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PM2D Spring Amy L > Community Pharmacy Services > Flashcards

Community Pharmacy Services Flashcards

1
Q

List 6 ways that pharmacies make money?

A
  1. Essential services
  2. Advanced services
  3. Locally commissioned services
  4. Private prescription and pharmacy services
  5. Pharmacy sales
  6. Specialist services = supplies to prisons/hospices/MOD
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2
Q

List the 3 tiers of service that pharmacies provide if they have an NHS contract

A
  1. Essential services
  2. Advanced services
  3. Enhanced/locally commissioned services
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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
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4
Q

Describe advanced services

A
  • Optional
  • Paid for each patient interaction
  • MURs, New Medicine Service (info when first dispensed)
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5
Q

Describe enhanced/locally commissioned services

A
  • Optional
  • Paid for each patient interaction
  • Out of hours, palliative care services, services to schools
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6
Q

What does PMR stand for?

A

Patient medication record

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7
Q

What 4 things must be included in a PMR?

A
  1. Supply
  2. Clinical interventions
  3. Owings
  4. Referrals
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8
Q

List the 4 extra services that pharmacies must provide to supplement the requirements of the NHS contract (with no NHS payment)

A
  1. Prescription collection service
  2. Delivery service
  3. Compliance aids (e.g.monitored dosage systems, MDS)
  4. Care home services
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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
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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
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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
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12
Q

What is the managed repeat service?

A

Pharmacy orders items and collects prescription for the patient

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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
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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
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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

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16
Q

What does RA stand for?

A

Repeatable authorisation form

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17
Q

What is an RA form?

A
  • Only 1
  • Signed
  • Not to be dispensed
  • Number of repeats required
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18
Q

What does RD stand for?

A

Repeat dispensing batch prescription

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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
  1. MUR and prescription intervention service
  2. New medicines service
  3. Flu vaccination service
  4. Appliance use review
  5. 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
Q

How do MURs achieve their aim?

A
  • Identifying poor or ineffective use of medication
  • Identifying side effects/drug interactions that may affect adherence
  • Reducing medicine wastage
26
Q

What must pharmacists have in order to carry out MURs?

A
  • 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
Q

What 4 things are MURs designed to review?

A
  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
Q

What 5 things make a patient eligible for an MUR?

A
  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
Q

Which 4 categories of patients are targeted for MURs?

A
  1. Patients taking high risk medicines 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
Q

What is a prescription intervention prompted by?

A

Significant problem with patients medication

31
Q

List the 4 patient groups that are eligible for NMS

A
  1. Asthma or COPD
  2. Type II diabetes
  3. Anti-platelet/anticoagulant therapy
  4. Hypertension
32
Q

Why are these 4 groups of patients eligible for NMS?

A
  • Have greatest degree of non-adherence
  • Will benefit most from the service
33
Q

What is the aim of NMS?

A

Improve adherence

34
Q

What are the 3 stages of NMS?

A
  1. Patient engagement (day 0)
  2. Intervention (day 7-14)
  3. Follow-up (day 21-28)
35
Q

List 4 benefits of NMS

A
  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
Q

Which groups of people are eligible for the flu vaccine?

A
  1. Over 65s
  2. Pregnant women
  3. Care home residents
  4. Carers
37
Q

What does administration or supply of POMs without a prescription require?

A
  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
Q

What is Patient Group Direction? (PGD)

A
  • 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
Q

List 3 things that are included in PGD documents

A
  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
Q

What is a Patient Specific Direction?

A

Same as a PGD except instead of a group of patients identified by the inclusions and exclusions, it is specific for named patients

41
Q

Why should a patient’s GP be informed after a flu jab?

A
  1. Collate national flu vaccination data
  2. Add to medical records
  3. Ensure that patient is not vaccinated twice
42
Q

Who are enhanced services funded by?

A
  1. CCGs
  2. Public Health England via local authorities (councils)
  3. NHS England
43
Q

What is the role of Local Pharmaceutical Committees (LPCs)?

A

Keep local pharmacies involved and informed

44
Q

List 2 enhanced/locally commissioned services funded by CCGs

A
  1. INR clinics and warfarin supply
  2. Palliative care service
45
Q

List 2 enhanced/locally commissioned services funded by NHS England

A
  1. Minor ailments scheme
  2. Emergency supply
46
Q

List 2 enhanced/locally commissioned services funded by PHE (via local councils)

A
  1. Chlamydia testing kits and condoms
  2. Stop smoking services
47
Q

List 3 examples of private pharmacy PGDs

A
  1. Erectile dysfunction = Viagra, Cialis, Levitra
  2. Anti-malarials = Malarone. Doxycycline, Lariam
  3. Emergency contraception = Levonelle, ellaOne

PM2D Spring Amy L (9 decks)

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