SERVICE SPECIFICATION CARE AT THE CHEMIST
1.
Introduction
1.1
The Care at the Chemist scheme allows patients to consult a community
pharmacist rather than a GP for a defined list of minor ailments. Patients who
are exempt from NHS prescription charges receive treatment from an agreed
local formulary free of charge.
1.2
Patients who pay for their prescriptions can be treated under the scheme;
however they will pay the cost of the item(s) or a prescription charge
whichever is the lowest amount.
2.
Service Description
2.1
The pharmacy will provide advice and support to people on the management
of minor ailments, from the agreed formulary including where necessary, the
supply of medicines for the treatment of the minor ailment, for those people
who would have otherwise gone to their GP for a prescription.
2.2
Where appropriate the pharmacy may sell OTC medicines to the person to
help manage the minor ailment, as described in Essential Service 6 of the
Community Pharmacy Contractual Framework.
2.3
The pharmacy will operate a triage system, including referral to other health
and social care professionals, where appropriate.
3.
Aims and Intended Service Outcomes
3.1
To improve access and choice for people with minor ailments by:
3.1.1 Promoting self-care through the pharmacy, including provision of
advice and where appropriate medicines and/or appliances without the
need to visit the GP Practice;
3.1.2 Operating a referral system from local medical practices or other
primary care provider; and
3.1.3 Supplying appropriate medicines and devices (dressings etc.) at NHS
expense.
3.2
To improve primary care capacity by reducing medical practice workload
related to minor ailments.
SLA Care at the Chemist 2015-16
Review date: 31st March 2016
1
3.3
Patients are under no obligation to use the service if they prefer to consult
a GP or other suitable health professional
4.
Service Outline
4.1
Premises
4.1.1 The part of the pharmacy used for provision of the service should
provide a sufficient level of privacy and safety.
4.2
Client Group
4.2.1 This service is available to patients registered with GP practices in
Knowsley or resident in Knowsley. Patients need to provide suitable
identification to be accepted onto the scheme
4.2.2 Groups of people who are eligible to receive treatment under the
scheme can access from the following options:
i.
ii.
Local access – any patient registered with a GP practice in
Knowsley CCG or resident in Knowsley can present in the
pharmacy and access the scheme.
Referral – where people may be referred from another health
care team member.
4.2.3 The service only applies to the ailments and remedies listed in 'Care at
the Chemist’ formulary and treatment protocols available in a l l
pharmacies on the Webstar Servicepact data base.
These
documents may be updated periodically and contractors should refer to
the most up to date list.
4.2.4 The service is unavailable to infants less than 1 year old.
4.3
Training and Competence
4.3.1 The pharmacy contractor has a duty to ensure that pharmacists,
including locum pharmacist, and staff involved in the provision of the
service have relevant knowledge to provide this service.
4.3.2 The pharmacy contractor has a duty to ensure that pharmacist and
staffs involved in the provision are aware of, and operation within local
protocols.
4.4
Consultation
4.4.1 The consultation should take place in a quiet place with minimal
disruption.
4.4.2 Normal rules of patient confidentiality apply.
4.4.3 The patient must be experiencing an acute episode at the time of
treating. Patients must not be treated prophylactically under the scheme.
SLA Care at the Chemist 2015-16
Review date: 31st March 2016
2
4.4.4 The patient should be seen in person. However, the pharmacist may
use professional judgement to decide whether to provide advice and
treatment to the patient via a carer or representative.
4.4.5 The pharmacist will assess the patient's condition.
In certain
circumstances the pharmacist may use professional judgement and
delegate this responsibility to a suitably trained member of staff,
ensuring professional supervision maintained at all times. In such a
case the pharmacist must still sign the C are at the Chemist
prescription form.
4.4.6 The consultation will consist of:
i.
ii.
iii.
iv.
v.
vi.
vii.
Patient assessment, in line with treatment protocols;
Provision of advice on the management of the ailment; OR
Provide advice and medicine from the local formulary, supported
by advice on its use; OR
Provide advice on the management of the ailment plus a referral
to an appropriate health care professional;
Completion of a care at the chemist prescription form;
Labelling of any product supplied;
Record of supply or advice on the patients PMR.
4.4.7 After the consultation, if a medicine is recommended, patients will sign
a declaration of they are exempt from NHS charges. The declaration is
the same as the reverse of prescription forms, and the same proofs of
exemption are acceptable. If the patient is not exempt and the cost of
the medicine exceeds the current NHS prescription charge the
pharmacist should collect the NHS levy in the normal way.
4.4.8 At busy periods the pharmacist may ask the patient to wait or return to
collect their medication i.e. once the consultation has taken place the
patient must wait in line with prescriptions received in the usual way.
4.4.9 If the pharmacist suspects that the patient/parent or guardian is
abusing the scheme they should contact a member of Knowsley CCG
Medicines Management Team 0151 244 4124
4.4.10 Patients should be made aware that abuse of the service may result in
their removal.
4.5
Referrals
4.5.1 The pharmacist should use their professional judgement and protocols
provided to refer patients presenting for treatment under Care at the
Chemist to other health professionals as appropriate.
4.5.2 To facilitate rapid referral to the GPJWIC/OOH in accordance with
treatment protocols, the pharmacist should ask the patient for consent
to phone/fax a referral to the relevant service.
SLA Care at the Chemist 2015-16
Review date: 31st March 2016
3
4.6
Record Keeping and Administration
4.6.1 The pharmacy should record all consultations on Webstar Servicepart
database.
4.7
Registration Cards
4.7.1 Registration will be via Webstar Servicepact database
4.8
Exclusion Criteria Client Group (Include Suitable Patients and Excluded)
4.8.1 Patients who present with the same condition more than twice in a 4
week period. Unless rapid referral is necessary, they should make a
GP appointment in the normal way.
4.8.2 Refer to treatment protocols for additional criteria.
5.
CCG Support
5.1
The CCG will provide a framework for the recording of relevant service
information for the purposes of audit and the claiming of payment.
5.2
The CCG will be responsible for the promotion of the service l o c a l l y ,
including the development of publicity materials, which pharmacies can
use to promote the service to the public.
5.3
The CCG will provide leaflets to support self-care messages related to
specific ailments covered by the scheme and making these available to
pharmacies.
5.4
The CCG will need to provide details of relevant referral points which
pharmacy staff can use to signpost service users who require further
assistance.
5.5
Client information relating to the use of the service has to be passed to other
health service organisations, for example, clients GP or the local NHS
commissioning body for a variety of purposes such as audit or payment.
The client's informed consent must be obtained before information can be
passed to their GP.
6.
Clinical Governance
6.1
The pharmacists participating will be expected to have completed the
appropriate training and update this training when changes to the service are
made.
6.2
Participating pharmacist will be required to take part in regular CPO, and
act on updates and information provided by the CCG.
6.3
Pharmacist must follow treatment protocols provided unless there are clear
clinical reasons, which must be documented.
SLA Care at the Chemist 2015-16
Review date: 31st March 2016
4
6.4
Pharmacists involved in the scheme will participate in multidisciplinary audit
of the scheme as specified by the CCG.
6.5
Pharmacists will carry out satisfaction surveys involving patients and GP
practices in conjunction with the CCG.
7.
Audit
7.1
The CCG will monitor prescribing patterns quarterly and provide appropriate
feedback to community pharmacists and GPs.
8.
Financial Arrangements
8.1
Payment is subject to meeting the requirements of the service.
a. A fee of £2.00 will be paid for each consultation under the scheme.
b. A fee of 95p will be paid for each item dispenses as part of the scheme
c. There will be an annual review of the payment. The contractor will be
notified of any agreed members.
d. NB if more than on remedy is supplied for the same ailment, only one
consultation fee will be paid
e. The pharmacy will be reimbursed for any medication supplied including
VAT. It is the responsibility of the community pharmacy contractor to
ensure the VAT is declared to Customs and Excise.
f. Where patients are not exempt from prescription charges and have paid
the NHS Levy to the Pharmacy, COM will deduct such sums from the
relevant month’s remuneration. Prescriptions should be presented in two
bundles to facilitate this.
g. Webstar Servicepact will generate an invoice for each pharmacy, each
month which will be sent to Shared Business Services in Wakefield, who
will process payments on behalf of the CCG. Payment will take place by
Bank Automated Credit on the 20th of the month following that to which the
payment relates.
h. Pharmacists are requested to ensure monthly returns to the CCG in order
to facilitate monitoring of accurate financial forecast. Continual failure of
timely returns may result in removal of the service.
i. Activity in non-payment CCG activity the previous financial year (1 April –
March 31)
j. There will be an annual review of the payment. The contractor will be
notified of any agreed amendments
k. NB if more than one remedy is supplied for the same ailment, only one
consultation fee will be paid.
l. The pharmacy will be reimbursed for any medication supplied including
VAT. It is the responsibility of the community pharmacy contractor to
ensure the VAT is declared to Customs and Excise.
m. Where patients are not exempt from prescription charges and have paid
the NHS Levy to the pharmacy, COM will deduct such sums from the
relevant month's remuneration. Prescriptions should be presented in two
separate bundles to facilitate this.
SLA Care at the Chemist 2015-16
Review date: 31st March 2016
5
n. Webstar Servicepact will generate an invoice for each pharmacy each
month which will be sent to Shared Business Services who process
payments for the CCG.
o. Payment will take place by Bank Automated Credit on the 20th of the
month following that to which the payment relates.
p. Pharmacists are requested to ensure monthly returns to the CCG in order
to facilitate monitoring of accurate financial forecast. Continual failure of
timely returns may result in removal of the service.
q. Activity in non-payment CCG activity the previous financial year
Medicines Management Team
Knowsley Clinical Commissioning Group
Nutgrove Villa
Westmorland Road
Huyton
L36 6GA
Tel: 0151 244 4126
Fax: 0151 244 3437
Review date 31st March 2016
SLA Care at the Chemist 2015-16
Review date: 31st March 2016
6