Pharmacies receive up to £10 per consultation in smoking cessation pilot

Pharmacies are being paid up to £10 per patient consultation as part of a national smoking cessation service pilot.

The pilot, which was first set out in the Community Pharmacy Contractual Framework for 2019 to 2024, sees patients referred from secondary care to community pharmacies for continued smoking cessation support.

The service is currently being trialled in 12 community pharmacies in Oldham, Greater Manchester.

As part of the pilot, hospital trusts identify patients who smoke, before providing them with a pre-quit assessment and starting them on treatment.

Then, with their consent, patients are referred to a participating community pharmacy when they are discharged from hospital.

According to the service specification, the referrals are made using a secure electronic referral system and include details of the tobacco dependence treatment items and quantities supplied to the patient.

Patients can choose which pharmacy they are referred to, but the pharmacy must contact the patient within five days of receiving a referral.

At each level, a patient’s smoking status is validated using carbon monoxide (CO) monitoring, with a successful quit attempt defined as a CO test reading of less than 10 parts per million, 4 weeks after the quit date. Progress is measured at week 4 and week 12 of the programme.

“This does not imply that treatment should stop at four weeks,” the service specification explains.

“Ongoing support will be provided for successful week four quitters for up to 12 weeks from their quit date.”

Owing to COVID-19 restrictions, the specification says pharmacies participating in the pilot can rely on self-reported smoking status and conduct telephone consultation, where the service would otherwise require face-to-face consultations.

Pharmacies will be paid £10 per consultation with patients undertaking level 3 of the programme, and £5 per consultation with level 2 patients.

The consultation fee covers CO monitoring, behavioural support and advice at follow-up appointments every 1 or 2 weeks, and for week 4 and week 12 reviews.

Pharmacies will also be paid £2.60 per visit from patients on both levels to cover dispensing activity as well as a one-off £180 payment to cover training.

“The pilot creates additional capacity and is not a replacement for local authority commissioned services where treatment may be started in a community pharmacy or elsewhere in primary care,” says the NHS England service specification.

The Pharmaceutical Journal revealed in 2018 that almost a fifth of local authorities in England had decommissioned pharmacy-led smoking cessation services in the previous three years.

Luvjit Kandula, director of pharmacy transformation at Greater Manchester Local Pharmaceutical Committee, said the pilot ”is a real positive step in supporting the integration of community pharmacy and secondary care to support our local populations to stop smoking and support the prevention agenda through collaborative working”.

“We hope that the evaluation will further demonstrate the value of community pharmacy in supporting healthier lifestyles and the prevention agenda,” she told The Pharmaceutical Journal.

The pilot is expected to run until 31 March 2021, and the service specification said the pilot will “inform the 2021–2022 Community Pharmacy Contractual Framework negotiations as part of the five-year agreement from 2019–2024”.