Advanced Services
- The Pharmacy First service will launch on 31st January 2024 (subject to IT systems being in place).
- The service involves providing consultations to give advice and NHS-funded treatment (via Patient Group Directions), where appropriate, for seven common conditions (clinical pathways consultations). The consultations can be provided to patients who self-refer to the pharmacy (e.g. walk-ins) as well as those referred by NHS 111, GPs and others.
- The seven conditions are: sinusitis, sore throat, acute otitis media, infected insect bite, impetigo, shingles and uncomplicated urinary tract infections in women.
- Distance Selling Pharmacies (DSPs) will be able to provide six of the seven Pharmacy First clinical pathways remotely via video consultations but may not provide clinical pathways consultations on their premises (due to links with the support for self-care Essential service and restrictions regarding the provision of Essential services on the pharmacy premises). The acute otitis media clinical pathway requires the use of an otoscope, so that pathway will not be provided by DSPs.
- The Pharmacy First service will also incorporate the existing Community Pharmacist Consultation Service (CPCS). Pharmacies will be paid £15 per consultation.
- An initial fixed payment of £2,000 will be available to claim from December up to the launch of the Pharmacy First service, which will be reclaimed if pharmacy owners do not provide five clinical pathways consultations by the end of March 2024.
- From February 2024, in addition to the £15 consultation fee, a monthly fixed payment of £1,000 will be paid to pharmacy owners who meet a minimum activity threshold of clinical pathways consultations (the threshold will increase over time as set out below).
Please find more information here.
These two services were introduced in April 2010 and they can be provided by both community pharmacy contractors and dispensing appliance contractors.
The service involves the customisation of a quantity of more than one stoma appliance, based on the patient’s measurements or a template. The aim of the service is to ensure proper use and comfortable fitting of the stoma appliance and to improve the duration of usage, thereby reducing waste. The stoma appliances that can be customised are listed in Part IXC of the Drug Tariff. If a pharmacy intends to provide the SAC service the pharmacy must in the first instance notify Local NHS NHS England team and NHSBSA by completing the forms here.
Appliance Use Reviews (AURs) can be carried out by a pharmacist or a specialist nurse in the pharmacy or at the patient’s home. AURs aim to improve the patient’s knowledge and use of their appliances. If a pharmacy intends to provide the SAC service the pharmacy must in the first instance notify Local NHS NHS England team and NHSBSA by completing the forms here.
The NHS Community Pharmacist Consultation Service launched on 29th October 2019 as an Advanced Service. Since 1st November 2020, general practices have been able to refer patients for a minor illness consultation via CPCS, once a local referral pathway has been agreed.
The service will help to tackle elements of existing health inequalities by providing urgent access to patients who are not registered with a GP and will support the following:
- To support the integration of community pharmacy into the urgent care system, and to divert patients with lower acuity conditions or who require urgent prescriptions, releasing capacity in other areas of the urgent care system.
- To offer patients who contact NHS 111 the opportunity to access appropriate urgent care services in a convenient and easily accessible community pharmacy setting on referral from an NHS 111 call advisor and via the NHS 111 Online service.
- To reduce demand on integrated urgent care services, urgent treatment centres, Emergency Departments, walk in centres, other primary care urgent care services and GP Out of Hours (OOH) services, and free up capacity for the treatment of patients with higher acuity conditions within these settings.
- To appropriately manage patient requests for urgent supply of medicines and appliances.
- To enable convenient and easy access for patients and for NHS 111 call advisor referral.
- To reduce the use of primary medical services for the referral of low acuity conditions from NHS 111 and the need to generate urgent prescriptions.
- To identify ways that individual patients can self-manage their health more effectively with the support of community pharmacists and to recommend solutions that could prevent use of Urgent and Emergency Care services in the future.
- To ensure equity of access to the emergency supply provision, regardless of the patient’s ability to pay for the cost of the medicine or appliance requested.
- To increase patient awareness of the role of community pharmacy as the ‘first port of call’ for low acuity conditions and for medicines access and advice.
- To be cost effective for the NHS when supporting patients with low acuity conditions.
The table on the link below sets out the range of scenarios associated with the Community Pharmacist Consultation Service (CPCS) and when a consultation within the service is complete (and hence can be included in the total number of completed CPCS claimed at the end of the month on the FP34c).
- Guidance on when a CPCS is complete here. Tips for preparing for GP CPCS
- Reading the updated NHS CPCS Toolkit for pharmacy staff, so you understand more about how the pathway will operate.
- Reading the updated service specification.
- Briefing relevant staff on the changes to CPCS.
- Ensuring pharmacists that will provide the service read the updated toolkit and service specification.
- Support for pharmacists to reflect on continuing professional development activity they could undertake to provide the best possible service to patients, which could include undertaking the NHS-funded CPCS training provided by the Royal Pharmaceutical Society and the Royal College of General Practitioners or additional CPPE modules.
- Watch the GP CPCS webinar hosted by CPSS- GP-CPCS Webinar.
- More information for all pharmacies in England
- Advanced Service Specification – NHS Community Pharmacist Consultation Service (published March 2021).
- CPE information hub about Community Pharmacist Consultation Service (CPCS) and the GP referral pathway
- CPCS resources for pharmacy teams.
- GP referral pathway to the CPCS – Action Plan template for pharmacy teams (PDF).
- Community Pharmacist Consultation Service (CPCS) CPE Guidance.
- Appendix C information for CPCS can be obtained by emailing lpc@communitypharmacyss.co.uk.
Community pharmacy has been providing flu vaccinations under a nationally commissioned service since September 2015.
Each year from September through to March the NHS runs a seasonal flu vaccination campaign aiming to vaccinate all patients who are at risk of developing more serious complications from the virus.
Community pharmacists can vaccinate all eligible patients outlined the service specification.
Please view our Flu pages in A-Z here.
More information can be found here.
Hypertension case-finding service has been commissioned as an Advanced service from 1st October 2021.
The service specification and other details; additional information, guidance and support materials are available here CPE information hub.
Download the service specification
Service Directions & Determination
The Secretary of State Directions provide the legal basis for the provision of the service.
CPE Briefing 041/21: Guidance on the Community Pharmacy Hypertension Case-Finding Advanced Service
This CPE Briefing provides additional guidance for community pharmacy contractors and their teams on the service.
The service will have two stages – the first is identifying people at risk of hypertension and offering them blood pressure monitoring (a ‘clinic check’).
The second stage, where clinically indicated, is offering 24 hour ambulatory blood pressure monitoring (ABPM). The blood pressure test results will then be shared with the patient’s GP to inform a potential diagnosis of hypertension.
The following fees have been agreed:
- A set-up fee of £440;
- A fee for each clinic check of £15; and
- A fee for each ambulatory monitoring of £45.
In addition, the following incentive fees across Years 3, 4 and 5 of the CPCF 5-year agreement, will be available. Pharmacies must reach a threshold of ABPM activity to trigger the payment of the incentive fee.
- An incentive fee of £1,000 will be available if 5 ABPM intervention are provided in 2021/22.
- Followed by a payment of £400 in the subsequent years if the pharmacy reaches the thresholds for those years (15 ABPM interventions will be required in 2022/23 and 20 in 2023/24).
- Contractors who sign up after Year 3 must achieve the ABPM activity thresholds specified for the given financial year and will receive £1,000 as a first payment. If a contractor signs up in Year 3 and fails to do 5 ABPMs, they can earn £1000 by doing 15 ABPMs in Year 4.
Contractors must notify NHSE&I that they intend to provide the service by completion of an electronic registration through the NHS Business Services Authority’s (NHSBSA) application. Further information is available.
To view an interactive map of pharmacies who have signed up for the service please click here.
The pathway has been developed as a guide for using AccuRx messaging in a targeted approach and can be adapted locally as required. It has been designed to enable a collaborative approach between GP surgeries and Community Pharmacies, targeting specific patient cohorts to increase detection rate. This pathway may facilitate workstreams such as Quality and Outcomes Framework (QoF) and Impact and Investment Fund (IIF) indicators including tackling neighbourhood health inequalities outlined in the Directed Enhanced Service.
There are pilot sites in Surrey and Sussex with the ambition to rollout across Sussex and Surrey Heartlands offering viable options to aid capacity in GP practice by reducing some demand on nursing and health care assistant appointments.
How to guide- Implementing the Accurx Pathway in a GP practice or PCN.
The LPC and NHS Sussex created a document for GPs and PCNs to use which supports the implementation of the AccuRx pathway. This how to guide provides guidance on suggested text message content, using AccuRx to send batches, cohort searches, the pathway diagram and more.
Please view “How to implement the AccuRx Pathway“.
The Pharmaceutical Journal published the Community Pharmacy Surrey and Sussex AccuRx Pathway
We are proud to announce that The Pharmaceutical Journal has published the AccuRx pathway, this article outlines the pathway, outcomes of the pilot, the importance of working collaboratively and how using digital tools can support the identification of undiagnosed hypertension.
Please read the published article here:
Download PDF here.
Please contact LPC@commmunitypharmacyss.co.uk if you would like to know more or are a GP practice interested in implementing the pathway.
Community Pharmacy Surrey & Sussex and NHS Sussex have been shortlisted as a finalist at the HSJ Digital awards. For more information click here.
The NHS offers COVID-19 treatment to people with COVID-19 who are at risk of becoming seriously ill. Prior to the introduction of this service, rapid lateral flow device (LFD) tests were available to order by these patients on GOV.UK or by calling NHS 119. These kits were then delivered directly to the patient’s home.
From 6th November 2023, LFD tests will no longer be available via GOV.UK or via NHS 119. LFD tests still need to be available and easily accessible to people who are potentially eligible for COVID-19 treatments through routine NHS access routes. It is estimated, that in the short-term, the number of potentially eligible patients will remain at around 3.9 million. Although access to LFD tests may be supplemented by other pathways (e.g. through anticipatory or specialist care), community pharmacy is well placed within the local community to provide local and rapid access for patients.
Access to COVID-19 community-based treatment will continue to be based on a confirmed COVID-19 infection, which can only be reliably achieved with a diagnostic LFD test, in line with some of the recommended treatment’s product licences. Given the short efficacy window for treatment and practical implications of point of care testing, tests need to be available for patients to access in advance of developing symptoms.
The objective of this service is to offer eligible at risk patients access to LFD tests to enable testing at home for COVID-19, following symptoms of infection. A positive LFD test result will be used to inform a clinical assessment to determine whether the patient is suitable for and will benefit from NICE recommended COVID-19 treatments.
More information is available here.
The service provides support for people with long-term conditions newly prescribed a medicine to help improve medicines adherence; it is focused on specific patient groups and conditions.
Changes to the NMS service were agreed as part of the Year 3 5-year CPCF deal, with these implemented from 1st September 2021:
- Additional eligible conditions were added to the service – see the Patients eligible for the service and the NMS medicines list section below for the details. The rationale for selection of the conditions mirrors that used in identifying the original four therapy areas/conditions: firstly, that there is evidence from research that adherence to medication in this condition could be improved and secondly that reviews of available research suggest these are areas where community pharmacists are best able to support improvements in patient understanding and adherence to treatments.
- Contractors who have received an exemption from the requirement to have a consultation room (due to their premises size) from their regional NHSE&I team, can provide the service remotely or at the patient’s home. All other contractors providing the service can similarly continue to provide the service remotely, where appropriate, and in the patient’s home.
- The cap on the number of NMS which can be provided by contractors increased from 0.5 percent to one percent of monthly prescription volume and additional bandings were included.
- The service can be offered to support parents/guardians/carers of children and adults newly prescribed eligible medicines who could benefit from the service, but where the patient is not able to provide informed consent.
Supporting documents and information can be found on CPE website here and on NHSBSA here.
Service specification can be downloaded here.
Expanded NMS drug list can be downloaded here.
Expanded NMS BNF categories can be download here.
Smoking Cessation advanced service is a stop Smoking service for people referred to pharmacies by a hospital, commissioned as an Advanced service from 10th March 2022.
The service specification and other details; additional information, guidance and support materials are available here.
Download the patient flow diagram
Service Directions and Determination
The Secretary of State Directions provide the legal basis for the provision of the service.
CPE Briefing 008/22: Guidance on the Smoking Cessation Service
This CPE Briefing provides additional guidance for community pharmacy contractors and their teams on the service.
This service enables NHS trusts to refer patients discharged from hospital to a community pharmacy of their choice to continue their smoking cessation care pathway, including providing medication and behavioural support as required, in line with the NHS Long Term Plan care model for tobacco addiction.
The following fees have been agreed:
- A set-up fee of £1,000;
- A fee for the first consultation of £30;
- A fee for each interim patient consultation of £10; and
A fee last consultation of £40.
To view an interactive map of pharmacies who have signed up for the service please click here.
NHS Pharmacy Contraception Tier 1 service has been commissioned as an Advanced service from 24th April 2023. The service requirements are included in the service specification and Patient Group Directions (PGDs), which contractors must read before deciding whether to provide the service.
Download the service specification and Patient Group Directions
PGD Progesterone only contraceptive pill
PGD Combined oral hormonal contraceptive pill
Service Directions & Determination (published April 2023)
Map of participating pharmacies in Surrey
Map of participating pharmacies in Sussex
Initially the service will involve providing ongoing management of routine oral contraception that was initiated in general practice or a sexual health clinic; this is the Tier 1 service.
The supplies will be authorised via a Patient Group Direction (PGD), with appropriate checks, such as the measurement of the patient’s blood pressure and body mass index, being undertaken, where necessary.
NHS England has supported Cegedim Healthcare Solutions and PharmOutcomes to develop their IT systems to support the service, which includes the functionality of an API (application programming interface) with the NHSBSA’s MYS portal. More information can be found on here.
All payment claims for the service must be made through the API this transfers the data to MYS.
Other pharmacy suppliers have also expressed interest in developing their systems to support the service and plan to introduce this capability during 2023/24.
The following fees for Tier 1 have been agreed:
- A set-up fee of £900 per pharmacy, paid in instalments as follows:
- £400 paid on signing up to deliver the service via the NHSBSA MYS portal;
- £250 paid after claiming the first 5 consultations; and
- £250 paid after claiming a further 5 consultations (i.e. 10 consultations completed).
- A fee for each consultation of £18.
To deliver this service, the pharmacist should have evidence of competence in the clinical skills and knowledge covered in the following training modules on the Centre for Pharmacy Postgraduate Education (CPPE) and/or the Health Education England e-learning for healthcare (elfh) websites:
- CPPE Emergency contraception
- CPPE contraception including contraception e-assessment or the following four subsections of module 3 – Contraceptive choices of the FSRH sexual and reproductive health e-learning (e-SRH) on elfh:
- 03_01: Mechanism of action, effectiveness and UKMEC
- 03_02: Choosing contraceptive methods
- 03_03: Combined hormonal contraception
- 03_04: Progestogen only methods (oral and injectable).
- CPPE consultation skills for pharmacy practice and e-assessment
- CPPE Sexual health in pharmacies and e-assessment or the following four subsections of module 9 – STIs of the FSRH e-SRH on elfh:
- 09_01: Epidemiology and transmission of STIs
- 09_02: Sexually transmitted infection (STI) testing
- 09_03: STI management
- 09_04: Partner notification.
- and one subsection in the External resources module of the Sexual Health (PWP)e-learning on elfh:
- FSRH – Contraception counselling eLearning.
- For more information
- Please click here to see the National Services provided by West Sussex infographic for LPC’s 2021/22.
- Please click here to see the National Services provided by West Sussex infographic for LPC’s 2022/23.
- Please click here to see the National Services provided by East Sussex infographic for LPC’s 2021/22.
- Please click here to see the National Services provided by East Sussex infographic for LPC’s 2022/23.
- Please click here to see the National Services provided by Surrey infographic for LPC’s 2021/22.
- Please click here to see the National Services provided by Surrey infographic for LPC’s 2022/23.
- Please click here to see the National Services provided by CPSS infographic for LPC’s.
- See Community Pharmacy Contractual Framework 2019-2024 (NHS England)
- See Community Pharmacy Contractual Framework 2019-2024 (CPE)
- Contact us at lpc@communitypharmacyss.co.uk
