CPCS a 'complex mess' and needs reform, says leading GP
By Neil Trainis
Exclusive: Dr Richard Vautrey, the former chair of the British Medical Association’s GP committee, has described the Community Pharmacist Consultation Service as “a complex mess” and called on the government to review it.
Dr Vautrey, who stood down as chair of the BMA’s GP committee last year, made these comments in an interview with Independent Community Pharmacist to be published next month. He said the CPCS, which was set up to make it easier and quicker for patients to be seen for minor illnesses, complicated patient referrals from practices to pharmacies, was bureaucratic and time-consuming for GPs and increased their workload and stress levels.
He also warned that it made it difficult for eligible patients to get free prescriptions, arguing that the previous minor ailments scheme had allowed prescription charge exempt patients to access more medicines without paying. Under the CPCS, he said, patients were returning to practices from pharmacies upset that they had to pay.
“This is the way that NHS England has established the system," he explained. "They have put in place a referral process which adds to the burden of general practice and isn’t as good as what we had before when we had various minor ailment schemes where we effectively just directed patients to the pharmacy next door or over the road.
“And that’s what we want; we want to be able to encourage patients to use pharmacy appropriately and identify those patients who would benefit from the services of a pharmacist.
"But what we’ve got is a system that is more about trying to measure the number of referrals that are made and to make payments to pharmacists rather than supporting that direct engagement between practices and pharmacists.”
Filling forms 'takes up to 10 minutes'
Dr Vautrey said he and his staff at Meanwood Group Practice in Leeds have had first-hand experience of the difficulties of the CPCS which had left them with irritated patients.
“It’s just taking time. I was sat with my reception staff [recently] to work through what happens when they receive a call and it’s taking them up to 10 minutes to work through the questions and the form-filling that’s required. We could’ve dealt with that patient in that time,” he said.
“At the same time that the patient is being held on the phone, it means other patients are getting irritated because they can’t get through because the reception staff are trying to deal with the particular patient’s problem and direct them to a more suitable service.”
'Piecemeal funding with strings attached'
He also criticised the government for trying to incentivise GPs to increase referrals to community pharmacies and insisted ministers simply needed to trust them “to get on with it".
The primary care network contract contains an investment and impact fund that incentivises GPs to engage with pharmacies while the £250m winter access package came with a proviso that GPs engage with the CPCS.
“We need less targets and goals and bits of money in this pot and that pot and we just need to be given the proper resource to get on and deliver the service, similar with pharmacy, rather than having piecemeal funding and various strings attached to various different funding streams,” he said.
Calling for an immediate review of the CPCS, Dr Vautrey said: “Practices are expected to sign up to the scheme to access some other money and that’s just one of the many strings attached to the access of this funding which is really desperately needed in practices and yet they’re having to go through this process to access it.”