The community pharmacy referral system is not a new concept
“There’s no new idea…we keep spinning and making new combinations endlessly; but they are the same old pieces of colored glass,” Mark Twain wrote in his 1907 autobiography, North American Review Chapters.
And Twain’s principle could also be applied to health policy.
Take the NHS Community Pharmacist Consult Service (CPCS) – this allows patients to be referred to the community pharmacy for minor ailments or urgent medicine supplies by NHS 111 call handlers.
It was announced as part of the new Community Pharmacy Contract in July 2019, and on January 12, 2020, the program’s achievements were celebrated in a press release issued by the Department of Health and Social Care.
The statement said 114,275 patients had been referred to a “new ‘pharmacy first’ referral service” in its first ten weeks of operation. Matt Hancock, the Health and Social Care Secretary, said: “This ‘pharmacy first’ approach makes life easier for patients and will help reduce pressure on the NHS. I want to see more patients with minor illnesses assessed close to home, saving them unnecessary travel [hospital emergency departments] or GP, and help people get the care and advice they need faster. »
In Scotland, pharmacy minor ailment schemes have been commonplace since 2006
The CPCS is a significant achievement for community pharmacy and it has done an excellent job of rapidly scaling up to provide this service to over 100,000 patients referred by NHS 111 over the festive period. As the service expands to include referrals from hospital emergency departments and doctors’ surgeries, it will position the pharmacy even more firmly as the gateway to the NHS and provide a vital service to patients.
However, the government cannot claim that this is a completely new idea. The link to NHS 111 is new, but pharmacy minor ailment schemes have been commonplace in Scotland since 2006 for children, older patients and people on certain benefits. This will be extended in 2020 to cover all patient groups in Scotland.
In England, the CPCS is essentially an amalgamation of the NHS Advanced Emergency Medicines Supply Scheme (NUMSAS) – introduced in 2016 – and the digital referral service for minor illnesses, which was piloted in four areas in 2017 to 2019. Prior to this there were many similar programs for minor ailments created locally after the white paper ‘Pharmacy in England: building on strengths – delivering the future’ by the Department of Health time in 2008 promised to roll them out to all pharmacies in England.
Funding for these services – commonly referred to as ‘Pharmacy First’ schemes – was withdrawn in most areas after the introduction of NUMSAS and the NHS decided to withdraw from providing free ‘low value’ medicines. Then, a survey of The Pharmaceutical Journal in 2018 revealed that around one in five pharmacy services for minor ailments in England had been cut in the previous three years.
Policy makers may think they can get away with transporting us back a decade in a time machine and then pretending nothing happened, but this selective amnesia has real consequences when funding is suddenly cut and recycled into the latest “new” program. Imagine how many patients could have been helped over Christmas if England had developed programs for minor ailments, which had been gradually extended to cover urgent drug supplies over the past decade?
Yes, let’s celebrate CPCS, but we shouldn’t be fooled by what’s a slightly different configuration of the same colored glass.
- This article was modified on January 21, 2020 to correct the name of the community pharmacist‘s consultation service