The Community Pharmacy Consultation Service (CPCS) will be merged into Pharmacy First at the end of this month. Leela Barham takes stock of CPCS before it transitions

NHS England launched the CPCS at the end of October 2019. Its website says the service is “helping to alleviate pressure on GP appointments and emergency departments” by helping patients get a same-day appointment with a community pharmacist for a minor illness or urgent supply of regular medicine.

CPCS is going to be part of Pharmacy First from 31 January (IT willing), which allows for patients to present with defined conditions and, if appropriate, get treatment from a pharmacist without a referral from 111 or their GP.

Revenue stream...

For contractors, CPCS represented a revenue stream since a consultation – subject to sharing all the information required to get reimbursed – was paid for at a rate of £14 per consultation. That will change at the end of this month to £15, along with some fixed payments according to activity delivered under Pharmacy First.

At the national level, CPCS claims were over 2.8 million, and correspondingly fees reached over £40m between January 2021 and August 2023. January 2021 is the first time CPCS claims feature in NHSBSA data, and August 2023 is the most recent data available at the time of writing.

From a contractor’s perspective, CPCS income has been rising over time (figure 1). In August 2023, the average CPCS fees were £317 per contractor who claimed. The annual average for the financial year 2022/23 was £3,000. PharmData has a helpful comparative note on CPCS activity: pharmacies in England used to be able to claim for up to 400 MURS a year, which would be £11,200 in fees.

So the upward trend in activity and fee income is good, but as an income source, it’s nowhere near what it used to be.

...but only for some

For the sector, it’s a win to get paid for something that many have been doing without reimbursement in any case. But it’s only a win for some. P3pharmacy’s number crunching shows that the share of contractors who have claimed has never gone beyond 65 per cent of all contractors.

That so many – over 4,000 contractors in August 2023 – have no CPCS claims at all is worth investigating further. Is this because there really is no CPCS-like work being done? Doubtful.

Perhaps this is what led to the tweet from pharmacist and solicitor Thorrun Govind, who said that CPCS was “not where it needs to be but a welcome support for patients and recognition of the value of pharmacists and their teams”.

How to make CPCS work

Some contractors have fared well under CPCS. Savages Pharmacy in Maldon is in the top 10 claimants of all time with over 7,000 CPCS claims, according to PharmData. What’s its secret?

“Ensure a good communication link between any participating surgeries” is the main tip from pharmacist Sarah Read.

Communication should be two-way with the clinicians so that the set up at the practice can support CPCS. “If possible, have regular feedback as well from both sides as this ensures everyone is meeting expectations and these also stay realistic,” says Read. “Having a direct line to clinicians at the surgery ensures those patients who need to be seen are. Can surgeries hold some of their emergency appointments/ad hoc those who require same-day treatment for example?”

Being realistic about how much the pharmacy can do is also important. “I think it is important to not overwhelm yourself in the pharmacy,” adds Read. “Be open and transparent about what you can handle, whether that be a cap on the total number of patients referred each day or to refrain from services on certain days due to staffing levels. It is important that the service you do provide is credible and worthwhile to patients.”

Contractors don’t have to go it alone. The local Integrated Care Board should be able to support. Read says: “If you are struggling, I would suggest making contact with your ICB community pharmacy lead pharmacist if available, to see how they can help aid the transition.”

Savages is not at the top of the league, however: that honour goes to Wembley-based Optipharm, with over 98,000 CPCS claims (almost eight times as much as Clark’s Chemist’s in second place at just over 12,000 claims). Don’t forget about CPCS There’s going to be lots of work to make the most of the move to Pharmacy First. Yet it’s important not to lose sight of CPCS-style activity because when times are tough, every little helps.