19. Essential, Enhanced and Advanced Services Flashcards
What are essential services?
Services offered by all pharmacy contractors as part of the NHS Community Pharmacy Contractual Framework (the ‘pharmacy contract’)
What are locally commissioned services?
Locally commissioned community pharmacy services can be 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 the essential services provided by community pharmacy’s?
- Dispensing medicines
- Clinical Governance
- Dispensing Appliances
- Discharge Medicines Service
- Signposting
- Support for self care
- Repeat dispensing
- Public Health (promotion of healthy lifestyles)
- Disposal of unwanted medicines
What is meant by ‘dispensing medicines’ under essential services?
The supply of medicines and appliances ordered on NHS prescription, with information and advice (PIL), to enable safe and effective use by patients and carers, and maintenance of appropriate records
The Electronic Prescription Service (EPS) is also being implemented as part of the dispensing service
Pharmacists may regularly dispense appliances in the course of their business (see drug tariff)
What is meant by ‘repeat dispensing/electronic Repeat Dispensing (eRD)’ under essential services?
- Repeat dispensing is an Essential Service within the Community Pharmacy Contractual Framework (CPCF)
- Most prescriptions generated in primary care are for patients needing repeat supply of regular medicines.
- Under the repeat dispensing service pharmacy teams will:
— dispense repeat dispensing prescriptions issued by a GP
— ensure that each supply is required
— seek to make sure that there isn’t any reasons for the patient should be referred back to their GP. - Since the development of Electronic Prescription Service (EPS), the majority of repeat dispensing is carried out this way and is termed, electronic Repeat Dispensing (eRD).
What is EPS?
Electronic prescription service
What is eRD?
Electronic Repeat Dispensing (repeat dispensing under EPS)
What is meant by ‘clinical governance’ under essential services?
“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”
- Clinical governance (Continuous Quality Improvement) should be built into all professional services
- Examples include use of standard operating procedures; recording; reporting and learning from adverse incidents; participation in continuing professional development and clinical audit; and assessing patient satisfaction
What are the pillars of clinical governance?
- Processes for quality improvement
— 1. Patient and public involvement
— 2. Clinical audit
— 3. Risk management
— 4. Clinical effectiveness - Staff focus
— 1. Staffing and staff management
— 2. Education, training and CPD - Use of information
— 1. Use of information to support clinical governance and healthcare delivery
What is meant by the ‘discharge medicines service’ (DMS) under essential services?
- 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 is meant by ‘public health - promotion of healthy lifestyles’ under essential services?
- The provision of opportunistic healthy lifestyle advice and public health advice to 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 is the service outline for ‘public health - promotion of healthy lifestyles’?
- Prescription linked interventions:
— 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.
What is meant by ‘disposal of unwanted medicines’ under essential services?
Acceptance, by community pharmacies, of unwanted medicines from households and individuals which require safe disposal.
What is the service outline for disposal of unwanted medicines?
— 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 meant by ‘signposting’ under essential services?
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.
