CPCS – GP Referral Pathway
From 1 November 2020, the CPCS was extended across England to include referrals from general practices as well as from NHS 111. Unlike the implementation of the 111-referral pathway, the GP referral pathway will be activated at different times across the country, ideally happening across Primary Care Networks (PCNs).
CPH support for GP CPCS rollout in Hertfordshire
CPH continues to work closely with local stakeholders to support as many CPCS referrals from GP practices as possible.
The majority of Primary Care Networks and their GP practices in Hertfordshire have been supported to go live with varying degrees of referral rates.
All pharmacies should be ready to receive CPCS referrals from GP practices as according to the local process. Please ensure all team members are appropriately briefed and that referrals are picked up in a timely way.
Further information about the GP referral pathway including what contractors should have already done to prepare for the service is available within the resources section below along with some answers to FAQs we have received.
Below are some of the questions we received at the recent GP CPCS webinars run by Community Pharmacy Hertfordshire (CPH). If you have any further questions, please contact the CPH office as we will build on the below FAQs.
Q. Is there a way to get prompted when a referral is made via PharmOutcomes e.g, a text message?
A. There is no text service available for the pharmacies when a referral is made using the PharmOutcomes sytem. PharmOutcomes have provided a PharmAlarm service; a small device that plugs in to a USB port on your computer and flashes when you get a service message in PharmOutcomes. Please note this is additional cost to each individual pharmacy.
Q. In what ways can GP practices refer patients to community pharmacies?
A. There are a number of ways GP practice can refer to community pharmacies but the main way is using their clinical system in some way but sending it via nhs.net email. CPH is aiming for this to be as simple process as possible ideally with an integrated system that is simple for both GPs and pharmacies to use.
Q. Will GP CPCS referrals only be sent to the generic NHS mail address?
A. If GP referrals are being sent via nhs.net mail it will be sent to the pharmacy’s generic nhs.net mail only. If the referral is being sent via the integrated EMIS/PharmOutcomes route then that pharmacy will receive notification to the email addresses set on PharmOutcomes.
Q. What are the timescales by the community pharmacy for completion of a referral?
A. The local agreed process is that pharmacies should contact the patient within four working hours of the referral. Please note any referrals after 4.00pm are made the next day. If the patient has not made contact during the next working day, the pharmacist can close the referral, via the CPCS IT system, as ‘no intervention made’. No payment is due where there is no consultation (remotely or face-to-face) with the patient.
Q. Are there expected to be a large number of GP CPCS referrals
A. It is expected that referrals will start off on a small scale and the plan is to build this up to be business as usual.
Q. Which community pharmacys’ details are given to the patient for the service when referring?
A. GP practices must ask the patient for the details of their usual pharmacy. If the patient does not know they can search on the NHS pharmacy finder to agree their closest and most convenient community pharmacy for them. GP practices should not direct patients to a particular pharmacy and this will be monitored as part of the rollout by CPH.
Q. Community pharmacies already receive a lot of informal referrals from GP practices for the identified conditions. How will it be ensured that this is now undertaken via the CPCS referral route?
A. CPH is working hard to ensure that as part of the rollout in Hertfordshire that the informal referrals are now undertaken via the CPCS route and part of this is to ensure the referral from the GP practice end is as simple as possible. CPH would also encourage individual community pharmacies to feedback to the GP practices whereby they receive an informal referral to help educate the GP practice teams. Communications between community pharmacy and GP practice teams is key to the success of this service.
Q. Can we record an informal referral from the GP practice to the community pharmacy as a CPCS referral?
A. No. Community pharmacies will need to receive a formal referral from the GP practice by whichever route agreed in order for this to be a valid CPCS referral.
Q. How often do pharmacies have to contact patients before they can close the referral?
A. Pharmacies should aim to contact the patient up to 3 times. If the patient cannot be contacted and does not contact the pharmacy the referral can be closed on the next working day.
Q. Will community pharmacies receive out of area referrals?
A. Yes, community pharmacies can get out of area referrals as it is a national service however it is less likely with the GP practice referral than with NHS 111 due to the GP practices registered patient list. You are more likely to receive an out of area referral from a GP practice that is situated outside of Hertfordshire but you deal with on a regular basis.
Q. What if the pharmacy has a different contact number for the patient than the one provided by the GP practice?
A. The patient’s contact number is sent across with the referral, the receptionist must ask their preferred telephone number on which they can be contacted on and add it to the referral.
Q. Will the NHS conditions list identifying those patients that can be referred be shared?
A. Yes, the NHS conditions list for identifying the most appropriate patients along with potential red flags will be provided to all GP practices and community pharmacies before go live.
Payments and Claims
Q. What is the payment to the community pharmacy for a CPCS consultation?
A. £14; the same as for any referrals from NHS 111.
Q. Pharmacies often border with other areas and may end up with different ways in which GP practices refer. Is there recognition in the GP CPCS payment for the additional work that may be required if it is more onerous for the pharmacy to receive and complete the referral?
A. The same GP CPCS completion payment is £14 for community pharmacies regardless of the referral route. Please note this service was nationally negotiated and CPH is supporting its local implementation.
Q. Are claims automatically transferred to the Manage Your Service (MYS) portal when recorded on PharmOutcomes?
A. All claims for CPCS must be made via the MYS portal. Activity recorded and saved in PharmOutcomes will be used to prepopulate your claim information displayed in MYS. PharmOutcomes will not automatically submit your pharmacy’s claim? All national service claims submitted via MYS will require pharmacy confirmation. The information you record on PharmOutcomes will prepopulate the MYS claim screen, but you will need to login to MYS to confirm and submit the claim before the 5th day of every month. Further information on the claiming process can be found in the help section on CPCS on PharmOutcomes.
Q. If I receive a referral but cannot contact the patient, can I claim the consultation fee?
Q. How do we get access to the Virtual Outcomes training for GP CPCS?
Q. Is the Virtual Outcomes training mandatory for GP CPCS?
A. No. However, we would strongly encourage you to undertake this training. It has been designed by those that are already live and all pharmacy staff involved within the service do have to undertake some form of training. We would suggest this is one of the best options in order to successfully brief and train your team. Please note CPH has funded this training module out of its funds in order to support you.
Q. What are the back-office telephone numbers to the practices?
A. This information has been collated and shared with the pharmacies that are already live. CPH will work to ensure that this information is provided to all pharmacies that go live. If you pharmacy is already live and does not have this information please contact the CPH office for these details.
Q. What happens if GP practices do not want to participate?
A. There are a few GP practices that may not wish to participate in the CPCS service and that is their decision because it is not part of their contract. However, there are a number of GP practices that see the benefit of the service and by working with these practices first CPH hope to report back on the successes and outcomes therefore encouraging other GP practices to take part. CPH is also hoping to rollout this out amongst Primary Care Networks (PCNs) in order that the GP practices in a PCN will support each other to make the service a success.
Q. Are GP practice managers and staff prepared to engage in CPCS?
A. CPH is working closely with all local stakeholders to ensure that GP practices are aware of the benefits dealing with any queries and encouraging them to engage.
Q. Have all local GP practice staff i.e. receptionists received their training?
A. No. All GP practices staff will have support and training when they are going live. It is recognised that when the service goes live there will be a need for continuing support and training on an ongoing basis to ensure the service is a success.
Q. Will GP practice staff receive training on triaging patients?
A. No. GP practice staff will receive training on the service and how to utilise the service. GP practice receptionists will not be triaging patients clinically as they are signposting them to the community pharmacy via a referral process.
Q. Is there a cost benefit to GP practices to refer for CPCS?
A. There is no direct cost benefit or incentive because they are not paid to engage or make the referral. However, there are indirect cost and resource benefits as it frees up appointments for other patients.
Service Requirements and Rollout
Q. What are the record keeping requirements for this service?
A. Full information on the requirements of the service is available on the PSNC website. All pharmacies should ensure they are familiar with the service specification and the toolkit as a minimum.
Q. How do we get updates on GP CPCS and when it is going live in my area of Hertfordshire?
A. Please keep an eye on our weekly e-news for all updates. If you don’t get our e-news you can email email@example.com to be added. A local meeting for all pharmacies will be set up when go-live is imminent in order to prepare pharmacies for how it would work once the GP practices go live.
Q. When will all GP practices be live with CPCS in Hertfordshire?
A. CPH is working with the Herts and West Essex Integrated Care System to ensure that all PCNs and GP practices have the opportunity to go live with GP CPCS by end of February 2022. h
Q. Who pays for the medicines cost for patients?
A. The only medicines being supplied to patients at the current time are OTC medicines so that cost will be for the patient. There are currently no NHS PGD services (other than the ones already commissioned by Public Health in Hertfordshire) although this is being looked at for the future but this will be in addition to CPCS as an additional signposting service.
Q. Can the community pharmacy use PGDs with this service?
A. If your community pharmacy has private PGDs, you can offer this as a signposting to this service if the patient is willing to pay. You can use any public health commissioned PGDs where relevant as this will be a signposting into this as an additional service. Community pharmacies must complete the full CPCS consultation in order to claim the payment. There are no NHS commissioned PGD services currently.
Q. Does the community pharmacy need written consent from patients in order to deliver the service?
A. No, written consent is not required from patients but the pharmacist conducting the consultation will need to take the appropriate verbal consent as part the CPCS consultation as outlined with the service requirements.
Q. Do we have to keep manual printed paper records of the CPCS consultation?
A. Depending on how you choose to record your consultation, you do not have to keep paper records if this is recorded electronically for example on PharmOutcomes.
Q. Can we use the Summary Care Record (SCR) as part of the CPCS referral and consultation?
A. Yes as long as it is indicated and you follow your normal pharmacy protocols for accessing patient information on the SCR.
NHS 111 CPCS Referrals
Q. Is there a back office number for NHS 111 similar to the one provided for GP practices for CPCS?
A. Yes. Pharmacies are reminded that if they receive a referral from the local NHS 111 service, they should not make the patients call back NHS 111 if they cannot resolve the issue.
Pharmacies have been provided with the relevant details in order to refer back into the NHS 111 service. CPH has recently sent out by post one copy of a quick guide to our local NHS 111 and the contact details you require for your relevant SOP to each pharmacy that we have recently checked with the relevant organisations in Hertfordshire. Unfortunately we can’t provide it within the e-news or on our website because the information must not be made publicly available. If you would like a copy electronically, please email the CPH office and we will email you a copy.
- PSNC CPCS GP Referral Pathway Information
- GP referral pathway to the CPCS – Action Plan template for pharmacy teams (Word)
- GP referral pathway to the CPCS – Action Plan template for pharmacy teams (PDF)
- Hertfordshire Conditions List for referral to community pharmacies
- Referral Process for EMIS Hertfordshire GP practices
- Systm One Local Pharmacy Process GP-CPCS Hertfordshire
- GP-CPCS Local Pharmacy Process
- Virtual Outcomes Training (free for all Hertfordshire Pharmacy Teams) funded by CPH. This online training includes a comprehensive CPCS training package to support pharmacies and GP practices with the CPCS service. The package of courses includes local implementation and delivery training for pharmacy teams as well as CPCS training aimed at GP Practice teams.
- CPPE has a range of training resources on their CPPE website which can be used by pharmacists in preparation to provide the CPCS, including a self-assessment framework which supports pharmacists in reflecting on their knowledge and skills. It is recommended that pharmacists use this framework to plan their learning ahead of providing the service.
- CPCS free workshops delivered by RPS – CPD for pharmacists is available to support effective patient-facing consultations and clinical assessments for a range of common minor illness. The training is delivered via a combination of online pre-learning and interactive online workshops and facilitated by experienced individuals, including GPs and advanced practitioner trainers. These workshops have been designed to support pharmacists in managing CPCS referrals and provide an excellent opportunity to be able to practice the skills required to deliver effective CPCS consultations.