Community Pharmacy Services Flashcards
1
Q
List 6 ways that pharmacies make money?
A
- Essential services
- Advanced services
- Locally commissioned services
- Private prescription and pharmacy services
- Pharmacy sales
- Specialist services = supplies to prisons/hospices/MOD
2
Q
List the 3 tiers of service that pharmacies provide if they have an NHS contract
A
- Essential services
- Advanced services
- Enhanced/locally commissioned services
3
Q
Describe essential services
A
- Mandatory
- Paid for offering the whole NHS service and for each patient interaction for dispensing
- E.g. dispensing, sign-posting, promoting healthy lifestyle, clinical governance = SOPs
4
Q
Describe advanced services
A
- Optional
- Paid for each patient interaction
- MURs, New Medicine Service (info when first dispensed)
5
Q
Describe enhanced/locally commissioned services
A
- Optional
- Paid for each patient interaction
- Out of hours, palliative care services, services to schools
6
Q
What does PMR stand for?
A
Patient medication record
7
Q
What 4 things must be included in a PMR?
A
- Supply
- Clinical interventions
- Owings
- Referrals
8
Q
List the 4 extra services that pharmacies must provide to supplement the requirements of the NHS contract (with no NHS payment)
A
- Prescription collection service
- Delivery service
- Compliance aids (e.g.monitored dosage systems, MDS)
- Care home services
9
Q
What are repeat prescriptions?
A
- No need to see GP each month
- Patients can use the repeat request form to reorder medication
- Can also use surgery websites/email/fax to reorder
10
Q
What is the prescription collection service?
A
- Pharmacy collects prescription from GP so patient doesn’t have to drop it in
- They are called when prescription is ready
11
Q
What is the keep repeat service?
A
- Pharmacy keeps the repeat form and patients phone/email/call in to order medication
- Pharmacy orders medication from GP surgery and collects prescription
12
Q
What is the managed repeat service?
A
Pharmacy orders items and collects prescription for the patient
13
Q
What are compliance aids?
A
- 7 day packs
- Each day has time sections
- Tablets/capsules are put in appropriate blister
- Examples = dossette boxes, NOMAD, Medisure
- Pharmacist must be satisfied that patient can use the device safely
14
Q
What are care home services?
A
- Medicines for residents of care homes packed into individual blister packs
- Colour co-ordinated for different times of day
- Easier and safer for care home staff
15
Q
What is repeat dispensing?
A
Up to 12 months of prescriptions are issued at once so the patient doesn’t need to return to the GP Only for patients on stable medication - pharmacists’s responsibility to ensure suitability Formatted for EPS2
16
Q
What does RA stand for?
A
Repeatable authorisation form
17
Q
What is an RA form?
A
- Only 1
- Signed
- Not to be dispensed
- Number of repeats required
18
Q
What does RD stand for?
A
Repeat dispensing batch prescription
19
Q
What is an RD?
A
- Many copies
- Unsigned
- Specifies which repeat
- Can be enough to last 12 months
20
Q
Describe the disposal of waste medication (essential service)
A
- Unwanted or out of date medication can be returned
- NHS pays for specialist waste contractor
- Can accept waste from care homes
- No sharps/chemicals
21
Q
Describe the support for self-care service (essential service)
A
- Provision of advice for self limiting illness (RTS) and long term conditions
- Document interventions
22
Q
Where can pharmacists signpost patients?
A
- Information service
- Local support group
- Other healthcare professionals
23
Q
What are the 5 nationally-commissioned advanced services?
A
- MUR and prescription intervention service
- New medicines service
- Flu vaccination service
- Appliance use review
- Stoma appliance customisaton service
24
Q
What is the aim of MURs?
A
Aim is to improve patient knowledge, adherence and use of their medicines
25
**How** do **MURs** **achieve** their aim?
* Identifying **poor or ineffective use** of medication
* Identifying **side effects/drug interactions** that may affect adherence
* Reducing **medicine wastage**
26
What must **pharmacists have** in order to **carry out MURs**?
* Be **accredited** through completion of a **recognised course**
* Be **satisfactorily complying** with essential services
* Have **appropriate SOPs** in place
* Have a **suitable consultation area**
27
What **4 things** are **MURs designed to review**?
1. If patient **takes their medication**
2. **How** they **take their medication**
3. If they have **problems with their medication**
4. Assesses if **medication is appropriate** and is **cost-effective**
28
What **5 things** make a patient e**ligible for an MUR**?
1. Must take **at least 2 medications for chronic conditions** (one if high risk medicine)
2. Must have been **using the pharmacy** for the **previous 3 months**
3. Must **not** have had an **NMS in the last 6 months**
4. Must **not** have had an **MUR** in the **previous 12 months**
5. Must be able to **provide signed consent**
29
Which **4 categories** of patients are **targeted for MURs**?
1. Patients taking **high risk medicine**s e.g. anticoagulants, diuretics, NSAIDs
2. Patients **recently discharged** from hospital
3. Patients with **respiratory diseases** (asthma, COPD)
4. Patients at risk of/diagnosed with **CV disease and regularly prescribed for at least 4 medicines**
30
What is a **prescription intervention prompted by**?
**Significant problem with patients medication**
31
List the **4 patient groups** that are **eligible for NMS**
1. **Asthma or COPD**
2. **Type II diabetes**
3. **Anti-platelet/anticoagulant therapy**
4. **Hypertension**
32
**Why** are these **4 groups of patients eligible for NMS**?
* Have **greatest degree of non-adherence**
* Will **benefit most** from the service
33
What is the **aim of NMS**?
**Improve adherence**
34
What are the **3 stages of NMS**?
1. **Patient engagement** (day 0)
2. **Intervention** (day 7-14)
3. **Follow-up** (day 21-28)
35
List **4 benefits of NMS**
1. Improves **patient adherence**
2. Increases **patient engagement** with their conditions and medication
3. Reduces **medicine wastage**
4. Reduces **hospital admissions** due to medication-related adverse events
36
Which **groups of people** are **eligible for the flu vaccine**?
1. **Over 65s**
2. **Pregnant women**
3. **Care home residents**
4. **Carers**
37
What does administration or supply of **POMs without a prescription require**?
1. **Patient Group Direction** or **Patient Specific Direction**
2. Verification of online and/or face-to-face **training**
3. **SOPs**
4. Regular **renewal and review** of training/contract
38
What is **Patient Group Direction**? (PGD)
* **Written instructions** for the supply/administration of **POMs** to a **group of patients without individual prescriptions**
* **Legal framework**
* **Labeling requirements** for POMs still apply
39
List **3 things** that are **included in PGD documents**
1. **Designated staff authorised** to supply medicines prescribed **under PGD**
2. **Written and signed off** by doctor and pharmacist
3. **Clinical condition or situation** to which this direction applies - inclusions and exclusions
40
What is a **Patient Specific Direction**?
**Same as a PGD** except instead of a group of patients identified by the inclusions and exclusions, it is **specific for named patients**
41
Why should a patient's **GP** be **informed after a flu jab**?
1. Collate **national flu vaccination data**
2. Add to **medical records**
3. Ensure that patient is **not vaccinated twice**
42
Who are **enhanced services funded by**?
1. **CCGs**
2. **Public Health England via local authorities (councils)**
3. **NHS England**
43
What is the role of **Local Pharmaceutical Committees** (LPCs)?
**Keep local pharmacies involved and informed**
44
List **2 enhanced/locally commissioned** services **funded by CCGs**
1. **INR clinics** and **warfarin supply**
2. **Palliative care** service
45
List **2 enhanced/locally commissioned** services funded by **NHS England**
1. **Minor ailments scheme**
2. **Emergency supply**
46
List **2 enhanced/locally commissioned** services **funded by PHE** (via local councils)
1. **Chlamydia testing kits and condoms**
2. **Stop smoking services**
47
List **3 examples** of **private pharmacy PGDs**
1. **Erectile dysfunction** = Viagra, Cialis, Levitra
2. **Anti-malarials** = Malarone. Doxycycline, Lariam
3. **Emergency contraception** = Levonelle, ellaOne
