Community Pharmacy Lecture

Question 1

The pharmacy contract

Answer 1

introduced in 2005
introduced tiered framework
income stream model required delivery of multiple services to maintain profitability

Question 2

when was the quality payments scheme introduced?

Answer 2

in december 2016

Question 3

Community pharmacy contractual framework

Answer 3

(2019-2024)
sets how community pharmacy will support the delivery of the NHS longterm plan
QPS renames as Pharmacy quality scheme part of the new CPFC

Question 4

What are the different service types of the Pharmacy Contractual Framework

Answer 4

Essential services
clinical governance
advanced services
national enhanced services
pharmacy quality scheme
locally commissioned services

Question 5

Types of essential services

Answer 5

Dispensing medicines
dispensing appliances
repeating dispensing/electic repeat dispensing (eRD)
disposal of unwanted medicines
public health
signposting
support for self care
discharge medicines service
healthy living pharmacies

Question 6

Dispensing medicines
(essential)

Answer 6

Pharmacies are required to maintain a record of all medicines dispensed and interventions made which they judge to be significant
electronic prescription service is also part of the dispensing service

Question 7

Electronic Prescription Service (EPS)

Answer 7

sent electronically from prescriber to the pharmacy
(patients nominate which is sent to the NHS spine)
pharmacy is then able to access prescription via NHS smart card
once dispensed sent to NHSBSA

Question 8

What does the BNF guidance state about EPS control drugs (CDS)

Answer 8

medicines that are not control drugs should not be prescribed on the same form as a schedule 2 or 3 controlled drug

Question 8

Rules for control drugs

Answer 8

no equivalent for FP10MDA for EPS
prescribers must use a green paper form or blue mad form

Question 9

Tokens

Answer 9

green
when patients have not nominated a regular pharmacy
scan barcode and retrieve prescription
same way as an fp10
CAN PRINT ON WHITE TEMPLATE
if patients filled back of green token then they have to redo this on eps token
prescriber signature not required = separate between two

Question 10

EPS one off nomination

Answer 10

most gp systems
may be beneficial over a token
during emergencies when patient is going through a temporary closure
patients not ready to commit to monition but unable to receive phase4token
holiday patients

Question 11

Dispensing appliances (essential service)

Answer 11

intention is to stop stock piling
ensure appliance used correctly
only order what is needed to minimise waste
pharmacy name address and telephone number
unable to dispense : give another pharmacy
also may offer home delivery which should be prompt
method and packaging shouldn’t give contents

Question 12

repeating dispensing/electic repeat dispensing (eRD)

Answer 12

When a pharmacy is asked to dispense a medicine via batch prescriptions
* Has been an essential service since 2005
* Reduce surgery/prescriber workload - at least two thirds of prescriptions are for repeat medication
_ More convenient for patient - No need to order or wait for dispensing
keep records
explain benefits

Question 13

benefits of eRD for the GP

Answer 13

> Benefits for G harmacy
“ No need for RA, so no need for a manual signature
No need to inform pharmacy of medication changes

Question 14

Benefits for Pharmacy

Answer 14

> Benefits to the pharmacy ATO
≥ Do not have to securely store a batch of prescriptions
Do not have to physically take/send any unwanted RDs back to GP
* Claim for electronically
* Extra step of sending RA becomes obsolete

Question 15

benefits to the patient and environment

Answer 15

*Benefits to patient IMACY
No need to store batch if not left with pharmacy
> Can collect from a different pharmacy each time without the need of an RD
≥ Reduces clinical errors as only one Rx available at any given time
“Benefits to the environment
* No paper wastage if a medication change occurs

Question 16

Disposal of unwanted medicines (essential service)

Answer 16

Pharmacies must take back unwanted medicines from patients
* Local NHS England & NHS improvement (NHSE&l) team arrange collection from pharmacies at regular intervals
* The pharmacy must, if required by NHS England & NHS improvement or the waste contractor,
- Sort medicines into solids (including ampoules & vials)
≥ Liquids
* Aerosols
> The waste contractor can advise is this necessary
* Clinical waste from self-administration is ‘household waste’ and responsibility of local council to dispose of

Question 17

Public health (essential service)

Answer 17

Public Health campaigns
* Participate in up to six campaigns/years at the request of NHS England &
NHS Improvement (NHSE&I)
> Only includes the display and distribution of leaflets provided by NHS
England
* Undertake Rx-linked interventions on major public health concerns
* For each campaign, where requested by NHS England, pharmacies record the number of people to whom information is provided

Question 18

Signposting (essential service)

Answer 18

Pharmacies are expected to help people who ask for assistance by directing them to the most appropriate source of help
* By means of a written referral where appropriate
*A record of the signposting advice is kept where appropriate
* Examples: Their GP, an out of hours service, another healthcare professional, a support group or a website
^NHS England provides pharmacies with lists of sources support in the area

Question 19

Support for self care (essential service)

Answer 19

Minimise inappropriate use of the health service by offering support with regards to managing minor ailments & common conditions
> Via advice, sale of medicines & dealing with referrals from NHS 111
* Keep a record of advice given and medicines supplied where appropriate

Question 20

Essential service - discharge medicines service (dMS)

Answer 20

Added to CPCF on 15th February 2021
> Why has this service been added?
Discharge from hospital associated with increased risk of avoidable medication related harm
≥ Recent audit - 79% of Pts prescribed at least one new medication on discharge from hospital
* New Rxs can cause potential problems
*Over 65s less likely to be readmitted to hospital if given help with their medication post discharge and if readmitted will experience a

Question 21

aims of DMS

Answer 21

The service seeks to ensure better communication of changes made to pt’s medicines in hospital
_It’s aims are to:
*Optimise use of medicines, whilst facilitating shared decision making
“ Reduce harm from medicines at transfers of care
≥ Improve patients’ understanding of their medicines & how to take them post hospital discharge
“ Reduce hospital readmissions
≥ Support development of effective team-working acr provide clarity about respective roles

Question 22

Essential service (healthy living pharmacies

Answer 22

The Healthy Living Pharmacy (HLP) framework is aimed at achieving consistent provision of
* Broad range of high quality services aimed at meeting the health needs of the local population
“Improve and health and wellbeing in the community
* Reduce health inequalities in the community
_It provides a mechanism for community pharmacy teams to utilise their local insight and experience in the delivery of high quality health promoting initiatives

Question 23

Advanced services