pharmacy IT systems have the capability to receive ITK messages and they have been contracted to provide the IT support for the service in 2019/20:
During 2019/20 and 2020/21, contractors providing the service must use the above CPCS IT systems made available to them by NHSE&I.
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.
Continuing professional development (CPD) for pharmacists, coordinated by Health Education England and funded by NHSE&I, is now available to community pharmacists to help further embed community pharmacy in urgent care pathways and help improve the care of patients presenting with minor illness.
The programme of workshops is being delivered to support community pharmacists in effective patient-facing consultations and clinical assessments for a range of common minor illnesses.
The CPD is being delivered in partnership with the Royal Pharmaceutical Society (RPS), Royal College of General Practitioners and the Centre for Pharmacy Postgraduate Education (CPPE).
The workshops build on those provided since October 2019 by CPPE to help pharmacists manage patients referred from general practices and NHS 111 to the CPCS; so far more than 2,100 community pharmacists have undertaken the CPCS CPD provided by CPPE.
Pharmacists will have the opportunity to refresh and update their practical clinical assessment and examination skills, including how to carry out an effective remote consultation and communicate more effectively with GPs. They will also learn new ways of working as part of the primary care network multidisciplinary team, and learn how the CPCS sits alongside urgent care, general practice and the wider NHS healthcare system.
The training will be delivered via a combination of online pre-learning and interactive online workshops. It will be facilitated by experienced individuals, including GPs and advanced practitioner trainers.
Further information about the workshops is available on the RPS website.
CPCS webinar and NHS 111 animation
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.
NHSE&I’s national Directory of Services team have created the following short animation on the CPCS. It has been developed as part of the training for NHS 111 call advisers, but it is also an excellent way to introduce pharmacy team members to the service.
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)
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.