Community pharmacy contractual framework Flashcards
advanced services
optional, national services
can only provide if fully compliant with essential services
must meet requirements to provide
currently 8 services
what are the 8 advanced services
- new medicines service
- community pharmacist consultation service
- appliance sue reviews
- stoma appliance customisation
- NHS seasonal flu vaccinations
- hypertension case finsding service
- smoking cessation
- pharmacy contraception service
conditions eligible for NMS
asthma and cOPD
Diabetes
hypertension
hypercholesterolaemia
osteoporosis
gout
glaucoma
epilepsy
parkinsons disease
urinary inconteninee
heart failure
acute coronary syndromes
atrial fibrillation
long term risks of venous thromboembolism
stroke
coronary heart disaese
process of NMS
- engagement- make sure it is a new medicine for pt, gain written consent, give any necessary counselling at this stage and offer any relevant healthy lifestyle advice, set a date for next stage in 7-14 days
- Intervention- have they started the new medicine? check how they’re getting on, do they understand what its for, ant side effects
offer any advice which may help resolve any problems or concerns
refer to GP if necessary
arrange next stage for 14-21 days later - follow up- similar to intervention
refer back to any issues identified, lifestyle advice and refer to gp if necessary
aims of community pharmacist consultation service
to reduce demand on integrated agent services, urgent treatment centres
by diverting requests for urgent supply of medicines and referral of low acuity conditions to community pharmacies
to support the integration of community pharmacy into the urgent career system
to increase pt awareness that cmommunity pharmacist should be first port of call
CPCS urgent medicine request
- pt calls 111/attends A and E
- 111 refer to pharmacy via IT platform or NHS emial
- pharmacy must check both regularly for referrals
- pt phones pharnmacy
must attempt 3 times to contact them if they don’t ring within 2 hours - speak to pt, find out more info regarding what they need, use EPS tracker to see if there is a Rx available for dispensing, gain permission to access SCR to check/confirm they are on the medicines they are requesting
- supply if appropriate and print out token
usual payment/exemptions apply
use judgement over quantity to supply - record reasons for no supply
- refer to gP OOH if emergency supply not possible
- if referral appropriate but don’t have stock, forward to another cPCS pharmacy
CPCS minor illness
- pt calls 111 or GP surgery
- referred to community pharmacist to triage via IT platform or nHS email
- consultation should be face to face if possible in consultation room
- make one attempt to contact pt if they don’t contact us within 12 hours
- must check for red flags, medication, medical conditions and SCR
possible outcomes of CPCS minor illness
- advice provided
- advice plus OTC sale
- escalate to GP in hours or GP OOH
- A and E or 999
Signpost to other services
appliance use reviews
carried out by pharmacist or specialist nurse in pharmacy or at pts home
aim is to improve pts knowledge and use of a specified appliance by:
establishing how pt uses appliance and their experience of use
resolving poor or ineffective use of appliance
advising on storage
advising on disposal
stoma appliance customisation
- involves customisation of stoma appliances based on pts measurements or a template
- must refer Rxs needing customisation to another contractor if unable to provide this service
- must notify NHS England that you wish to provide this service
- must have SOP
- must have appropriate area of pharmacy
flu vaccinations
- service runs September-march each year
- face to face training on injection technique and basic life support every 3 years
- declaration of competence annually
- new PGD and service specification each year
hypertension case finding service inclusion criteria
- adults who are 40 years old or over, who don’t have a current diagnosis of hypertension or a related condition
- any pt under 40 who requests service because they have a recognised family history of hypertension
- adults between 35-39 at pharmacists discretion
- adults specified by local GP practice for measurement of blood pressure
hypertension case finding service
- obtain and record consent, take bP reading
- if irregular pulse detected, refer to GP
- normal bP- lifestyle advice, advise to check again in 5 years
- low BP- no symptoms, advise as for normal BP
- fainting regularly, same day referral to GP
- dizziness, nausea, fatigue, see GP in 3 weeks - high BP- lifestyle advice, ambulatory blood pressure monitoring
- very high BP- same day referral/A and E if only option
smoking cessation service
- pts identified in hospital
- nicotine replacement therapy initiated in hospital
- pharmacy provides carbon monoxide monitoring, behavioural support and NRT over 12 weeks
pharmacy contraception service
1st phase- oral contraception initiated by GP/sexual health clinic
pharmacists provide ongoing management
- supplies via PGD up to 12 months each time
2nd phase- extended to include initiation via PGD, ongoing clinical checks and annual reviews
