Realist evaluation of the NHS Community Pharmacist Consultation Service (NHS-CPCS) for urgent, low acuity conditions: how, when, why, for whom and to extent does it work to benefit patients

PI Title:  Ellen Schafheutle

Lead member: Manchester

"BACKGROUND
When people contact their general practitioner (GP), they are usually offered an appointment with a member of the general practice team (e.g. GP, nurse). With general practices under pressure, the NHS Community Pharmacist Consultation Service (NHS-CPCS) was recently introduced across England. This service enables general practice to refer people with urgent, non-serious symptoms to a community pharmacist in a local chemist. Being given options means more patient choice but could also makes navigating healthcare more complex for people. General practices and community pharmacists need to work together, so that people receive the right care from the right person at the right time.

AIM
To evaluate the NHS-CPCS GP referral service, to better understand what makes the service work (or not), for whom (people with urgent, non-serious conditions, and staff in general practices and community pharmacies), how, when and why.

METHODS
We will use an approach called ‘realist evaluation’ in our study.

In Part 1, because we have a very good understanding of how people’s urgent, non-serious conditions are looked after in primary care, and if/how general practice and community pharmacy work together, we will start by looking at the intentions of policy makers in England and Scotland. This will help us understand how they see the NHS-CPCS’s role in primary care integration, staff in general practice and community pharmacy, and services for urgent, non-serious conditions.

Part 2 will test our understanding of what works well and less well in the NHS-CPCS service for urgent, non-serious condition management and why. We will:

- select up to six general practices, up to four where NHS-CPCS referrals are made, and two where the service works less well; these will be located in different areas (urban and rural, deprived and affluent),
- interview 36 staff in these general practices and up to three community pharmacies they refer to,
- survey and interview people (including carers/parents) who contact their general practice about urgent, non-serious conditions, whether they agree to a referral or not.

Part 3 will bring together (online) people and staff from general practice and pharmacy, and local and national policy makers, to discuss our findings and recommendations. From this we will develop a ‘set of considerations’ aimed at those implementing NHS-CPCS, so that the service works for people’s different needs.

Two lay persons are part of our team to ensure lay voices are heard throughout this project. We will include people likely to need support with non-serious conditions, particularly those in deprived and hard to reach areas, especially in Parts 2 and 3 of the project.

There is a glossary of terms and abbreviation in the final section."

Amount awarded: £249,636