NHS Somerset is aiming to grow its referral rate through GP Community Pharmacist Consultation Service (GP CPCS) to between 4,000 to 6,000 patients a month.
Since June 2021 GPs in Somerset have successfully referred around 1,000 patients a month through the Somerset GP Community Pharmacist Consultation Service (GP CPCS)
Currently, 59 of NHS Somerset's 64 GP practices and all of Somerset's 102 community pharmacists are using the Somerset GP CPCS.
NHS Somerset found that providing the right training for GPs and for reception staff and practice managers was key to a smooth rollout and uptake of the service.
As was making sure the technology worked when making referrals from general practice to community pharmacists.
NHS Somerset is using software called Patient Access Connect, which seamlessly integrates with the EMIS Web GP system used in Somerset, to give practices a quick
and easy way to capture the patient information needed to deliver a referral.
The National Health Service said that over 425,000 patients have utilised its new national online service to complete GP registration within its inaugural year.
The GP surgery registration service, managed by NHS England, has granted NHS patients efficient and user-friendly access to GP registration since its inception in
August 2022.
According to the NHS, more than 1,400 GP surgeries, a fifth of the national count, have joined the NHS online registration service as part of a new plan to improve
access to primary care. "This aligns with a new strategy to enhance primary care access, with a target of enrolling 2,000 practices in the Register with a GP
surgery service by December 2023."
Many GP surgeries still use paper forms, requiring patients to visit surgeries to collect paperwork. However, the new online service has been shown to save GP
surgery staff up to 15 minutes per registration by helping to reduce paperwork and admin time, the NHS said.
The NHS said that this service enables patients to register with a local GP online at any time, eliminating the need for in-person visits and simplifying the
process for both patients and GP surgeries.
General practitioners (GPs) across England have made a resolute stand against proposed alterations in the 2024/25 national GP General Medical Services (GMS)
contract put forth by the Department of Health and Social Care (DHSC) and NHS England.
This firm opposition coincides with the declaration of an extended six-month strike by 33,869 junior doctors within the NHS, advocating for full pay reinstatement
and reforms in the pay recommendation process.
The latest survey conducted by the British Medical Association (BMA) has revealed that an overwhelming 99.2% of GPs in England are against any changes to the
existing contract.
The proposed amendments, slated for implementation from April 1st, 2024, encompass a meagre national practice contract baseline funding uplift of just 1.9%,
notably falling short of recent inflation rates.
This corroborates with GP Online poll that recently unveiled widespread GP dissatisfaction with proposed changes to the national GMS contract. 83% of GPs in
favour of strikes cite pay and funding concerns, while burnout, high workloads, and patient safety also fuel discontent.
The GP Community Pharmacist Consultation Service (GP CPCS) is also delivering 'unexpected' insights to help transform patient care and facilitate integrated
working between pharmacists and GPs across Greater Manchester.
Since April 2021, almost 14,000 appointments have been referred using the GP CPCS across the Greater Manchester Health and Social Care Partnership - a figure that
is growing as its success gathers pace and they continue to support practices to increase referral activity.
Joshua Nolan, a pharmacist at Internet Pharmacy in Heywood, one of the first in the area to join the referral service, said: "The number of patients we're seeing
from GP CPCS has been building consistently month-on-month. On average we see around 50 patients, but recently we recorded 53 in just one week."
The pharmacist, who has been practising for six years and is also an independent prescriber, believes the GP CPCS has helped bring about more awareness to the
clinical services community pharmacy can offer.
People in the UK are increasingly relying on community pharmacies for health advice and support as they are unable to access their general practitioner (GP).
According to a recent report by the Liberal Democrats, there was a significant increase in the number of patients waiting four weeks or more to see a GP in
England last year, rising from 12.8 million in 2022 to 17.6 million.
Responding to this research report, the Royal College of General Practitioners (RCGP) highlighted that GPs are also struggling to meet the increasing demand for
their services due to severe staff shortages.
Dr. Victoria Tzortziou-Brown, Vice Chair of the RCGP, stated that the average number of patients each GP is responsible for has increased by 158 compared to five
years ago.
Although she acknowledged that many patients are forced to wait for weeks to see their GP, she said that doctors too are grappling with "unmanageable and
unsustainable workloads" and "we can't keep doing more with less."
To maximise the benefits of the Pharmacy First service for patients, the NHS, and community pharmacies, Community Pharmacy England (CPE) has advised the
community pharmacists to to establish a robust relationship between community pharmacies and local general practices.
The news comes after several reports highlighted issues regarding GP referrals for the seven minor ailment conditions under the Pharmacy First services.
According to the reports, many pharmacists claimed that "many GPs in England are not sending patients to them to be treated - and that some are refusing to
participate at all in the "groundbreaking" Pharmacy First scheme".
In response to foster better relationship with the GPs, CPE has said that strong local collaborations will enable general practice teams to confidently refer
patients to the Pharmacy First and other community pharmacy services where appropriate.
Moreover, the organisation emphasised implementation of long-term changes in practice will take time. The current focus on integrating GP referrals to Pharmacy
First will likely require sustained effort over several months or longer.
At their recent online briefing, DAUK's GP committee outlined a comprehensive 10-point plan designed to relieve pressure on GPs, improve access, reduce
mortality rates, lower hospital admissions, and enhance patient satisfaction.
DAUK's manifesto advocates reallocating resources, including the Additional Roles Reimbursement Scheme (ARRS), currently directed towards Pharmacy First and
acute care hub pilots, amounting to £2 billion.
This strategic reallocation aims to enhance primary care capacity and reduce reliance on acute services.
Dr Lizzie Toberty, DAUK's GP lead, emphasised the critical need for patients to have timely access to GPs who understand their needs, stating, "We need patients
to be able to see a GP who knows them and understands their needs in a timely way wherever possible."
She highlighted DAUK's vision to restore general practice as the cornerstone of the NHS through practical, achievable solutions.
NHS England delivered 358 million general practice (GP) appointments, including Covid-19 vaccinations, in the 12 months to October 2023, an increase
of 50.9 million compared to October 2019.
This equals to 44 more appointments per practice per working day, with over 70 per cent of these taking place within two weeks of booking, data published by
NHSE on Thursday (30 November) showed.
Health Minister, Andrea Leadsom, thanked GPs and primary care teams across the country for making it possible to deliver around 32,500 more appointments
every day, which clearly demonstrate that "more people are getting the care they need, when they need it."
"While this is positive news, we know that there is more to do to make it easier and quicker for patients to contact their general practice and continue to
focus on delivering the Primary Care Recovery Plan," she added.
The Primary Care Recovery Plan published earlier this year is focused on improving access to primary care. It provided GPs in England with £240 million to
support them to embrace the latest technology to tackle the 8am rush, and handle more appointments.
As of August 2023, more than 1,000 general practices had signed up to digital upgrades to make booking GP appointments easier.
Ensuring comprehensive healthcare services for the community necessitates collaboration between pharmacies and GP surgeries. However, several pharmacists
have voiced concerns about a lack of cooperation from their local GPs in implementing the Pharmacy First (PF) service.
In a survey conducted by the National Pharmacy Association (NPA) covering 470 pharmacies across England, three-quarters of pharmacists (77 per cent) indicated
that local GP practices are not appropriately referring patients to the new service.
The survey highlighted instances of patients either not being referred or being referred but found ineligible for support through Pharmacy First. Additionally,
one in five NPA members (19 per cent) felt that their local GP practices were not engaging with the initiative at all.
Commenting on the issue, NPA chair Nick Kaye said: "Feedback from across our network suggests that the rollout of Pharmacy First varies considerably from area
to area.
Thanks to the NHS primary care access recovery plan, more than 23 million people can now view test results and check their consultation notes online without
needing to contact their GP practice.
NHS England on Monday (4 December) announced that over 81 GP practices in England (more than four in five) are now giving patients access to their new health
records online through the NHS App.
In May, the NHS announced the primary care access recovery plan setting a target of 9 in 10 GP practices offering patients access to their records through the
NHS App by March 2024.
By making access to healthcare easier and quicker, the NHSE also aims to free up to 10 million GP appointments a year by next winter.
The Company Chemists' Association (CCA)'s analysis on permanent closures of community pharmacies in England showed that there has been a net loss of 670
pharmacies between 2015 and 2022.
The analysis highlighted that 37 per cent of permanent closures of pharmacies and GP practices have occurred in the 20 per cent most deprived parts of England.
Current trends indicate that primary care 'cold spots' could soon emerge - areas where there is significantly reduced or inadequate access to a pharmacy or a GP.
The CCA's analysis shows that some of the most deprived neighbourhoods concentrated in the North West, the West Midlands and Yorkshire have faced the highest losses
of local pharmacies and GP practices since 2015.
It demonstrates that the trend of permanent closures amongst pharmacies and GP practices is worsening. Moreover, this burden is likely to be felt unevenly with
permanent closures occurring disproportionately in areas of high deprivation. Without action, deprived communities, where need is typically greater, may no longer
be able to access the GP and pharmacy services they require.
New data published by NHS England on Thursday (4 January) showed that more than 31.4 million GP appointments (excluding vaccinations) were delivered
in November 2023.
This is four million more than the number recorded in the same month before the pandemic, and is considered the busiest November on record for GP teams.
Compared to the previous month (October 2023), 3.3 per cent more appointments were booked and attended on the same day in November.
Almost seven in ten patients attended their appointments within seven days of booking, an increase of 4.5 per cent from the previous month.
With the Pharmacy First services scheduled for launch end of this month, legislators explored the potential of community pharmacies to offer specific
diagnostic and treatment services in the second public evidence session of pharmacy inquiry this week (January 16).
The new service, which will enable pharmacists to offer advice and prescribe treatment for seven minor ailments, is expected to alleviate the pressure on the
NHS, reduce GP workload, and cut waiting lists.
But MPs and healthcare leaders also acknowledged that there's hesitancy and the mindset of 'GP first, not Pharmacy First' among members of the public.
"We must accept that many patients are used to seeing their GP as their first port of call for many health conditions. Pharmacy First is welcome, but there are
going to be some restrictions on how quickly some patients will want to take up some of those services, rather than seeing their GP," said William Pett, Head
of Policy, Public Affairs and Research, Healthwatch England.
EMIS Pinnacle, the leading Pharmacy First IT supplier, has begun implementing the GP Connect Update Record feature to all community pharmacies in England that
use PharmOutcomes.
Starting June 28, this new feature was made available for use with the Hypertension case-finding service and the Pharmacy contraception service, as announced by
the Community Pharmacy England (CPE).
The GP Connect Update Record will enable community pharmacies to securely share "structured" information with GP practices regarding consultations conducted under
the Pharmacy First programme, which includes minor illness and clinical pathways, along with Hypertension Case Finding and Pharmacy Contraception services
Live testing is underway with EMIS Pinnacle for Pharmacy First minor illness and clinical pathways.
There are plans to expand the system in the future to include updates for urgent supply of medicines under the Pharmacy First service.
EMIS Pinnacle is the third CPCF IT system supplier to offer this functionality, following Cegedim's Pharmacy Services system and Positive Solutions' HXConsult
system.
The Pharmaceutical Services Negotiating Committee (PSNC) has called the 'new general practice contract' which was imposed by NHS England on Monday (6 March)
as 'simply unreasonable'.
The imposition of new contract followed a failed talk of British Medical Association (BMA)'s with the negotiator. The association's main issue with the contract is
the lack of further funding beyond that agreed in 2019 as part of the five-year deal.
PSNC Chief Executive Janet Morrison said: "The breakdown in GP contract negotiations for the second year running is another blow for primary care. The verdict of the
GP negotiators is that the demands being made of doctors by Government and the NHS are simply unreasonable."
"Community pharmacy is being treated with the same disregard: too much is being asked of us, with far too little funding available."
The committee has been raising the issue and challenges faced by the community pharmacists with the government. The government is asking pharmacies to do more by
taking giving additional services but the committee is of view with no extra funding the community pharmacies will collapse.
The Community Pharmacist Consultation Service (CPCS) has been running as a national advanced service since October 2019 to relieve pressure on the National
Health Service which aims to help with on the day demand in relation to minor illness and medicines.
The NHS Community Pharmacist Consultation Service CPCS (NHS CPCS) aims to meet the objectives of the NHS Long Term Plan to use community pharmacists' skills to
advise patients, and to build relationships with GP surgeries, primary care teams and wider NHS providers and to assist with urgent care system repeat prescription
requests. Referrals from the GP referral pathway and urgent care systems and urgent treatment centres are digitally routed to community pharmacies so that patients
can receive same-day appointments and have their queries resolved.
The numbers
Based on the estimated annual number of minor ailment GP appointments, the service was expected to save the NHS up to £640 million per year . Three years later, the
nation has weathered the Covid 19 pandemic, which had widespread effects and put further strain on already overstretched NHS staff.
The pandemic impact has resulted in higher numbers of GP appointments than initially anticipated. Nevertheless, this may offer an opportunity to proactively engage
pharmacy teams in patient contact help ease strain across the wider NHS.
A recent report by the Company Chemists' Association (CCA) has revealed a significant disparity in patient engagement with the Pharmacy First service across
the UK.
In response, Santosh Sahu, Founder and CEO at Charac, has emphasised the need for technological reform to address "the interoperability gap between pharmacists
and GPs".
Sahu identified the lack of GP referrals for Pharmacy First consultations as a key issue, attributing it to inadequate IT infrastructure.
He urged the sector to "implement technological reforms to enhance interoperability between pharmacists and GPs, enabling them to share patient records, identify
care pathways, and address health needs more effectively".
Pharmaceutical Services Negotiating Committee has submitted its evidence to the House of Commons Health and Social Care Select Committee's recent inquiry into 'The future of General Practice'.
The committee, chaired by former health secretary Jeremey Hunt MP, had launched an inquiry to explore the future of NHS GP over the next five years.
PSNC's evidence focused on what community pharmacy is currently doing to support GPs, and what more can be done in the future.
The negotiator said: "We focused on how pharmacies supported patients throughout the pandemic as the only primary care access point offering healthcare advice on a walk-in basis.
National Health Services (NHS) patients across England are set to experience a significant enhancement in accessing key healthcare services such as
community nursing through the expansion of self-referral options that no longer require a GP appointment.
The recent announcement is part of the NHS primary care access recovery plan and is set to offer hundreds of thousands more individuals each month the opportunity
to refer themselves for essential services such as "incontinence support", "podiatry", or "hearing tests" without GP referrals.
This move aims to alleviate the burden on general practitioners through self-referrals for more than 180,000 patients, allowing them to focus their time and
resources on patients in need of immediate care and recover the long waiting times.
As per the NHS data, approximately 200,000 people per month self-refer themselves which under the new plan will extend to additional critical services tailored
to local population needs to "continue modernising GP, expand pharmacy services, and offer patients more choice in how they access care".
Leaders from across the pharmacy sector and trade bodies dwelled on the challenges faced by the pharmacists at the Sigma Conference held on Sunday (2 October).
"If the cost of carrying out regulation is higher than the benefits, it's time for all the bodies to sit together and talk on what can be adjusted accordingly,"
said Salim Jetha, Chairman, Avicenna.
Jetha highlighted the challenges faced by the independent pharmacy and also raised the concern about the 'level playing field' for pharmacists compared to GPs. He
said: "GPs get paid for energy cost, premises cost, the staffing cost. We don't get paid for that. So don't be misled by saying we are being exactly the same. Yes,
on paper we are, but in reality we are not. I think also the rules of engagement are different."
He called for better collaboration with GPs, and urged PSNC and other trade bodies to ensure a level playing field.
Janet Morrison, CEO, Pharmaceutical Services Negotiating Committee(PSNC), warned that the pressure in the sector is building up to a 'breaking point'.