Community Pharmacy Referral Service – a Digital Minor Illness Referral Service (DMIRS) project – extended to 31 March 2019 in the North East

In December 2017, NHS England commissioned the Community Pharmacy Referral Service (CPRS) funded by the Pharmacy Integration Fund. The CPRS is a new digital minor illness referral project to enable NHS 111 to refer patients with minor illnesses - such as sore throats, coughs, colds, tummy troubles, teething, and aches and pains - to a local pharmacy. 

The initial project ran from 4 December 2017 to 31 March 2018 across Durham, Darlington, Tees, Northumberland and Tyne and Wear where the North East Ambulance Service NHS Foundation Trust (NEAS) is the NHS 111 provider. It was extended to 30 September 2018 and is now further extended to 31 March 2019.

Over 8,500 patients in the North East have been referred into the CPRS for advice from a pharmacist and over 80% of patients are ‘very satisfied’ with the service. Only 11% of those patients seen have been referred to a GP for an urgent in hours appointment.

The award-winning North East initiative is being piloted in other areas to help reduce pressure on GP care and A&E departments and deliver better access to care, closer to home, and with a self care emphasis.

Previously, less than 1% of NHS 111 referrals were to a community pharmacy - calls were referred to other primary care locations such as general practices (in and out of hours), walk-in centres or, in some cases, A&E. These appointments can restrict access and reduce the time GPs have to focus on patients with greater clinical need.

Background

The NHS England Hospital to Home Pharmacy Reference Group and Pharmacy Integration Oversight Group have overseen the CPRS development. It builds on the clinical skills and knowledge in the community pharmacy network, and improves the integration of pharmacy into urgent care services. 

It is funded by NHS England’s Pharmacy Integration Fund to enable pharmacist and pharmacy technician integration in primary and urgent care as part of new multi-disciplinary healthcare teams.

How it works

Referral to the CPRS is through NHS 111. After speaking to a call handler, if the patient’s symptoms dictate that they could be assessed and treated by a community pharmacist, the Directory of Services will suggest a number of nearby pharmacies. 

Details of the call are securely transferred electronically to the receiving pharmacy and the patient is given the address and asked to attend within a timeframe.

The pharmacist assesses symptoms and considers any long-term conditions, and the medicines that the person is taking. They will either:

1.    Support/advise the patient to self care.

2.    Advise on an ‘over the counter’ medicine (which doesn’t need a prescription or a visit to a GP) that will help relieve symptoms and make the person more comfortable - in some cases this may result in the patient purchasing the medicine;or refer into a Minor Ailments Service, if appropriate.

3.    Signpost the person to themost appropriate medical care if needed.

The patient must be in attendance; for children under-16, the parent or guardian must also be in attendance or a consultation under CPRS cannot be carried out. 

CPRS is an opt-in service for patients and those who wish to consult their GP or other health care provider for their condition are free to do so. 

The service is being evaluated independently and an important part of the service is encouraging completion of the patient questionnaire after a patient has received a CPRS.

GP practices

Pharmacies send post-consultation messages to GP practices; depending on symptoms, some patients may be referred directly by the pharmacist to general practice or another NHS service. 

Communications  

NHS England and pharmacies are working in partnership with stakeholders to raise awareness of service.

Further information 

The service has been developed collaboratively by an NHS England led local Cumbria North East steering group and project managed by Andre Yeung, LPN Chair Northumberland, Tyne and Wear, NHS England, and Mike Maguire, Chair Durham Darlington and Tees Local Professional Network (Pharmacy); email: andre.yeung@nhs.net or mike.maguire2@nhs.net  

Web link: https://www.england.nhs.uk/north/north-east-pharmacy-service-wins-health-initiative-award/