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PHAY00010 > NHS > Flashcards

NHS Flashcards

CPCF, PGDs and NMS

1
Q

Why is CPCF needed?

A

Tackle strain of staff and finance of NHS

GP overwhelmed

Development of IT

Introduction to SCR and IP clinics

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2
Q

Provision of CPCF

A

Pharmacists - upskilled

More resources provided -> more clinical service

Pharmacy technicians upskilled

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3
Q

CPCF is agreed between what bodies?

A

Government

NHS

Community Pharmacy England (CPE)

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4
Q

What are the four elements of CPCF?

A

Essential services

Advance services

National Enhanced Services and Locally Enhanced Services

Pharmacy Quality Payments

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5
Q

Name 9 current essential services

A

Dispensing medicines

Healthy living pharmacy

Discharge medicines service

Support for Self-care

Signposting

Disposal of unwanted med

Repeat medication

Dispensing appliances

Public Health

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6
Q

10 advance services of CPCF

A

Flu Vaccination Service

Hypertension Case-Finding Service

Pharmacy Contraception Service

Lateral flow device test Service

New Medicine Service

Appliance Use Reviews

Stoma Appliance customisation

Community Pharmacy Consultation Service

Hepatitis C Testing service

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7
Q

What service has been replaced?

A

Medicine Use Review (MUR) to Discharge Medicine Service (essential)

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8
Q

How can patients obtain community consultation service?

A

NHS 111

999 Service

GP referral for minor illness consultation

Primary care out-of-hour service

Referred by other urgent and emergency care provider

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9
Q

What are the 2 stages of hypertension case-finding services?

A

Identification of ppl at risk of hypertension -> offer BP measurement

If clinically indicated, offering 24 hours ABPM

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10
Q

What are the 3 stages of the Discharge Medicines Service?

A

Referral received to pharmacy

Medicines reconciliation process

Patient consultation on understanding

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11
Q

What are the two main dimensions in the pharmacy quality scheme?

A

Gateaway criteria: must be met on day of declaration to qualify for payment

Domains of the quality criteria: quality within a domain to be met for a payment for that domain

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12
Q

Differences between gateaway domains and domain of quality criteria

A

Gateaway domain must be met first to be able to qualify for a payment of domain of quality critera

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13
Q

The 6 current legislation of the CPCF?

A

Health and Social Care Act 2012

Equality Act 2010

Health Act 2009

NHS act 2006

NHS regulation 2019 - Serious Shortage Protocols (SSPs)

Human Medicines Regulations 2012

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14
Q

When is Serious Shortage Protocols (SSPs) used?

A

In the even of medicine being in a serious shortage

Considered by the Secretary of State for Health and Social Care

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15
Q

What should be stated in the SSPs?

A

Specify action to be taken for specific patient groups within a timeframe

Specificy alternative product or quantity may be supplied

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16
Q

What happened to the prescriptions after the medications are dispensed to the patients?

A

Seperated into specific sections

Include submission document FP34C which states quantity of items, prescription dispensed and services completed + code linked with pharmacy

Send to NHS Business Service Authority (NHSBSA)

17
Q

What are the requirements of a PGD?

A

Name of business own direction

Start and end date

Description of med applied

Class of healthcare professional who can supply

Signature of a doctor/dentist AND a pharmacist

Authorisation by an appropriate organisation

Clinical condition or situation apploed

Description of exclusion

Description of when to get more advice + referrals

Details of drugs (dosage, quantity supploed, strength, route of administration,..)

Warnings, potential ADRs

Statement of records

18
Q

What must be recorded when PGDs are applied?

A

Name of HCPs supplying or providing

Patient identifiers

Medicines providedW

19
Q

What medicines can be supplied through PGDs?

A

All POM, P and GSL meds

Except: unlicensed meds, dressings, appliances and devices, radiopharmaceuticals, abortifacients, certain CDs.

20
Q

Who cannot supply CDs under all five schedules under PGD?

A

Dieticians

Speech and language therapists

Dental therapists

Dental hygienist

21
Q

What CDs can be listed in PGD legislation?

A

Schedule 2: morphine and diamorphine for treatment of conditions, NOT addiction. Only provided by nurses and pharmacists

Schedule 2: Ketamine

Schedule 3: Midazolam

Schedule 4: All drugs except anabolic steroids and injectables for addiction

Schedule 5: All drugs

22
Q

Who contribute to the development of a PGD?

A

Doctor

Pharmacists

Representative of any professional group expected to supply

Authorisation from NHS trust, CCGs, LAs.

23
Q

How and when should be the expiry date of the PGD decided?

A

Decided on a case-by-case basis

Should not be more than THREE years from authorisation

24
Q

Two types of PGDs?

A

NHS PGDs - commissioning and authorisation and delivery from NHS body

Private PGDs - commissioned by NHS by delivered by public funded organisation

25
Q

What should be considered when making decision to supply through PGDs?

A

Medicines

Patient group

Reasons why

Who will supply

Under Patient Specific Direction?

26
Q

How can patients access PGDs in practice?

A

Engaged by advertising

Referred by satisfied customer

Engaged in-store by pharmacist or HCPs

Referred by HCPs

Returned after being given leaflet

27
Q

Differences of EHC supply between from PGDs and as P pharmacy?

A

Free of charge

Given to clients aged more than 13

Taken immediately, before leaving

Specific verbal advice

Record-keeping requirements

28
Q

What is the rationale of New medicines service (NMS)?

A

Support people with long-term conditions with newly prescribed medicines

Aim: improve adherence

29
Q

What are the 6 conditions that the contractors of NMS need to achieve to provide the service?

A
  1. Satisfactorily complying with obligations under the terms of service
  2. SOPs present
  3. Have necessary knowledge and skill -> declared by NHS self-assess form
  4. Notify GP surgeries within locality of intention to provide service
  5. Consultation room complying with the requirements outlined
  6. Completed intention to provide surface through declaration form through NHSE&I team
30
Q

Conditions that are included in the NMS.

A

Respiratory: Asthma and COPD

Neurology: PD, Epilepsy, use of antidepressants

Mucoskeletal: Osteoporosis

Cardiology: AF, HTN, VTE long-term risk, HF, Stroke/TIA, Hypercholesterolaemia, ACS, CHD

Endocrinology: T2DM, Gout

Urinary incontinence or retention

31
Q

Eligible criteria of NMS?

A

Must be first prescription of that new medicines

Verbal consent obtained and recorded

Referral by a HCP at hospital responsible for that course of treatment

32
Q

What do patients need to know while consenting for NMS?

A

Provision of service

Sharing of information between pharmacy and GP

Sharing of information with NHSE&I

Sharing of information with NHSE&I and NHSBSA

33
Q

Structure of NMS service

A

Stage 1: engagement stage (day 1) - consultation about the new meds

Stage 2: 7 - 14 days after stage 1 - discussion about the ongoing of meds + advice

Stage 3: 14 - 21 days after stage 2 - discussion and resolve issues

34
Q

Benefits of NMS for patients

A

Encourage shared decision making

Early identification of issues

Improve adherence -> improve quality of life

Increase patient engagement -> self-manage their long-term conditions

Range of healthcare providers

Lifestyle changes + interventions

Increase access to advice

35
Q

Benefits of NMS for pharmacists and healthcare system.

A

Expanding roles of the pharmacist

Reduce medicine wastage

QIPP agenda contribution

Promote multidisciplinary working

Support integration of community pharmacy -> signposting and referral service

Improve pharmacovigilance

Reduce hospital-related admissions

Evidence-based effectiveness

NHS long-term plan

36
Q

Is it possible to provide NMS service alongside the DMS service?

A

DMS - first-post discharge prescription is received

NMS can be offered if clinically appropriate (if patient would get additional benefits)

PHAY00010 (4 decks)

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