The Pharmacy First Scheme | What Does it Mean for Primary Care Networks?

Updated: Apr 4

At THC, we provide resources to support primary care leaders, and in this week's blog, we are discussing the pharmacy first scheme due to start on 31st January 2024.

In this blog, we provide an overview of the scheme and have sourced some views on the challenges and opportunities from a Primary Care Network perspective.

We have also created an editable infographic that you can amend to meet your own needs.

DISCLAIMER

As with all blogs we create, if the terminology, interpretation or approach doesn't resonate with you, please disregard it.

Please also triple-check the guidance so you are 100% clear on what the requirements are.

Now, let's jump in!

Launching on 31st January The NHS Pharmacy First Service incorporates the previous Community Pharmacist Consultation Service and builds on it to enable community pharmacies to complete episodes of care for seven common conditions.

1. Uncomplicated urinary tract infections (UTIs) in women

2. Shingles

3. Impetigo

4. Infected insect bites

5. Sinusitis

6. Sore throat

7. Acute otitis media (ear infections)

Pharmacy First is part of the 'delivery plan for recovering access to primary care' £645 million investment to expand services offered by community pharmacies and strengthen the overall primary care offer.

An overview of the service can be found in the infographic below, which highlights the process for patients coming via the practice but its important to note, that this is not an NHS approved document.

This infographic can be amended to meet the needs of your practice and patients and its just a starter for ten.

Please note that the guidance does state that patients can directly go to the pharmacy without a GP referral.

If you want to use this graphic as a template to create your own using Canva, you can access and edit this using the link below.

Click here to create your own pharmacy first infographic.

What does this mean for primary care networks and their practices?

As more heads are better than one, I thought I would crowdsource a few views on this.

Gary Hughes, a former practice manager and now director of leadership in practice, said “If I were supporting a PCN or practice, I’d engage with my community pharmacies and jointly promote and educate patients to ensure clarity of what was being offered and what patients could expect to maintain/build trust.”

Rebecca Gane, primary care network digital and transformation manager, also agreed that opening up a dialogue with local pharmacists was key to ensuring effective communication between practices and pharmacies, along with having good referral processes in place.

Shaun Hockey, pharmacist and managing director for Medacy, says, “As a pharmacist, I’ve always felt that community pharmacy is a much-underutilised element of the primary care picture.” It’s still going to be a big leap for many community pharmacists but one that I think many pharmacists will enjoy and one that practices will benefit from.”

From the people I have spoken to, there is a feeling that, along with increased appointments, there is a real opportunity for PCNs and their community pharmacy partners to work together to create an at-scale service that can work for everyone.

However, there are a few concerns

One PCN clinical director felt that funding was a threat in that inevitably, there is only so much money in the health pot, and pharmacists receiving a point-of-service payment puts them at a significant advantage compared to primary care, who effectively would be required to see the same cases for free.

There is also the potential for increased workload falling on practices, due to the paperwork and admin required to process patients through the new scheme.’

Whilst 90% of pharmacies have signed up for the scheme, there was some concern as to whether the capacity was truly there due to workforce pressures.

One practice manager also felt that reception teams could feel increased pressure when signposting out of fear a pharmacist may miss something a GP might pick up.

However, Daniel Vincent, CEO of Enhanced Primary Care, has seen many practices prepare for this issue and more by putting in place care navigation teams whose job it is to make the practice ready to embrace the new scheme.

I also spoke with a PCN transformation manager and clinical director, who highlighted that the CPCS has been unsuccessful in some areas, so trust between practices, patients, and the pharmacy has broken down. This will make the introduction of the new scheme an even greater challenge.

And lastly, while in some areas, they are able to email referrals directly from S1, in others, IT remains an issue and a barrier to efficiency.

So, the takeaway messages are:

1️⃣ Local pharmacies, PCN clinical leads, practice managers, and other key staff in your PCN need to be in the conversation now and until the service is truly embedded to ensure everyone is on the same page and patients receive a consistent message.

2️⃣ The referral process needs to clear.

3️⃣ Practices should monitor the referrals to highlight any issues.

The full specification can be found here.

A letter confirming the launch of the scheme published on 25th January by NHSE can be found here.

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About the Author

Tara and Team THC provide project and network management and training to Primary Care Networks. Between our training programmes, facilitation and interim network programmes, we have now supported over 120 PCNs!

Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs, and also hosts The Business of Healthcare Podcast .