GP referrals 'key' to Pharmacy First success, analysis suggests

Referrals from GP practices and NHS services are ‘key’ to the success of Pharmacy First, the Company Chemists' Association (CCA) has suggested, following its analysis of Pharmacy First consultations around the country.

Latest analysis of the number of Pharmacy First consultations in CCA pharmacies across England has suggested disparity between the success of the service in different parts of the country, with the highest-performing integrated care systems (ICS) delivering seven times more Pharmacy First consultations than the lowest performing.

The data found that CCA pharmacies in the North East and North Cumbria delivered a total of 12,931 Pharmacy First consultations between 31 January and 21 April 2024.

When weighted according to population and the number of CCA branches in each area, this made North East and North Cumbria ICS the highest-performing integrated care system in England.

And the three highest-performing ICSs – North East and North Cumbria, Greater Manchester, and Cheshire and Merseyside – also had the highest number of electronic referrals from other parts of the NHS, the CCA found.

It said that three in 10 GP surgeries have referred a patient for a Pharmacy First consultation, but added that 69% of those referrals were from a very small minority (7%) of GP surgeries.

At the other end of the scale, just 948 consultations were completed across Gloucestershire ICS, while the 1,783 consultations recorded by CCA multiples in Cornwall and the Isles of Scilly made it the lowest-performing ICS when the numbers were weighted for population and CCA branches.

Source: CCA

Locally commissioned services and engagement were ‘likely a key contributor to this variation’, the CCA suggested.

It highlighted that in the North East and North Cumbria, an NHS urinary tract infection (UTI) pilot has been running since 2022. ‘The success of this pilot has likely provided a very strong base for Pharmacy First in that locality,’ the CCA suggested.

Last year, The Pharmacist reported that a walk-in consultation service in Cornwall and the Isles of Scilly had delivered more than 8,000 face-to-face consultations within 12 months, for conditions including sore throat, UTIs, infected insect bites and shingles.

According to Community Pharmacy England, the walk-in service in Cornwall is still ongoing, alongside the national Pharmacy First service. The Pharmacist is seeking clarification on how these consultations are recorded alongside Pharmacy First.

Kate Huddart, deputy director of medicines at NHS North East and North Cumbria Integrated Care Board (ICB), told The Pharmacist that the ICB had funded service coaches to support both pharmacies and GP practices in Pharmacy First referrals and delivery, as well as running an award-winning public communications campaign.

‘We are delighted to see that this collaborative approach within our system is making it easier and faster for our patients to get the help they need, when they need it, at their community pharmacies,’ she said.

Ms Huddart also said that Pharmacy First ‘built on the foundations’ of the ‘extremely successful’ UTI pilot previously commissioned by the ICB, calling the new national service a ‘natural expansion for community pharmacists to offer advice and treatment for other clinical conditions.’

And she highlighted support that the ICB continues to provide to local pharmaceutical committees and the North East and North Cumbria Primary Care Collaborative to support the roll out of Pharmacy First ‘including hosting webinars and clinical skills workshops as well as providing IT support and access to iPads to facilitate the efficient delivery of the service and enhance patient experience’.

Malcolm Harrison, chief executive of the CCA, suggested that ‘boosting public awareness and supporting GP surgeries to refer patients’ was ‘key’ to the success of Pharmacy First.

The CCA also suggested that ‘tracking of delivery data’ indicated that the NHS public campaign had ‘little to no impact’, with no noticeable uplift in consultation numbers around the time of the campaign but rather a gradual and consistent increase in volume week to week.

Mr Harrison said this was ‘concerning’, and called for ‘a high-quality and targeted awareness campaign over the coming months to embed behaviour change well before winter pressures set in’.

‘Moreover, GP surgeries need targeted support to boost referrals and efforts to share best practice across and between ICSs,’ he added.

And Janet Morrison, Chief Executive of Community Pharmacy England (CPE), said: 'We need the NHS to be actively promoting Pharmacy First in all communities, as well as across primary care, for the service to reach its potential and to help address both health inequalities and primary care capacity.'

She said that CPE expected to work closely with NHS England and the Department of Health and Social Care in the coming months 'to understand the emerging data for the service and to jointly address obstacles and challenges – including advancing IT implementation, having more public marketing campaigns, and increasing engagement with GPs and the wider NHS.'

This week, NHS England has announced funding for new PCN community pharmacy engagement roles which are intended to help ensure ‘high quality and appropriate referrals from general practice to community pharmacy’.