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Learning sustains CPCS at General Practice Solihull Healthcare PCN

The General Practice Solihull (GPS) Healthcare primary care network (PCN) serves a population of 44,000 patients in low-deprivation areas of Birmingham and Solihull. It became an early adopter site for referring to the Community Pharmacist Consultation Service (CPCS) in March 2021 when it began a month-long pilot at Tanworth Lane and Village Surgeries. Following the pilot, the service was rolled out to the five other practices in the PCN.

The GP-CPCS pathway manages the pressures of demand for primary care and addresses patient access. The general practices refer patients with minor health conditions to CPCS for an on-the-day or next-day consultation with a community pharmacist. Patients benefit from a prompt resolution of their minor illnesses, while GPs gain the time to focus on patients presenting with more complex needs, or those who need continuity of care.

Solving early referral challenges

The pilot was successful, and along the way identified some practical areas to focus on including email and learning issues, such as pharmacy staff who lacked confidence in how the process would work. These concerns were addressed by developing training and solutions through sustained learning with patients, reception teams and community pharmacies.

Zoom training sessions for all clinicians and reception staff reiterated the conditions to be referred to community pharmacists, to ensure correct referrals. Susan Youssef, CPCS lead for GPS Healthcare, presented a chart that identified minor illnesses with green sections for conditions that could be referred to a community pharmacist and red to show where to apply caution and not refer.

To reinforce the learning, the PCN community pharmacist lead also gave her experiences, setting out exactly what she did when she received a referral, how she contacted the patient, screening for red flags, and how she referred back to the GP surgery when necessary.

Meeting IT issues and addressing lack of confidence

Strong liaison between the GP practices and the local pharmacies flagged several IT challenges, such as incorrect NHS email addresses, which training also helped to put right.

The PCN reinforced the service specification requirements that pharmacies should check their NHS mail regularly and the PCN confirmed that the pharmacies received emails when the practices made referrals. Another action they took was to ensure pharmacies had the correct patient contact details
The third challenge was addressing confidence issues, which came up in a survey three months after the launch. It showed a lack of confidence among new starters in the GP practice reception team, about the process for making the referral, which meant targeting that practice for further training

Operational confidence grew over time and this gave reassurance to patients who were choosing this service, as the PCN team became more accustomed to making referrals.

Follow-up learning and referral data help resolve issues

A data analyst from GPS helped with data collection and processing, monitoring referrals via the national PharmOutcomes database and gathering data on referrals to CPCS. It allowed GPS Healthcare to give each practice feedback on their performance and improve the quality of the service provided.

Data helped the PCN discover that a dip in referrals after Christmas 2021 was partly due to general practice staff turnover and sickness.

Knowing this meant the PCN could step in and organise more staff training in February and March to re-engage the practice with the CPCS.

Surveys ensure targets are met

Patient and reception team surveys following the launch of the CPCS were not only vital for finding out what people thought of CPCS, but also fundamental to a streamlined delivery.

Very good patient satisfaction

Three months after CPCS rolled out in the PCN, GPS conducted a patient satisfaction survey to ensure patients were happy and flag any problems. The PCN sent it to patients, asking them about their consultation with the community pharmacist. The response rate was 17%.

The survey showed steady growth in satisfaction among patients. Most rated their consultation as 4 out of 5 (very good).

Reception team confidence rises

Four months after CPCS was launched, the reception teams received a confidence-in-service survey, and 27 staff responded. In the survey, 67% of respondents said they were ‘very confident’ or ‘extremely confident’ with sending CPCS referrals.

Susan explained: “Those who weren’t confident sending referrals were new starters in the organisation, so this allowed more targeted training. Eighty per cent of respondents felt CPCS was a good option to offer patients.”

Culture of open communication safeguards momentum

It’s just as important for communication to be maintained. Each month, staff at the practices receive a newsletter to see how they are performing and keep up the momentum.

Susan said: “Regular updates are an opportunity to discuss issues at practice meetings. Any local problems with changes, such as staffing at the practice or the community pharmacy, can be resolved rather than the service coming to a complete halt.”

A culture of open communication, engagement and collaboration has meant the GP-CPCS has grown in popularity and saw a steady increase in referrals from each site between April and December 2021.

Susan said: “Without doubt, ongoing learning and sharing of referral data helps ensure the service’s sustained delivery.”

For more information, visit our website or email enquiries@pcc-cic.org.uk.

Last Updated on 31 March 2023