W19 The Pharmacy Contract Flashcards
(38 cards)
Who are locally commissioned Pharmacy services created by ?
Contracted via a number of different routes and by different commissioners, including local authorities, Health Boards (Wales), Clinical Commissioning Groups (CCGs - England) and local NHS England teams.
What are essential services in a pharmacy? (9)
(offered by all pharmacies)
Dispensing Medicines
Dispensing Appliances
Clinical Governance
Discharge Medicines Service
Repeat Dispensing
Public Health promotion
Signposting
Support for Self Care
Disposal of Unwanted Medicines
Prescribing Vs Dispensing
Prescribing- Assessment, History taking, Clinical Check, Writing prescription, Giving out medication
Dispensing- Giving out medication
What is Dispensing?
What has been implemented as a modern way to dispense?
The supply of medicines and appliances ordered on NHS prescriptions, together with information and advice, to enable safe and effective use by patients and carers, and maintenance of appropriate records.
The Electronic Prescription Service (EPS)
What is Repeat Dispensing/electronic Repeat Dispensing (eRD)?
Under the repeat dispensing service pharmacy teams will..? (3)
An essential service within the CPCF.
Most prescriptions generated in primary care are for patients needing repeat supplies of regular medicines.
- Dispense repeat dispensing prescriptions issued by a GP
- Ensure that each repeat supply is required; and
- Seek to ascertain that there is no reason why the patient should be referred back to their GP.
The majority of repeat dispensing is carried out via EPS and is termed electronic Repeat Dispensing (eRD).
What is the definition of Clinical Governance?
“A framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”.
nutshell= continuous quality improvement
What are examples of Clinical Governance? (4)
- Use of standard operating procedures
- Recording, Reporting and learning from adverse incidents
- Participation in continuing professional development and clinical audit
- Assessing patient satisfaction
What are SOPs?
=Standards of Operating Procedures
Steps to do a task correctly
What are the Pillars of Clinical Governance? (7)
1.Processes for quality improvement
2. Staff focus
3. Use of information
1) Processes for quality improvement
1. Patient and public involvement
2. Clinical audit
3. Risk management
4. Clinical effectiveness
(2) Staff focus
5. Staffing and staff management
6. Education, training and CPD
Use of information
7. Use of information to support clinical
governance and healthcare delivery
What is the Discharge Medicines Service (DMS)?
- Patients who have recently been discharged from hospital will get greater support from local
pharmacy teams to manage their medicines. - Hospitals refer patients who would benefit from extra guidance around new prescribed medicines to their community pharmacy.
- Patients are digitally referred to their pharmacy after discharge from hospital.
- The NHS DMS will help patients get the maximum benefits from new medicines they’ve been prescribed by giving them the opportunity to ask questions to pharmacists and ensuring any concerns are identified as early as possible.
- This is part of the Health Secretary’s ‘Pharmacy First’ approach to ease wider pressures on A&Es and GP.
What are the 4 key areas for giving opportunistic advice?
Patients receiving prescriptions who appear to:
* Have diabetes;
* Be at risk of coronary heart disease (CHD), especially those with high BP;
* Who smoke;
* Are overweight.
What are the services that help promote public health/healthy lifestyle in a pharmacy? (2)
- Prescription linked intervention
-Pharmacists and their staff will give opportunistic advice to people presenting prescriptions.
-The advice is given verbally, but may be backed up by written information.
-A record of the advice given is made on the patient’s pharmacy record.
-Pharmacy contractors have systems in place to ensure that appropriate advice is given to patients. - Campaign based service
- The pharmacy provides this service to its primary care organisations (PCO) for up to 6 campaigns per year.
Explain the Pharmacy service of Disposal of unwanted medicines:
Acceptance, by community pharmacies, of unwanted medicines from households and individuals which require safe disposal.
Service outline:
* Community pharmacies act as a collection point for the public’s unwanted medicines.
* Returned medication are stored in UN type containers provided by the waste disposal contractor.
* Returned solid medicines/ ampoules, liquids and aerosols are separated.
* Pharmacy contractors should ensure that their staff are made aware of the
risk associated with the handling of waste medicines.
* Appropriate protective equipment, including gloves, overalls and materials to deal with spillage, must be readily available close to the storage site.
What is Signposting?
The provision of information to people visiting the
pharmacy, who require further support, advice or treatment which cannot be provided by the pharmacy, on other health and social care providers or support organisations who may be able to assist the person.
Describe the Support for self care service:
The provision of advice and support by pharmacy staff to enable people to derive maximum benefit from caring for themselves or their families.
Service outline
- Pharmacy staff provide advice to people, including carers, requesting help with the treatment of minor illness and long-term conditions, including general information and advice on how to manage illness.
-Pharmacy staff advise on the appropriate use of the wide range of non-prescription medicines which can be used in the self-care of minor illness and long-term conditions.
-Pharmacy staff make healthy lifestyle interventions opportunistically when appropriate.
-Pharmacy staff receive self-care referrals from NHS Direct and HCPs.
-Pharmacy staff signpost patients to other health and social care providers.
-For patients known to the pharmacy staff, records of advice given, products purchased or referrals made are made on a patient’s pharmacy record when the pharmacist deems it to be of clinical significance.
Give examples of Advanced Services provided by a pharmacy (10):
Appliance Use Review (AUR)
Community Pharmacist Consultation Service (CPCS)
C-19 Lateral Flow Device Distribution Service
Flu Vaccination Service
Hepatitis-C Testing Service
Hypertension Case-Finding Service
New Medicine Service (NMS)
Pandemic Delivery Service
Stoma Appliance Customisation (SAC)
Stop Smoking
Explain the Appliance Use Review (AUR) advanced service:
Introduced into the NHS (CPCF).
* AURs can be carried out by a pharmacist or a specialist nurse in the pharmacy or at the patient’s home OR provided by telephone or video consultation.
AURs should improve the patient’s knowledge and use of any appliance by:
* Establishing the way the patient uses the appliance;
* Identifying, discussing and assisting in the resolution of poor or ineffective use of the appliance by the patient;
* Advising the patient on the safe and appropriate storage of the appliance;
* Advising the patient on the safe and proper disposal of the appliances that are used or unwanted.
What is the Community Pharmacist Consultation Service (CPCS)?
- The service CONNECTS patients who have a minor illness or need an urgent supply of a medicine with a CP.
- Referrals from GPs, NHS 111, Integrated Urgent Care Clinical Assessment Services, 999 in some cases
- Aims to relieve pressure on the wider NHS by connected patients with a CP
What 4 priority services does the CPCS encompass?
1-Common ailments
2-Emergency contraception
3-Emergency medicine supply
4-Seasonal flu jabs combined in a single, national
Clinical Community Pharmacy Service (CCPS).
Which main categories are advised to have a flu vaccine? (4)
(Seasonal Flu Vaccine Service)
Where are they given?
- You are pregnant
- You are aged 50 or over
- You have a long term health condition that puts you at increased risk from flu
- You live in a care home
Community Pharmacies and GP practices
Other groups:
* Children aged two and three years old (age on 31 August 2021)
* Children and young people in school years Reception to Year 11
* Carers
* People working directly with patients/clients in health or social care
* Those who live with someone who has a compromised immune system
C-19 Lateral Flow Device Distribution Service- For info
(This service no longer exists)
- At the end of March 2021, a new Advanced service – the NHS community pharmacy COVID-19
lateral flow device distribution service (or ‘Pharmacy Collect’) – was added to the NHS CPCF - This service, which pharmacy contractors can choose to provide, as long as they meet the
necessary requirements, aims to improve access to COVID-19 testing by making lateral flow device (LFD) test kits readily available at community pharmacies for asymptomatic people, to identify COVID-positive cases in the community and break the chain of transmission. - The service is part of the Government’s offer of lateral flow testing and it works alongside NHS
Test and Trace’s other COVID-19 testing routes.
What is the Hepatitis C Testing Service?
- The service is focused on provision of point of care testing (POCT) for Hepatitis C (Hep C)
antibodies to people who inject drugs (PWIDs), i.e. individuals who inject illicit drugs, e.g. steroids or
heroin, but who haven’t yet moved to the point of accepting treatment for their substance use. Where people test positive for Hep C antibodies, they are referred for a confirmatory test and treatment, where appropriate. - The CP Hepatitis C Antibody Testing Service was added to the CPCF in 2020.
What are the 2 stages in the Hypertension case-finding Service?
- The first stage is identifying people at risk of hypertension and offering them blood pressure measurement (a ‘clinic check’).
- The second stage, where clinically indicated, is offering 24 hour ambulatory blood pressure monitoring (ABPM). The blood pressure test results are then shared with the patient’s GP to inform a potential diagnosis of hypertension.
Contractors opting to provide the service must undertake both stages of it, where clinically required, i.e. it is not possible to just undertake clinic
BP readings and not ABPM.
- The service is only provided by pharmacists,
- The service must be delivered under pharmacist supervision it is provided by other staff.
What is the New Medicine Service (NMS)?
Give some examples of conditions eligible for this service.
This service provides support to people who are newly prescribed a medicine to manage a long term condition, which will generally help them to appropriately improve their medication adherence and self-manage their condition.
