Community pharmacy has always provided an important role in supporting patients with minor illnesses. This was recognised across the country with various Local Enhanced Services providing dedicated resources to support this over and above the vital dispensing services they deliver.
In 2019 NHSE sought to formalise this support and piloted the CPCS both with 111 and Primary Care practices. At the time Xytal supported several practices to integrate this service into their day-to-day care navigation.
The scheme was opened nationwide in March 2021 with the inclusion of a target in the Primary Care Network Investment and Impact Fund to boost uptake. It was reported in October 2021 that less than 800 out of 6000 practices had signed up to take part. Anecdotal evidence suggests that this was due to the need to electronically refer patients to the service rather than the verbal or even self-referral that was found in schemes of old.
Here at Xytal, we have found, within the nearly 150 practices that we have supported to review their appointment utilisation within the last 5 years, a significant opportunity to redirect demand to other services including community pharmacists. In fact, the opportunity was so great that we developed a “spin-off” support programme, community pharmacy interface, designed to “iron out the creases” that often exists between general practice and their local pharmacies.
During this support, we have identified several critical success factors for implementing and then integrating the CPCS into the care navigation team.
- Map the process - The gripes are true, the electronic referral process (including gaining patient consent) is a little clunky. Generally, this can be overcome with a clear process that new users can follow to gradually build their muscle memory.
- Truly understand the patient’s need - Patient feedback on the early scheme was mixed. This largely resulted from patients being bounced as inappropriate for the service. In our care navigation skills training, we talk about “listening to understand and not just to respond”. This comes into its own when it comes to active signposting. If our care navigation teams can truly understand what our patients need, they will be able to signpost them to the correct service, the first time, every time.
- Relationships, Relationships, Relationships! It does feel like the work done by both GP practices and Pharmacies during the pandemic has fostered greater mutual respect (if you disagree then you would certainly benefit from our Pharmacy Interface Support!). The introduction of EPS and a reduction in the squabbling over who “lost the prescription” has also helped! Understanding what your local pharmacies are actually able to support and their capacity to do so can inform who you refer your patients to. Build this information into your practice’s “Directory of Services” so that it is available to all.
- Above all else, ensure your team have the confidence to offer services that sit outside the practice team. Patients are very used to ringing the practice and getting an appointment (if there are any left!). Therefore, without appropriate training, coaching, and support, it is very difficult for your team to offer the alternatives with confidence.
We are confident that practices that are able to carve out the headspace to carefully consider implementation, and integration, of the scheme at their practice will enjoy significant benefits. In addition, the increased uptake will also release funds into the Primary Care Network that might otherwise be lost. This feels like one of the fairly unique opportunities, where applied successfully, both the patient and practice wins.
Xytal is the leading British consultancy in the health sector. ‘Notes from the coaching room’ is drawn from our real experience of the issues faced by many leaders in improving their leadership practice. Get in contact with us to learn more. If you found this article beneficial, you might also consider checking out our Care Navigation and Enhanced Communication Skills programme.
This blog was written by Daniel Vincent.