CPCS referral from urgent and emergency care settings to launch next week

The Community Pharmacist Consultation Service (CPCS) will be expanded to enable urgent and emergency care settings to refer patients to a community pharmacist for a consultation for minor illness or urgent medicine supply from Monday (15 May), the DHSC and NHSE said.

The service builds on the progress made in GP referrals via the CPCS and hospital referrals under the Discharge Medicine Service. It was originally planned to launch in March, and fee for this service will be the existing CPCS fee of £14, as per the agreement for both year 4 and year 5 of the Community Pharmacy Contractual Framework (CPCF) 2019 to 2024 5-year deal.

In an update on the CPCF, published today (12 May), the Department of Health and Social Care (DHSC) and NHS England (NHSE) has also committed to the 4 October 2023 launch date for the Tier 2 of the Pharmacy Contraception Service, subject to a positive evaluation of the pilot.

The Tier 1 of the service was launched on 24 April, delayed by over three months. This new service enables community pharmacists to provide ongoing management, via a patient group direction (PGD), of routine oral contraception that was initiated in general practice or by a sexual health clinic. The fees for this service are as follows: a fee for each consultation of £18; and a set-up fee of £900, paid in instalments.

The Tier 2 will “enable community pharmacists to also initiate oral contraception, via a PGD, and provide ongoing clinical checks and annual reviews,” Alette Addison, deputy director for pharmacy, dental and optical at the DHSC and Ali Sparke, director for dentistry, community pharmacy and optometry at the NHSE, said in a letter.

The letter also informed that the pilot to expand the New Medicines Service (NMS) to include antidepressants is underway, adding that further update on the expansion of the existing service will be provided in due course.

The service was expected to launch last month.

The reduced Year 5 CPCF Pharmacy Quality Scheme (PQS) scheme will launch on 1 June, Addison and Sparke confirmed. “The reduced scheme is valued at £45 million to retain key priorities from the NHS Long Term Plan while reducing the burden on pharmacy contractors,” they said.

It will consist of one gateway criterion (15 NMSs between 1 April 2023 and the end of 31 December 2023) and four quality criteria:

• reducing harm from anticoagulants – re-audit and implementation of learnings and recommendations from 2021 to 2022 audit
• palliative and end-of-life care – as per year 4 requirements
• respiratory – as per year 4 requirements
• antimicrobial stewardship – as per year 3 and year 4 requirements plus advice on safe disposal of unused or expired antibiotics

The update noted that the monthly payment of a flat fee started in April to all pharmacy contractors who dispense at least 101 items a month up to a national total of £70 million on an annual basis.

“This amount is subject to change if clinical service volumes grow beyond our forecasts and all unallocated funding is spent on new services. The monthly payment is currently £533,” the letter read.

Following the review of the concessionary price process, from April  products granted a concessionary price are classified as ‘discount not deducted’ (DND) for the month(s) they are on concession, the update said.

“Furthermore, for products requested after the 23rd of the month, the concessionary price granted can be rolled over to the following month. We are continuing to work with PSNC on how a ‘retrospective increased payment’ may apply, when appropriate,” Addison and Sparke said in the letter.

On reimbursement reforms, they said the transition to the new discount deduction arrangements is ‘progressing but we will continue to monitor the implementation’.

“While the intent is to rely on the margin survey to adjust for any increased or decreased delivery of margin, we may need to consider other adjustments, for example applying a tolerance level where adjustments to discount rates need to be applied, to reduce the impact on margin delivery,” they added.