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Inappropriate CPCS referrals have taken us ‘beyond breaking point’


Inappropriate CPCS referrals have taken us ‘beyond breaking point’

By Neil Trainis

The owner of a regional pharmacy chain in the South-West of England has said the GP community pharmacist consultation service is taking his teams “beyond breaking point” because large numbers of patients including some with severe mental health problems are being inappropriately referred to them.

Max Punni, who owns 11 pharmacies from Bristol to Exeter, told BBC Points West that his pharmacies have been overwhelmed at times by people coming in with eye infections, Strep A and stiches they want removing.

He said a patient who had been sectioned, self-harmed and bled in his pharmacy and insisted his staff have had to deal with people with “complex mental health problems” who have broken down and cried. One patient, he claimed, died in one of his branches.

“We've seen a large increase in the number of people being referred, sometimes inappropriately, to the pharmacy. We are effectively the front line (of the NHS), especially after hours,” he said, suggesting the situation was putting some patients and staff at risk.

“To say it's stress and pressure, that's just part of the job and it's always been that way – this is beyond breaking point.”

Insisting the £14 fee per CPCS consultation was not enough, Mr Punni said: “We're looking at sort of a real-terms payment cut that we work out to be about 16 per cent over the last three years (with) no allowances made for inflationary pressures. The cost of everything has gone through the roof.”

PSNC chief executive Janet Morrison told Independent Community Pharmacist: "The volume of people and the complexity of the health needs that pharmacies are now being asked to help undoubtedly go well beyond the work that is affordable for them to do.”

She said pharmacy’s negotiator will continue to press the government for a fully funded Pharmacy First service which she insisted needed “to be commissioned urgently.” Ms Morrison said PSNC members told the prime minister Rishi Sunak “about the benefits of using pharmacy” during emergency talks with NHS leaders at Downing Street on Saturday.

“We are ready to negotiate this service as soon as Government and the NHS want to,” she said.

The National Pharmacy Association’s director of corporate affairs Gareth Jones told ICP it was “a good thing that even more people are trusting pharmacies with their healthcare” but warned “the context of immense financial and workforce pressures makes it extremely hard for pharmacies to satisfy the growing demand for care.”

“The community pharmacist consultation service is an important scheme, benefitting patients considerably when referrals are appropriate," he said. "With or without CPCS, the level of demand on pharmacists for healthcare advice and the complexity of the cases, appears to have increased – possibly linked to waiting times in other parts of primary care.

“Also as highlighted in the NPA-commissioned report from economists at UCL and LSE, seven years of real-terms cuts is having a very significant impact on the sector. Fresh funding is needed urgently, to maintain even the most basic pharmacy services as well as newer NHS schemes like CPCS.”

The Royal Pharmaceutical Society's director for England James Davies said the CPCS has "in some areas greatly benefited patients and improved access to constrained GP services for the public" but insisted "pharmacy services need to be sustainable and their roll-out must minimise administrative burden and be backed by investment and support for implementation."

"The local health system should work to ensure that referrals are appropriate," he added. Somerset LPC told ICP the GP CPCS in its area is “working well.”

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