A pilot for GP referral into the community pharmacy consultation service (CPCS) has helped to free up appointments and reduce demand, enabling GPs to focus on more complex cases.
Practices in Bristol, North Somerset and South Gloucestershire started making GP referrals into the service, which refers patients requiring advice for minor illnesses to a local pharmacist, in July last year.
Debra Spencer, practice manager at Birchwood Medical Practice, one of the participating practices in Bristol, said: ‘The pilot is working really well for us and means a great deal to our surgery team, freeing up appointments to enable our GPs to focus on more complex cases.
‘It’s also great that the patient has had the education from the right healthcare professional at the right time and that self-care and their local pharmacist is where they look first, before coming to their general practice.’
The CPCS was launched in October 2019 and currently allows NHS 111 to refer patients for a consultation with a pharmacist, but is due to be extended to include referrals from GPs this autumn.
Care navigation training
The pilot involved 35 GP practices and 104 pharmacies in Bristol, North Somerset and South Gloucestershire (BNSSG). All practices involved used the same EMIS clinical and referrals system.
During the pilot, practice reception teams – who had received care navigation training -offered patients requesting a GP appointment for minor illnesses the alternative option of a consultation with a local community pharmacist.
Where patients agreed, receptionists would send secure personal data, including a short description of the condition, to a local pharmacy of their choice.
Pharmacists would then carry out a clinical consultation on the patient’s arrival at their pharmacy, which includes viewing their summary care records, to identify any red flags.
Key findings
To date, over 4,000 consultations have been completed under the pilot scheme, with 71% of patients receiving advice from a local pharmacist and an over the counter product to manage their concern, according to NHS England and Improvement (NHS&I).
In 12% of cases, the pharmacist identified that the patient required an urgent GP appointment, which they were able to help arrange, while 17% of patients were signposted to another health care professional, or back to the GP for a non-urgent appointment. In these cases, community pharmacists would alert the GP practice of their subsequent referral.
The pilot is now being extended to include a further 10 practices in the area, NHSE&I said.
Improving access to care
The CPCS aims to ‘improve access to primary care’ for patients with certain minor conditions, by ensuring they get access to the same levels of care, close to home and on the same day.
Practices in the pilot also improved access to GPs for patients ‘who really need a GP consultation’, through freeing up capacity, NHSE&I said.
‘Patient feedback for those who have had a consultation with a pharmacist has been very positive,’ it added.
Freeing up capacity
Dr James Case, GP at Concord Medical Centre in Bristol, said: ‘We see constant requests throughout the week from patients wanting to see their GP, many with minor illnesses, which are more suitably addressed by a community pharmacist. We estimated between 5-10% of those patients would be better signposted to a community pharmacy for help instead.
‘With training, our reception team was able to pick up on the sorts of illnesses that can more suitably dealt with by a community pharmacist. We have a good process in place for referring patients to see the pharmacist and 70-80% of the issues are resolved by them.’
He added: ‘The CPCS has a real opportunity to help GP practices reduce our daily demand and manage our more complex patients, which is very valuable for us.’
Tom Gregory, a clinical pharmacist at 168 Medical Group Practice, said: ‘It’s been beneficial to have a formal referral route to community pharmacists and it’s really helped the work I’ve been doing within the practice to promote self-care.
‘I hope that patients will consider visiting a pharmacy first in future – many patients don’t realise the range of conditions that pharmacies can manage, whether they need just need advice, or an over-the-counter medicine.’
