NHS

Question 1

Why is CPCF needed?

Answer 1

Tackle strain of staff and finance of NHS

GP overwhelmed

Development of IT

Introduction to SCR and IP clinics

Question 2

Provision of CPCF

Answer 2

Pharmacists - upskilled

More resources provided -> more clinical service

Pharmacy technicians upskilled

Question 3

CPCF is agreed between what bodies?

Answer 3

Government

NHS

Community Pharmacy England (CPE)

Question 4

What are the four elements of CPCF?

Answer 4

Essential services

Advance services

National Enhanced Services and Locally Enhanced Services

Pharmacy Quality Payments

Question 5

Name 9 current essential services

Answer 5

Dispensing medicines

Healthy living pharmacy

Discharge medicines service

Support for Self-care

Signposting

Disposal of unwanted med

Repeat medication

Dispensing appliances

Public Health

Question 6

10 advance services of CPCF

Answer 6

Flu Vaccination Service

Hypertension Case-Finding Service

Pharmacy Contraception Service

Lateral flow device test Service

New Medicine Service

Appliance Use Reviews

Stoma Appliance customisation

Community Pharmacy Consultation Service

Hepatitis C Testing service

Question 7

What service has been replaced?

Answer 7

Medicine Use Review (MUR) to Discharge Medicine Service (essential)

Question 8

How can patients obtain community consultation service?

Answer 8

NHS 111

999 Service

GP referral for minor illness consultation

Primary care out-of-hour service

Referred by other urgent and emergency care provider

Question 9

What are the 2 stages of hypertension case-finding services?

Answer 9

Identification of ppl at risk of hypertension -> offer BP measurement

If clinically indicated, offering 24 hours ABPM

Question 10

What are the 3 stages of the Discharge Medicines Service?

Answer 10

Referral received to pharmacy

Medicines reconciliation process

Patient consultation on understanding

Question 11

What are the two main dimensions in the pharmacy quality scheme?

Answer 11

Gateaway criteria: must be met on day of declaration to qualify for payment

Domains of the quality criteria: quality within a domain to be met for a payment for that domain

Question 12

Differences between gateaway domains and domain of quality criteria

Answer 12

Gateaway domain must be met first to be able to qualify for a payment of domain of quality critera

Question 13

The 6 current legislation of the CPCF?

Answer 13

Health and Social Care Act 2012

Equality Act 2010

Health Act 2009

NHS act 2006

NHS regulation 2019 - Serious Shortage Protocols (SSPs)

Human Medicines Regulations 2012

Question 14

When is Serious Shortage Protocols (SSPs) used?

Answer 14

In the even of medicine being in a serious shortage

Considered by the Secretary of State for Health and Social Care

Question 15

What should be stated in the SSPs?

Answer 15

Specify action to be taken for specific patient groups within a timeframe

Specificy alternative product or quantity may be supplied

Question 16

What happened to the prescriptions after the medications are dispensed to the patients?

Answer 16

Seperated into specific sections

Include submission document FP34C which states quantity of items, prescription dispensed and services completed + code linked with pharmacy

Send to NHS Business Service Authority (NHSBSA)

Question 17

What are the requirements of a PGD?

Answer 17

Name of business own direction

Start and end date

Description of med applied

Class of healthcare professional who can supply

Signature of a doctor/dentist AND a pharmacist

Authorisation by an appropriate organisation

Clinical condition or situation apploed

Description of exclusion

Description of when to get more advice + referrals

Details of drugs (dosage, quantity supploed, strength, route of administration,..)

Warnings, potential ADRs

Statement of records

Question 18

What must be recorded when PGDs are applied?

Answer 18

Name of HCPs supplying or providing

Patient identifiers

Medicines providedW

Question 19

What medicines can be supplied through PGDs?

Answer 19

All POM, P and GSL meds

Except: unlicensed meds, dressings, appliances and devices, radiopharmaceuticals, abortifacients, certain CDs.

Question 20

Who cannot supply CDs under all five schedules under PGD?

Answer 20

Dieticians

Speech and language therapists

Dental therapists

Dental hygienist

Question 21

What CDs can be listed in PGD legislation?

Answer 21

Schedule 2: morphine and diamorphine for treatment of conditions, NOT addiction. Only provided by nurses and pharmacists

Schedule 2: Ketamine

Schedule 3: Midazolam

Schedule 4: All drugs except anabolic steroids and injectables for addiction

Schedule 5: All drugs

Question 22

Who contribute to the development of a PGD?

Answer 22

Doctor

Pharmacists

Representative of any professional group expected to supply

Authorisation from NHS trust, CCGs, LAs.

Question 23

How and when should be the expiry date of the PGD decided?

Answer 23

Decided on a case-by-case basis

Should not be more than THREE years from authorisation

Question 24

Two types of PGDs?

Answer 24

NHS PGDs - commissioning and authorisation and delivery from NHS body

Private PGDs - commissioned by NHS by delivered by public funded organisation

Question 25

What should be considered when making decision to supply through PGDs?

Answer 25

Medicines Patient group Reasons why Who will supply Under Patient Specific Direction?

Question 26

How can patients access PGDs in practice?

Answer 26

Engaged by advertising Referred by satisfied customer Engaged in-store by pharmacist or HCPs Referred by HCPs Returned after being given leaflet

Question 27

Differences of EHC supply between from PGDs and as P pharmacy?

Answer 27

Free of charge Given to clients aged more than 13 Taken immediately, before leaving Specific verbal advice Record-keeping requirements

Question 28

What is the rationale of New medicines service (NMS)?

Answer 28

Support people with long-term conditions with newly prescribed medicines Aim: improve adherence

Question 29

What are the 6 conditions that the contractors of NMS need to achieve to provide the service?

Answer 29

1. Satisfactorily complying with obligations under the terms of service 2. SOPs present 3. Have necessary knowledge and skill -> declared by NHS self-assess form 4. Notify GP surgeries within locality of intention to provide service 5. Consultation room complying with the requirements outlined 6. Completed intention to provide surface through declaration form through NHSE&I team

Question 30

Conditions that are included in the NMS.

Answer 30

Respiratory: Asthma and COPD Neurology: PD, Epilepsy, use of antidepressants Mucoskeletal: Osteoporosis Cardiology: AF, HTN, VTE long-term risk, HF, Stroke/TIA, Hypercholesterolaemia, ACS, CHD Endocrinology: T2DM, Gout Urinary incontinence or retention

Question 31

Eligible criteria of NMS?

Answer 31

Must be first prescription of that new medicines Verbal consent obtained and recorded Referral by a HCP at hospital responsible for that course of treatment

Question 32

What do patients need to know while consenting for NMS?

Answer 32

Provision of service Sharing of information between pharmacy and GP Sharing of information with NHSE&I Sharing of information with NHSE&I and NHSBSA

Question 33

Structure of NMS service

Answer 33

Stage 1: engagement stage (day 1) - consultation about the new meds Stage 2: 7 - 14 days after stage 1 - discussion about the ongoing of meds + advice Stage 3: 14 - 21 days after stage 2 - discussion and resolve issues

Question 34

Benefits of NMS for patients

Answer 34

Encourage shared decision making Early identification of issues Improve adherence -> improve quality of life Increase patient engagement -> self-manage their long-term conditions Range of healthcare providers Lifestyle changes + interventions Increase access to advice

Question 35

Benefits of NMS for pharmacists and healthcare system.

Answer 35

Expanding roles of the pharmacist Reduce medicine wastage QIPP agenda contribution Promote multidisciplinary working Support integration of community pharmacy -> signposting and referral service Improve pharmacovigilance Reduce hospital-related admissions Evidence-based effectiveness NHS long-term plan

Question 36

Is it possible to provide NMS service alongside the DMS service?

Answer 36

DMS - first-post discharge prescription is received NMS can be offered if clinically appropriate (if patient would get additional benefits)