NHS Community Pharmacy Contract Flashcards
What is CPCF?
NHS community pharmacy contractual framework
governs how community pharmacy contractors are remunerated for the provision of NHS services
- how they are paid
5 year deal
What are the benefits of the CPCF?
rewards high quality services rather than volume of service (number of prescriptions)
secures pharmacy funding and sets out a clear vision for the expansion of clinical service delivery over the next five years in line with the NHS Long Term Plan
Who governs the CPCF?
PSNC - pharmaceutical services negotiating committee
NHS England and NHS Improvement
What are the three levels of NHS community pharmacy contractual framework?
essential services
advanced services
locally commissioned services
What are essential services? What are the essential services offered?
are offered by all pharmacy contractors
must be offered to be considered for funding
dispensing medicine dispensing appliances repeat dispensing disposal of unwanted medicine promotion of healthy lifestyle - public health signposting patients to other healthcare providers support for self care discharge medicine service clinical governance
How is repeat dispensing carried out? What is eRD? What are the benefits of eRD?
carried out using electronic repeat dispensing - eRD (previously paper prescription)
- must stay in one pharmacy
electronic repeat dispensing
- no need for prescribers to hand sign authorised repeat prescriptions each time -
= only the first as it covers the authorisation of all batches
What is the difference between private and NHS repeat dispensing?
private
- paid for
- can be repeated
- requires a new signed prescription each time
NHS
- single record on NHS spine
- cannot repeat prescription
= service allows for a batch of prescriptions to be repeated
What must an eRD show?
intended interval - time between each batch/repeat
how many batch issues = repeat total
repeat authorisation
- signature
What is the pharmacists responsibility with eRDs?
checking the patient’s medication regimen has not been altered
- may indicate a review and referral is needed
checking the patient’s manner of utilisation has not changed
- may indicate a review and referral is needed
What is the process of disposal of unwanted medicines?
obligated to sort unwanted medicines into solids, liquids and aerosols
benefits public health
- prevents accidental poisoning and environmental hazards
How is a healthy lifestyle promoted as an essential service?
opportunistic service
campaign service
- 6 required annually = request of NHS England and Improvement
- required to undertake prescription linked interventions on major areas of public health concern
= smoking, high blood pressure, etc
What is the discharge medicine service in essential services?
NHS trusts transfers patients discharge from the hospital to the pharmacy
compare medicine they were previously taking with those they are currently taking - check PMR and SCR
- reduce hospital readmission
- reduce harm from transfer of care
- support the development of effective team working
What is clinical governance?
framework in which the NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care
examples
- patient satisfaction survey, complaints procedure, clinical audits, SOPs - standard operating procedures, patient safety incident analysis and reporting
What are advanced services? What are the advanced services offered?
optional services offered by contractors
requires accreditation
community pharmacy consultation service - CPCS new medicine service - NMS stoma appliance customisation - SAC flu vaccination service - FUS medicines use reviews - MURs hepatits C service appliance use services - AUS
What is MUR? What type of service is it a part of?
Medicine Use Review - MUR
similar to AUR - appliance use review
it is an advanced service
- aim to increase the patient’s knowledge of their medication and increase adherence
- can conduct adherence centred reviews on patients with multiple medications
Which patients are targets for MUR? How is an adherence centred review conducted for MUR?
medicine use review
patients on multiple medications
- especially those with long term conditions
patients with high risk medications
- NSAIDs, anti-coagulants, anti-platelets, diuretic
patients recently discharged from hospitals with changes to medication
conducted in a private consultation room by a registered accredited pharmacist
needs verbal consent only
may be provided by phone or video consultation
What is NMS? What type of service is it a part of?
new medicine service
it is an advanced service
aim is to improve understanding of newly prescribed medicine for long term conditions
- reduces risk of hospitalisation
- reduce side effects
What are the 5 conditions that NMS can be used with? What are the 3 stages of NMS?
new medicine service
long term conditions
- asthma
- COPD = chronic obstructive pulmonary disease
- type 2 diabetes
- anti-platelet/anti-coagulant
- hypertension
stages
1 = day 1 - patient engagement
2 = day 7-14 - initial intervention
3 = day 21-28 - follow up
What is the FVS?
flu vaccine service
aim is to sustain and maximise uptake of flu vaccine in at risk groups
builds up the capacity of community pharmacies as an alternative to general practice
What is the CPCS? What is the purpose of CPCS? What did it replace?
community pharmacist consultation service
- replaced NHS Urgent Medicine Supply Advanced Service (NUMSAS) and Digital Minor Illness Referral Service (DMIRS)
aim is to connect patients with minor ailments or need an urgent supply of medicine with a community pharmacy
takes referral from the NHS 111 - relieves pressure on wider NHS
replaced
NUMSAS - NHS urgent medicine supply advanced service
DMIRS - digital minor illness referral service
What are locally commissioned services?
only some pharmacies provide them
in line with the needs of the local population
funded and commissioned by local authorisation, clinical commissioning groups (CCGs) and local NHS England teams
What is the Pharmacy Quality Scheme? What is the pharmacy quality scheme made up of?
formerly known as quality payment scheme
quality criteria must be met in order to be eligible for funding
4 gateways - all must be met and new ones are made every year
domains fall into criteria which must be met
- all of the criteria of a single domain must be met to secure funding
- the more domains are met, the more PQS payments gained
What is the process of CPCS urgent medicine supply?
1 - patient calls NHS 111
2 - patient is triaged to community pharmacy
3 - message sent to a community pharmacy
4 - patient telephones pharmacy
a - pharmacy does not receive referral = check NHS system
b - patient does not call = pharmacy makes one attempt to call
5 - emergency supply made
a - emergency supply
b - message sent to the GP
or
6 - supply not made = not required or allowed/possible
a - medicine is not stocked
b - referral to GP
c - another reason to not supply
How is CPCS recorded?
recorded on CPCS IT system
FP10DT token used
only print the EPS token for those who are exempt
information printed on token in legible writing
token sent to NGSBSA as part of the month submission
What is the process of CPCS minor ailment/low acuity?
patient may not require any medication
patient may be referred to locally commissioned service
patient requires OTC medication support and self care advice
patient requires higher acuity care = use escalation pathway
escalation pathway
- pharmacist calls NHS 111
- support patient with urgent appointment at their own GP
- call 999 if needed
What type of service are the following? What is the procedure for each one?
dispensing medicine
dispensing appliances
signposting patients to other healthcare providers
support for self care
essential services - offered by all pharmacist
dispensing medicine dispensing appliances - supplying medicines or appliances - legal, clinical and accuracy checks - give information and advice
signposting patients to other healthcare providers
- referring patients who need further support to the correct healthcare provider
support for self care
- provision of advice for management of minor ailments and common conditions
- provide medication where appropriate
- patients with long term conditions/complex needs
What type of service are the following? What is the procedure for each one?
stoma appliance customisation - SAC
hepatits C service
appliance use services - AUS
advanced services - require accreditation, are optional
stoma appliance customisation - SAC
- aim is to ensure the proper use and comfortable fitting of the stoma appliance
- aim to improve duration of usage and reduce waste
hepatits C service
- service is based on point of care testing (POCT) for hepatitis C
- if people test positive they will be referred for confirmatory tests and treatment where appropriate
appliance use services - AUS
- aims to help patients understand and use their prescribed appliances
- carried out by a pharmacist or specialised nurse
