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GP receptionists to be able to refer patients for pharmacy consultation

Sodium valproate

GP practice receptionists will be able to refer patients for a pharmacy consultation from this autumn, after NHS England reached an agreement with the Pharmaceutical Services Negotiating Committee (PSNC).

This comes as a pilot across Bristol, North Somerset and South Gloucestershire showed the community pharmacy consultation service (CPCS) helped to free up appointments and reduce demand from patients with minor illness, enabling GPs to focus on more complex cases.

The CPCS was launched in October 2019 and currently allows NHS 111 to refer patients for a consultation with a pharmacist, but had until now not taken referrals from GPs outside the pilot which launched last July.

The pilot involved 35 GP practices and 104 pharmacies, which all 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.

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.

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, while work is under way to roll it out to all GP practices across England during the autumn.

Commenting on the announcement, made at the 2020 Local Pharmaceutical Committee Conference, PSNC chief executive Simon Dukes said: ‘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.’

Practices in the pilot also improved access to GPs for patients ‘who really need a GP consultation’, through freeing up capacity, NHSE said.

‘Patient feedback for those who have had a consultation with a pharmacist has been very positive,’ its evaluation said.

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.’

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.’

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.’


Patrufini Duffy 21 September, 2020 2:49 pm

Another GP directed scheme. The practice doesn’t need more work. An ironic failure of thinking. To the NHS, the more you do, the less useful and effective you actually are. Rule 784 of life.

Avish Punater 21 September, 2020 3:18 pm

I wonder where pharmacists record their clinical advice? What is the defence to being sued when a minor illness turns out to be meningitis etc?

Carl Hutson 21 September, 2020 8:49 pm

Don’t warn them about indemnity!
I was beginning to believe we had got away with offloading some work!

Bob Hodges 22 September, 2020 10:27 am

To be fair, this is a rational thing to do in an overburdened system.

We simply can’t have EVERYTHING going strauight to GPs.

This is not ‘triage’ because the receptionist is ‘signosting’ to the pharamcist. If the pharmacist feels they can’t deal with it, then it will go back to to a GP. Anything that debrides a bit of workload for GPs is worth exploring.

The vast majority of things diverted to pharamcists will be self-limiting seasonal things, and the extra few days of delay will help to identify stuff that needs looking at in detail. The system is FREE at the point of use, which currently means that people present to GPs way to early for us to differentiate a mild self-limiting seasonal thing from an evolving condition that needs attention.

Its easier to find a needle in a smaller haystack.

Charles Richards 17 November, 2020 5:20 pm

Your call is number 24 in the queue…. of course you don’t need to wait another 20 minutes while we navigate the 23 in front of you around the NHS, you could consider 111, the chemist MIU, WiC, 999 or A&E?