Pharmacy Contract Flashcards
What is the NHS community pharmacy contract? What is its purpose?
The pharmacy contract aimed to improve the range and quality of services of the community pharmacy and integrate it more into the NHS.
there are three tiers of service: essential, advanced and commissioned (locally commissioned /enhanced).
it incorporates public health at each of the three levels & the promotion of healthy lifestyle messages
What are aims of the NHS community pharmacy contract?
focused on high quality services rather than dispensing large volumes of prescriptions
aims:
- better health for the whole population
- increased quality of care for all patients
- better value for the taxpayer.
What are the new services of the NHS community pharmacy contract?
urgent care
-referrals to community pharmacies from NHS 111 initially, PILOT from GP practices
the prevention and detection of ill health
- e.g. detecting undiagnosed cardiovascular disease, stop smoking support for those beginning a programme of smoking cessation in secondary care and referred for completion in community pharmacy; the routine monitoring of patients
medicines optimisation and safety
- medicines reconciliation, expand the new medicine service (NMS), enhanced structured medication reviews
the community pharmacist consultation service (CPCS)
What are the tiers of service in the NHS community pharmacy contract?
essential services
advanced services
locally commissioned services (enhanced)
What are the 9 different essential services?
all pharmacies nationally as part for the NHS community pharmacy contract framework must provide these 9 services
1 - dispensing of medicines 2 - repeat dispensing 3 - supply of appliances 4 - disposal of unwanted medicines - are obligated to accept unwanted medicine back from patients and sort them into solids, liquids and aerosols 5 - promotion of a healthy lifestyle 6 - signposting 7 - support for self care 8 - clinical governance 9 - discharged medicine service
What does dispensing medicine entail?
patient must receive
- the item that is required
- information about the item = counselling, medicine/appliance usage, side effects
- receive supply in a timely manner
- review supply within a timely manner
- must be informed if supply is not available
What does repeat dispensing entail?
GPs could authorise the repeat supply of medicines through community pharmacies for a defined period of time and set interval
- the GP would only need to sigh one repeat authorisation (RA) with copies used by the pharmacist to claim pay for each supply
patients would not need to contact their medical practice each time
What should the pharmacist check before supplying a repeat prescription?
check if the patient needs the repeat supply and communicate any significant issues to the prescriber
check to see if the patient is suffering from any side effects
check to see if the patients medication regimen has been altered
check if there has been any other changes to the patients health
What does the promotion of a healthy lifestyle entail?
pharmacies are required to participate in up to 6 campaigns at the request of NHS England
involves the display and distribution of leaflets provided by NHS England
- winter vaccines
- weight management
- smoking cessation
What does support for self care entail?
pharmacist will help manage minor ailments and common conditions by
- giving advice
- sale of medicines
main focus is for self-limiting conditions but also for long term conditions
What does clinical governance entail?
recognition and maintenance of good practice, learning from mistakes and improving quality of services provided to patients
framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish
actions that can be taken include:
- display a leaflet about pharmacy
- visible complaints procedure
- patient satisfaction survey (annual)
- clinical audits (2 per year)
What does the discharged medicine service entail?
aims of the service include:
- optimises the use of medicines
- reduce harm from medicines at transfers of care
- reduce hospital readmissions
- improve patient understanding of medicines and how to take them following discharge from hospital
- support the development of effective team-working across hospital, community and primary care networks pharmacy teams and GP teams
What are the 9 different advanced services?
1 - New Medicine Service (NMS) 2 - NHS Urgent Medicine Supply Advanced 3 - Appliance Use Review 4 - Stoma Appliance Customisation 5 - Flu vaccination 6 - Hepatitis C service 7 - Smoking Cessation 8 - C-19 lateral flow device distribution service 9 - Hypertension case-finding service
What is the new medicine service? Who is targeted for this service?
provides supportfor people with long-term conditions newly prescribed a medicine to help improve medicines adherence
itis initially focused on particular patient groups and conditions
- asthma and chronic obstructive pulmonary disorder
- type 2 diabetes
- anti platelet therapy/anticoagulant therapy
- hypertension
- atrial fibrillation
- epilepsy
- parkinson’s disease
- osteoporosis
What are the steps involved in the NMS service? Why is it beneficial?
patient engagement: dispense the new medicine, give advice, explain NMS, agree to an ‘intervention’ stage, explain the need to care information if necessary, obtain consent
intervention: occurs 7-14 days after patient engagement stage, can be face to face or over the phone
follow up: 14-21 days after the intervention
record outcome
benefits
- improve patient adherence
- increase patient engagement
- reduce medicines wastage.
- reduce hospital admissions
- lead to increased Yellow Card reporting of adverse reactions to medicines by pharmacists and patients
