Pharmacy First GP referrals in Surrey and Sussex
Building on from the NHS Community Pharmacist Consultation Service (CPCS) that included referrals from general practices as well as from NHS 111. The New Pharmacy First service went live on the 31st January 2024 this service incorporates the two previous elements of the Community Pharmacist Consultation Service (CPCS) and encompasses the new seven common conditions clinical pathways.
The Advanced service involves pharmacists providing advice and NHS-funded treatment, where clinically appropriate, for seven common conditions:
- sinusitis
- sore throat
- acute otitis media
- infected insect bite
- impetigo
- shingles
- uncomplicated urinary tract infections in women.
Consultations for these seven clinical pathways can be provided to patients presenting to the pharmacy as well as those referred by NHS 111, general practices and others.
The service also incorporates the elements of the Community Pharmacist Consultation Service, i.e. minor illness consultations with a pharmacist and the supply of urgent medicines (and appliances), both following a referral from NHS 111, general practices (urgent supply referrals are not allowed from general practices) and other authorised healthcare providers (i.e. patients are not able to present to the pharmacy without a referral).
In the clinical pathway consultations with a pharmacist, people with symptoms suggestive of the seven conditions will be provided with advice and will be supplied, where clinically necessary, with a prescription-only treatment under a Patient Group Direction (PGD) or in one pathway, an over-the-counter medicine (supplied under a clinical protocol), all at NHS expense.
Communicating with GP practices and accessing the patient’s GP record
As part of the development of the IT systems to support Pharmacy First, NHS England is funding improvements to the digital infrastructure between general practice and community pharmacy.
From February 2024 onwards (dates to be confirmed), community pharmacy IT systems will start to automatically send details of a community pharmacy consultation to the GP clinical IT system via a structured message, ready for a staff member at the practice to check and update the patient’s record.
Once this functionality (GP Connect Update Record) is enabled, all Pharmacy First post-event messages sent by pharmacy IT systems will appear in the general practice IT system’s generic workflow.
The structured data will be provisionally held against the patient record and will be visible by people reviewing the record. A member of the practice team will need to review and accept the message. The structured information will then be ingested into the patient record without the need for transcribing or coding. Messages will be available to anyone accessing the general practice record including patients themselves (by logging into their account on the NHS website or NHS App).
Before this implementation The Pharmacy First IT systems will send a post-event message to the patient’s GP practice following a Pharmacy First consultation via NHSmail, with a summary of the consultation attached as a PDF. This is the approach which was previously used for the Community Pharmacist Consultation Service. Once the new GP Connect Update Record functionality is implemented, this will remove the need for practice staff to transcribe information from emails into the patient’s record.
GP clinical IT system suppliers will enable this functionality by default and further supplier specific information for general practices is available via the following links:
NHS England is also working with Pharmacy First IT system suppliers to add GP Connect Access Record functionality to their systems. In the meantime, pharmacists providing the Pharmacy First service can continue to access elements of the patient’s GP record via the National Care Records Service.
GP referral received
When a patient with a minor illness symptom phones the practice requesting an appointment, they can be referred for a private consultation with a community pharmacist and with their consent, an electronic referral message will be sent to their chosen pharmacy.
Upon receiving the referral, the pharmacist can contact the patient by phone, video consultation or arrange for the patient to attend the pharmacy if necessary. The pharmacist may access the patient’s National Care Records Service and ask about current symptoms and medication.
Following the consultation, the pharmacist will offer self-care advice, offer treatment under the seven common conditions if gateway criteria is met or may sell an over-the-counter product if appropriate.
Where symptoms suggest something more serious, the pharmacist will help the patient to arrange an urgent GP appointment or escalate to another provider if necessary. The pharmacist will record the outcome and send this to the patient’s GP.
Our Sussex, Surrey and Frimley local on-boarding plans involve a lot of engagement and negotiation behind-the-scenes as it is important that local referral pathways are right for both GP and pharmacy teams taking account, for example, of the software both use and if it is compatible.
Thank you for your patience while we work through this locally with ICSs, PCNs and individual GP and community pharmacy teams, who are all working at different speeds across Sussex, Surrey and Frimley.
These locality based updates were published on the dates shown. Click on a heading for more information
UPDATE February 2024 for Surrey Heartlands ICS
Surrey Heartlands is using the EMIS integrated Patient Access module and PharmRefer for non-EMIS practices. This greatly enhances the referral process for GP practice staff and fully integrates with the Community Pharmacy PharmOutcomes system. GP Pharmacy First referrals will be received at the pharmacy by the same route as NHS 111 referrals are.
More information
UPDATE February 2024 for Frimley ICS
Frimley is using the EMIS integrated Patient Access CPCS module and PharmRefer for non-EMIS practices. This greatly enhances the referral process for GP practice staff and fully integrates with the Community Pharmacy PharmOutcomes system. GP referrals will be received at the pharmacy by the same route as NHS 111 referrals are.
More information
UPDATE February 2024 for Sussex ICS
Sussex is using the EMIS integrated Patient Access CPCS module and PharmRefer for non-EMIS practices. This greatly enhances the referral process for GP practice staff and fully integrates with the Community Pharmacy PharmOutcomes system. GP referrals will be received at the pharmacy by the same route as NHS 111 referrals are.
More information
To view the PharmOutcomes Training video for The Pharmacy First Service click here.
Please find more information here.
To view the slides from the CPSS Pharmacy First Webinar held 24/01/24 click here.
Ahead of the NHS’s public PR campaign, CPE have released various resources to help pharmacies promote the Pharmacy First service.
Download posters, social media tiles, videos, and more.
Further information and support
Have you checked out CPE’s Pharmacy First FAQs?
Read CPE’s recent comment on concerns over the implementation of Pharmacy First