Sajid Javid wants all doctors to make CPCS referrals; announces £250 million winter access fund for GPs

Health secretary Sajid Javid wants all general practitioners in England to make full use of the GP CPCS referrals for minor illnesses "so our brilliant community pharmacists can do more in terms of prescribing".

A total of 800 practices have already signed up to provide the service, according to NHS England. The rest are being encouraged to sign up by December 1.

Making best use of community pharmacy

The NHS today (October 14) published a blueprint for improving access to GP appointments in which it highlighted how use of the CPCS referrals could help alleviate pressure on GPs by "harnessing the skills and knowledge of community pharmacists to treat a range of minor illnesses.

"Using the service gives a patient a same-day appointment in a community pharmacy and helps improve patient experience, as well as directing demand to the most appropriate setting."

In a column for The Daily Mail, the health secretary wrote: "I’m asking my department to work with the NHS and look at a ‘Pharmacy First’ scheme for England, so pharmacists can provide treatment for specific conditions such as sore throats, without patients having to go to their GP – building on pilot schemes in England and much as they already do in Scotland."

The Pharmaceutical Services Negotiating Committee (PSNC) has been looking at this as "an opportunity both to expand pharmacies’ role and to press for adequate funding for the walk-in advice that pharmacies are offering on a daily basis". The pharmacy negotiator hopes to discuss the details with the Department of Health and Social Care soon.

PSNC vice-chair and independent contractor Bharat Patel welcomed the government announcement but warned that "all of this comes with a caveat... We will continue to make very clear to government that while we absolutely want to help, this needs to be matched with extra support.”

Thorrun Govind, chair of the Royal Pharmaceutical Society in England, felt that funding for implementation, education and training would be key to making this a success.

She said: “Community pharmacy will be central to supporting the NHS recovery, including through increasing use of Pharmacist Independent Prescribers and commissioning innovative services to enhance patient care, safety and better manage demand across the NHS."

The Company Chemists' Association said: "There are significant pressures mounting on community pharmacy, particularly on resource and capacity, therefore to enable pharmacies to deliver on a greater scale an increased investment is required. Only through a holistic approach can patients’ needs be truly met.”

Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, was quoted in The Times as saying: “Investing in minor ailments services through pharmacies is an effective way to reduce GP-led appointments, reduce the burden on GP surgeries and A&Es and manage the demands for advice and support.”

£250 million boost for general practice

The health secretary announced that GPs in England will receive a new £250m winter access fund to improve their services but only if they increase the number of face-to-face consultations.

He said: "I am determined to ensure patients can see their GP in the way they want, no matter where they live. I also want to thank GPs and their teams for their enormous efforts in the most challenging times in living memory.

"Our new plan provides general practice teams with investment and targeted support. This will tackle underperformance, taking pressure off staff so they can spend more time with patients and increase the number of face-to-face appointments."

Admitting that online and telephone consultations could be more convenient for many patients, he said he was "determined to get us closer to pre-pandemic levels of face-to-face appointments".

"There’s no question that telephone and video calls will be a part of the future of general practice. But it cannot be the whole future."

He said his department expects that this new money will help improve access and deliver more face-to-face appointments but GP leaders have expressed disappointment that the funding will not help to relieve pressure on practices.

Potential opportunity for LPCs

As the winter access fund will be routed to the general practices via local commissioners, PSNC says this may present an opportunity for local pharmaceutical councils (LPCs) to bid for local community pharmacy services.

PSNC director of NHS services Alastair Buxton said: "CCGs and ICS should use the Winter Access Fund to commission additional local services from community pharmacy, including services to augment the CPCS, such as patient group directions, which are already being used successfully in several areas of the country to increase access to treatment, without the need to refer patients back to their GP.”

The document states that while the NHS continues to increase the role of community pharmacists in delivering appropriate clinical services, PCN pharmacists "will automatically be trained to prescribe" so they can lift workload from GPs.

NHS England will provide an incentive for PCNs to develop plans to implement CPCS or increase their current referral rate. It is also piloting the supply of contraception by community pharmacies, to expand the role of pharmacists in the supply of medication and relieve workload on GPs.

It instructs commissioners to considering making use of community pharmacy in delivering jabs in areas where GPs need to increase the levels of face-to-face appointments.

"Participation by a practice in the Covid-19 vaccination programme can never be at the expense of providing reasonable patient access to core GP services," the document points out.

The blueprint also mentions plans to increase the resilience of the NHS urgent care system during winter by expanding same day urgent care capacity, through other services in any primary and community settings.

It directs local health systems to review if any capacity funded through locally-commissioned enhanced services can be redeployed to support urgent same-day access.