Pharmacy First Toolkit

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Purpose of the toolkit

The Pharmacy First Toolkit is a resource designed to support the implementation of the Pharmacy First service within our Bedfordshire Luton and Milton Keynes integrated care system (BLMK ICS). While it primarily caters to general practice and community pharmacy teams, it also provides insights for professionals working across various sectors, including Urgent and Emergency Care (UEC).

Contents of the Toolkit:

Within this toolkit you will find a variety of resources that can be used to support the implementation of the Pharmacy First Service and includes the following:

  • Support Implementation: The toolkit equips healthcare professionals with essential resources, reference materials, and referral aides to facilitate the successful implementation of the Pharmacy First service. Whether you are a pharmacist, a GP, or part of the wider healthcare team, this toolkit offers practical guidance.
  • Background Information: Understand the context and rationale behind the Pharmacy First service. Learn about the seven new clinical pathways that allow pharmacy teams to assess and treat common conditions that would traditionally require treatment in general practice.
  • Urgent Repeat Medicines Supply: Explore the section on urgent repeat medicines supply. UEC and 111 settings can refer patients to community pharmacies for timely access to essential medications. General practices do not handle referrals for this element of Pharmacy First.
  • NHS Referrals for Minor Illness: Learn how patients can be referred from general practice, UEC, or 111 settings to a community pharmacy where a community pharmacist assesses the patient, provides advice, recommends treatments, or makes appropriate referrals.
  • Collaboration and Resolution: The toolkit supports the growth of the Pharmacy First service and provides solutions for any challenges encountered. It is a dynamic resource that is evolving as Pharmacy First is being implemented nationally and will be updated regularly with the latest information and guidance.

Please note that the contents of this toolkit are not intended for patient/public use but serve as a guide for healthcare professionals. If you need further information or support, refer to the contacts listed within the toolkit.

NHS Pharmacy First Service Overview

The NHS Pharmacy First Service builds upon the existing Community Pharmacist Consultation Service (CPCS), which has been operational since October 2019 effectively ended on the official launch of the Pharmacy First Service. The service was first announced as an essential part of the Primary Care Access and Recovery Plan in May 2023, and included a commitment to community pharmacies and one of the key elements of this commitment was strengthening the role of pharmacies in primary Care.

The NHS Pharmacy First Service which is a new community pharmacy advanced service launched on the 31st of January 2024 empowering pharmacists to assess and treat seven common conditions previously requiring GP visits in addition to the minor ailment referral, and urgent repeat medicines supply previously known as Community pharmacy consultation service (CPCS). This service aims to free up GP time, provide faster patient care closer to home, and reduce the pressure on the NHS by effectively managing minor illnesses in community pharmacies.

Enhanced Access:

The primary objective is to provide patients with quicker and more convenient access to healthcare services directly from their local pharmacy. By offering advice and NHS-funded treatment for common health conditions, these minor health issues are addressed promptly and prevented from worsening. The full Pharmacy First service is made of three elements below:

1. Pharmacy First- Clinical Pathways:

The Pharmacy First service includes seven new clinical pathways that enable pharmacists to manage specific health conditions. These pathways cover common issues such as sore throat, earache, sinusitis, and urinary tract infections. Please see the seven clinical pathways below in a separate section.

2. Pharmacy First- Urgent Repeat Medicine Supply:

Community pharmacies will continue to provide urgent repeat medicine supply to patients, through Urgent Care Centres and NHS 111 settings and other emergency care settings where patients are referred to community pharmacies for a supply of urgent repeat medicine. Note that general practices cannot refer into this element of pharmacy First.

3. Pharmacy First- NHS Referrals for Minor ailments:

Patients can be referred from various settings (general practice, urgent and emergency care, NHS 111) to community pharmacies for minor ailments consultations. Pharmacists will assess the patient, offer self-care advice, recommend appropriate treatments following robust clinical pathways, or refer to another setting or service if needed.

The New clinical pathways

The seven common conditions on the clinical pathways’ element of pharmacy First service are:

Information on the clinical pathways, including who can access, the inclusion/exclusion criteria have all been clearly set out in patient group directions (PGDs) to support the decision making for community pharmacists.

Patients can only self-refer into pharmacy service through the seven clinical pathways and general practices can also refer patients to pharmacies for conditions on the clinical pathways in addition to the minor ailment referral process of the pharmacy first service.

Referral Process and Patient Journey through Pharmacy First Service

A detailed patient journey and referral process has been written and included in the NHS Pharmacy First Service specification. See an outline.

General practices should refer patients to pharmacies using either an integrated GP electronic referral system or NHS mail. Community Pharmacies will send the outcome of the consultation via the referral routes according to locally agreed communication feedback processes.

Resource List for General Practice

Below you will find resources that can be used to support the implementation of Pharmacy First in general practice:

  • Pharmacy First best practice checklist

    Pharmacy First best practice checklist

    This is a checklist based upon learnings from the CPCS service. General Practice teams can use the prompts in this checklist to maximise on service delivery and enhance collaborative working practices.

    Click here 

  • Seven clinical pathways poster

    Seven clinical pathways poster

    Practice staff poster detailing the 7 clinical conditions that can be treated under Pharmacy First, including appropriate age ranges.

    Click here 

  • Pharmacy First inclusion/exclusion poster

    Pharmacy First inclusion/exclusion poster

    Printable posters for GP reception teams detailing inclusion and exclusion criteria for Pharmacy First minor illness and clinical pathways.

    Click here 

  • Pharmacy First Aide-Memoire

    Pharmacy First Aide-Memoire

    Simplified printable poster for GP reception teams detailing inclusion and exclusion criteria for Pharmacy First clinical pathways.

    Click here 

  • Escalation process for Pharmacy First issues

    Escalation process for Pharmacy First issues

    There are likely to be issues in setting up new services. We suggest that the first two steps in the escalation process be followed to assist if there are any issues with Pharmacy First referrals. Should the first two steps recommended fail to resolve the issue please use the Microsoft form included in the report repeated issues to the ICB (Integrated Care Board).

    Click here 

  • Pharmacy First summary for GP teams

    Pharmacy First summary for GP teams

    BLMK ICB Community Pharmacy Integration team have produced a Pharmacy First summary aimed at GP reception teams and care navigators. This can be used to support training.

    Click here 

Resource list for Community Pharmacies

Below you will find a suite of resources that can be used to support the implementation of Pharmacy First in a community pharmacy.

  • Pharmacy First best practice checklist

    Pharmacy First best practice checklist

    This is a checklist based upon learnings from the CPCS service. Pharmacy teams can use the prompts in this checklist to maximise on service delivery and enhance collaborative working practice.

  • Campaigns | Campaign Resource Centre (dhsc.gov.uk)

    Campaigns | Campaign Resource Centre (dhsc.gov.uk)

    Patient Facing Promotional Materials – Produced by Department of Health and Social Care-NHS England. The Department of Health and Social Care (DHSC) are planning a significant communications campaign for Pharmacy First. Media assets will be available via the DHSC Campaigns resources website. You may need to register to access the resource.

    This will feature community pharmacists and is planned to start from the 19th February 2024

    Read more

  • Pharmacy First service specification

    Pharmacy First service specification

    Links to service specification, clinical pathways and patient group directions that support this service.

    Click here

  • NHS England Pharmacy First Webpage

    NHS England Pharmacy First Webpage

    In May 2023, NHS England and the Department of Health and Social Care announced a Delivery plan for recovering access to primary care.

    Part of the plan includes enabling patients to get certain prescription medications directly from a pharmacy, without a GP appointment. Please see the link below for more information:
    https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-first/ 

     

  • Process for Updating Directorate of Service (DoS)

    Process for Updating Directorate of Service (DoS)

    Printable poster on what pharmacy teams must do if they cannot open the pharmacy premises for services or temporarily unable to offer Pharmacy First.

    Click here

  • Escalation Process for Pharmacy First related issues

    Escalation Process for Pharmacy First related issues

    There are likely to be issues in setting up new services. We suggest that the following process above should be followed to assist if there are any issues with Pharmacy First referrals. Should the first two steps recommended fail to resolve the issue please use the attached BLMK Pharmacy First Feedback form to report repeated issues to the ICB.

    Click here

  • Pharmacy FIRST Resources for Community Pharmacy BLMK and Northants

    Pharmacy FIRST Resources for Community Pharmacy BLMK and Northants

    Pharmacy Northants MK merged on July 1st, 2023, with Bedfordshire LPC and is now known as Community Pharmacy BLMK & Northants. This LPC represent all Community Pharmacy Contractors in Bedfordshire Luton, Northamptonshire, and Milton Keynes. The LPC work with the NHS and Local Authorities, to negotiate pharmacy services and support integrated delivery of healthcare services in BLMK. Access to pharmacy First and other useful resources is also available on their website.

    Click here

  • Northants (Formerly LPC) Newsletter

    Northants (Formerly LPC) Newsletter

    To access the Weekly newsletter for CP BLMK & Northants please click here. For Local news and information for community pharmacy contractors and their teams.

    Click here 

  • Participating Pharmacies in BLMK

    Participating Pharmacies in BLMK

    Community pharmacies in Bedfordshire Luton and Milton Keynes are signed up to deliver all elements of Pharmacy First. There are 3 ways you can find pharmacy details:

    • Integrated GP IT referral system (SystmOne local services) – When sending a referral, the system will automatically return nearby pharmacies that are currently able to offer the Pharmacy First service. (Not all general practices are currently updated with this function).
    • NHS Service Finder– Tool for healthcare staff to search for live services close to a defined postcode. Search for ‘Pharmacy First’ under Type of Service.
    • NHS Find a Pharmacy– Public facing portal to enable anyone to search for a pharmacy close to a defined postcode. It currently cannot search for pharmacies specifically offering Pharmacy First, but 95% of pharmacies in England offer the service with a similar picture in BLMK with nearly 100% of community pharmacies now registered to provide the service.
    • Healthcare professionals can use the NHS Service Finder to locate pharmacies that are participating in the service.
  • Other Services

    Other Services

    NHS Pharmacy contraception Service

    NHS Community Pharmacy Oral Contraception Service – This service enables people seeking contraception to obtain supplies from community pharmacies without first visiting a GP or sexual health clinic. Please see service specification here
    Members of the public can find a local pharmacy offering this service by utilising the NHS Find a pharmacy offering contraception tool.

    NHS Blood Pressure Check Service

    This service allows community pharmacy teams to offer people over the age of 40, without a diagnosis of hypertension, a BP check to find those with undiagnosed hypertension. In addition, they can also carry out BP checks (including ABMPs) at the request of practices. Please see service specification here

    Members of the public can find a local pharmacy offering this service by utilising the NHS Find a pharmacy offering blood pressure checks tool.

     

  • Contacts

    Contacts

    For further information on how this can help support your practice.

    Shenaz Emamally, Pharmacy Integration Support Manager
    [email protected]

    Funmi Balogun, Community Pharmacy Integration Lead
    [email protected]

    Anne-Marie King, Chief Officer Community Pharmacy England- BLMK & Northants
    [email protected]

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