nhs community pharmacy services Flashcards

Question

benefits of NMS

Answer 1

- improves adherence - reduced hospital admissions - increase patients engagement with medication/condition - reduces medicine wastage - increased yellow card reporting - patients like it - Supports the development of outcome and/or quality measures

Answer 2

Provision of seasonal flu vaccines (IM injection) free of charge to eligible adult patients NHS advanced service for pharmacy 2015 onwards WHY? Improve patient choice GP service: High level of uptake by over 65s but low uptake of flu vaccine to ‘at risk’ groups Provide more consistent coverage and less local variation in flu vaccine uptake

Answer 3

Patient Group Direction (PGD) Verification of online and/ or face to face training Standard Operating Procedures (SOPs) Regular renewal and review of training/ contract

Answer 4

Written instructions for the supply or administration of medicines to a group of patients who may not be individually identified before presentation for treatment No prescription needed Labelling requirements for POMs still apply/PIL provided/ records kept as stated in PGD documentation.

Answer 5

Written and signed off by doctor (or dentist), pharmacist and an authorising body (with CQC registration) Introduction Clinical condition or situation to which this direction applies- Inclusions and exclusions Designated staff authorised to supply medicines prescribed under the PGD Description of treatment available under the PGD Documentation Facilities and supplies available at sites supplying PGD Management and monitoring of PGD

Answer 6

Over 65s - in 2021, over 50s Adults 18-65 in a clinical risk group such as: chronic respiratory disease, e.g. severe asthma, COPD chronic heart disease, e.g. heart failure chronic kidney disease at stage 3-5 chronic liver disease chronic neurological disease e.g. Parkinson’s disease, motor neurone disease, learning disability diabetes asplenia or splenic dysfunction weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment) splenic dysfunction, sickle cell disease morbidly obese (BMI ≥40) At risk groups-pregnant women, care home residents Carers, household contacts of immunocompromised individuals Care workers and workers in hospices and care homes

Answer 7

``` Training Face to face every 3 years: -anaphylaxis -basic life support (CPR) -injection technique IM/SC ``` e-learning and e-assessment (yearly) Declaration of Competence (DoC) NHS PGD and pharmacy SOP Patient assessment and consent

Answer 8

65 years and older - with no egg allergy = adjuvanted trivalent vaccine when they have a severe egg allergy = cell based quadrilevent influenza vaccine - flucelvax when 18-65 years old egg allergy = cell based quadrivalent influenza vaccine - flucelvax or egg grown quadrivalent influenza vaccine severe egg allergy = cell based quadrivalent influenza vaccine - flucelvax not eligible when younger than 18

Answer 9

Referral to community pharmacy from NHS 111, A&E or GP surgeries for: Minor ailments Urgent medicine supply (not GPCPCS) AIMS: part of NHS urgent care system (NHS 111 referrals) easy access for patients reduce demand on NHS urgent care and GPs for minor ailments promote pharmacy as the ‘first port of call’ cost effective for the NHS

Answer 10

Patient phones or calls into the pharmacy (referred from NHS 111 or GP surgery) Assess the patient’s presenting symptoms and check SCR (consultation room or phone) Check for ‘red flags’ Provide patients with self care advice and printed information ``` If needed: Sell OTC treatments OR Refer to PGD OR Supply under Minor Ailments Service (locally commissioned) Refer if needed Document consultation ``` ``` Acne, Allergic Reaction Ankle or Foot Pain or Swelling Athlete's Foot, Bites or Stings Blisters, Constipation, Diarrhoea Ear Discharge, Wax, Earache Red or Irritable, Sticky or Watery Eye Eyelid Problems, Hair loss Headache, Hearing Problems Limb Pain, Mouth Ulcers Nasal Congestion…………………… ```

Answer 11

In an emergency and at the request of a patient, a pharmacist can supply a POM without prescription to a patient who has previously been prescribed the requested POM (HMR 2012 Reg 225) Pharmacist (Responsible Pharmacist) MUST interview the patient him/herself and be satisfied that: Immediate need Impracticable to obtain a prescription without undue delay Treatment has previously been prescribed by a UK registered appropriate prescriber for the patient (or EEA or Swiss health professional) It is an appropriate dose for that patient in the circumstances CDs- Schedule 2 and 3? - no Schedule 4 and 5?- yes - limited amount Quantity to supply? Patient phones or calls into the pharmacy (referred from NHS 111) During the telephone call or consultation: Access referral (if not already done) Access SCR with patient’s consent Check NHS Rx tracker for an EPS Rx Give advice on ordering prescriptions in time, electronic repeat dispensing If supplying, create and print Rx on FP10DT Dispense as per emergency supply regs Supply (immediately or when patient arrives) and collect NHS charge (unless exempt) If emergency supply not possible: refer the patient to their GP or Contact GP out of hours provider If no stock: Forward referral to another pharmacy doing CPCS or Contact GP OOH service

Answer 12

Registration with NHSE: Transition payment of £900 per pharmacy Payment for service: £14 fee per completed consultation Medicines/appliances supplied under CPCS urgent medicines are reimbursed using Drug Tariff prices No reimbursement for medication supplied under CPCS minor ailments

Answer 13

Paid for by: Public Health England (PHE) via local authorities (LA/Councils) Clinical Commissioning Groups (CCGs) NHS England (NHSE) Local NHSE area teams can commission locally enhanced services listed in part 4 CCGs or PHE can also commission these but they are then termed ‘locally commissioned’ Sometimes services are commissioned from pharmacies via a formal tendering process for NHS standard contracts (or similar) Services local, often for a small area (Town, City, County Councils) Local Pharmaceutical Committees (LPCs) instrumental in keeping local pharmacies involved and informed.

Answer 14

pharmacies may or may not do enhanced/locally commissioned services depending on: Which services are on offer from the commissioners in that area Whether all pharmacies in the area are being offered the service (Any Qualified Person (AQP)) Whether it is only for those that bid for the service through a formal tendering process and win Choice

Answer 15

``` CCG funded INR clinics and warfarin supply Tailored dispensing service Latent TB service Palliative care service ``` NHS England funded Minor ailments scheme Out of hours service ``` PHE funded (via local councils) EHC to young people Chlamydia testing/treatment Free condoms Stop smoking Supervised consumption of methadone/ buprenorphine Needle exchange NHS Health Checks ```

Answer 16

Services: often very localised or offered countrywide but with different service specifications in different areas. - can involve supplying / administering POMs

Answer 17

Chlamydia testing kits supply to young people Azithromycin provision for positive test results Condom supply

Answer 18

AIM: To improve the quality and safety of community pharmacy and other linked primary care services Payments are made to community pharmacies if they meet certain quality criteria Up to 100 Quality Points to achieve (£6,400 (possibly more) per pharmacy per year) Changes every year

Answer 19

Part 1 £18.75 million 14 actions relating to the pandemic-all must be actioned for payment e.g. Individual COVID risk assessment for all staff All staff wearing NHS approved PPE (National Pharmacy COVID SOP) Update business continuity plan and SOPs Review examples of good practice during the pandemic and adopt them as considered appropriate for the individual pharmacy (GPhC website) Every registered staff member to read/ record they have read relevant COVID-19 guidance on the GPhC website Part 2 £56.25 million 5 domains-have to complete all actions in each one to claim: Domain 1 - Infection Prevention & Control and Antimicrobial Stewardship Domain 2 - Prevention Domain 3 - Risk management Domain 4 - Primary Care Network - Prevention Domain 5 - Primary Care Network - Business continuity