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Rural practices in Malling PCN share CPCS rollout success

Two practices in the Malling Primary Care Network (PCN) have demonstrated the benefit of rural dispensing practices referring to the Community Pharmacist Consultation Service (CPCS).

Malling PCN in Kent and Medway was one of the first PCNs to go live with the CPCS in July 2021. The CPCS enables GP practices to refer patients with minor illnesses and self-limiting conditions to a community pharmacist that day or the next day.

Referrals to the CPCS have saved and repurposed clinical time in Malling PCN, releasing 40 hours for healthcare professionals at the five practices over the first four months. The service has also freed the capacity for complex cases, strengthened links with pharmacists, improved patient access, and ensured patients receive swift support for minor illnesses without adding to reception teams’ workload.

Positive mindset helps practice teams get on board

The PCN consists of five surgeries serving around 60,000 people. Snodland, Thornhills, Medical Practices and West Malling Group Practices are in the urban area of Aylesford in West Kent. The other two are the semi-rural Wateringbury Surgery near Maidstone and the rural Phoenix Medical Practice in Burham – both dispensing practices.

Some dispensing practices in rural locations and, therefore, not close to pharmacies wondered whether people would want to travel to them. However, Phoenix and Wateringbury had no problems implementing referrals to CPCS.

Senior care coordinator Pam Lake, who managed the implementation across the PCN, said: “We can attribute this to how we rolled out CPCS and how both practices made sure staff were on board and understood the positives. We also held meetings with pharmacy leads and agreed on how the service would be rolled out.”

Practices/PCNs and local pharmacists worked together to agree how the service would work, ensuring the service rollout was straightforward. Regular communication and feedback from each remains a vital part of how the CPCS works successfully.

Ongoing training vital to successful implementation

Before the CPCS went live, one of the PCN’s training afternoons was to advise clinical and reception staff on what CPCS was about and how it could be beneficial and fulfilling to work with pharmacy colleagues to help manage the practice workload. Protected learning time was also ringfenced for training delivered virtually and face-to-face.

It’s vital to ensure ongoing training, says Senior programme manager Nicola Flisher, part of the Primary Care Transformation Development and Improvement team.

She said: “We recognise that perhaps because of Covid, general practice has seen a high turnover of reception staff, and some of their knowledge and understanding was lost. So, we’re re-engaging and have started refresher training for the whole PCN.”

Rural practices rise to the access challenge

The initial concern of the two rural practices was whether their patients could access a pharmacy. While pharmacies are usually close to a GP practice in urban areas, patients in rural locations may not be able to access a pharmacy easily without travelling to a town or city.

The question was uppermost in Nicola’s mind when she looked at the service specification with the CEO of Kent Local Pharmaceutical Committee (LPC) at the start of the PCN’s CPCS journey.

Nicola said: “The patient receives a telephone consultation from the pharmacist in the first instance. In most cases, the pharmacist can deal with the patient’s condition with advice and guidance over the phone. If a face-to-face appointment is required, the pharmacist will arrange this with the patient. This was a local agreement between pharmacy contractors and the practices.”

Although patients can always see a pharmacist face to face for CPCS, national CPCS data shows that three-quarters of CPCS consultations are held by telephone when referred by a GP.

The phone consultation process is seamless: the patient contacts the GP practice, which generates a referral, and the pharmacy calls the patient. If the pharmacist needs to escalate back to the practice, the pharmacist takes ownership of that escalation. The patient then gets a return call from the practice.

Patient-led choice helps improve referrals

Wateringbury and Phoenix are increasing referrals because they are led by patient choice and convenience and refer across the board to various pharmacists.

Referrals generated*
• Phoenix – 188
• Wateringbury – 85

*Between July 2021 and May 2022

CPCS supports patients to access the most appropriate service at the right time.

CPCS champion helps to drive referrals

According to Nicola, the PCN owes its CPCS success to a strong leader like Pam. She said: “I encourage every practice to have a CPCS champion to encourage receptionists to do at least one referral per session. That’s why it worked in Malling.”

Nicola also packaged all the information required by the practices, making implementation as simple as it could be from a practice management perspective. The pack included content for their websites, scripts to read to patients, and FAQs for patient participation groups.

In addition, at Malling, the LPC plays a crucial role in providing training to the pharmacies. It sends updates and a weekly newsletter to improve learning by responding to feedback and to ensure messages such as the need to close off referrals are cascaded to the people delivering the service.

What next? With the GP CPCS Investment and Impact Fund (IIF) PCN target achieved, the focus at Kent and Medway is now on reviewing and improving the quality of referrals and ensuring pharmacies and practices have the tools and resources to support them.

This toolkit is available to support general practices and PCNs.
Access the CPCS service specification.
Download the toolkit for pharmacy staff.

Last Updated on 31 March 2023