North Manchester CCG Community Pharmacy LCS Service Specification - February 2015
SCHEDULE 2 – THE SERVICES
B: Service Specifications
Mandatory headings 1 – 4. Mandatory but detail for local determination and agreement
Optional headings 5-7. Optional to use, detail for local determination and agreement.
All subheadings for local determination and agreement
Service Specification
CP-OOH
No.
Service
Supply of Palliative Care Medicines Out of Hours by
Community Pharmacists
Commissioner Lead
NHS North Manchester Clinical Commissioning Group
Period
1 April 2015 - 31 March 2017
Date of Review
March 2016
Contents:
1. Population Need and Purpose
2. Outcomes
3. Scope of the Service
- aims and service description, population coverage, criteria, links to other services
4. Service Standards
- record keeping, information collection, training & accreditation, adverse Incidents, governance,
key performance indicators.
5. Quality Requirements
6. Contract termination and Variation
7. Financial Details
1.
Population Needs
1.1
National/local context and evidence base
Out of hours medical providers already maintain an approved list of pre packs of emergency
medicines that may be dispensed to patients when seen by an out of hour’s doctor.
However, there may be an occasion when a patient requires a medicine not stocked by the
out of hour’s medical service.
The service requires pharmacists to supply a medicine on the approved palliative care
medicines list only as defined in Appendix 1 via a prescription when no pharmacy in the
locality is open. The pharmacist shall make the supply when contacted by the out of hour’s
North Manchester CCG Community Pharmacy LCS Service Specification - February 2015
provider. The service is voluntary with the community pharmacists choosing to have their
name and pharmacy included on the list.
The pharmacy shall agree to stock an agreed list of drugs for Palliative Care as defined in
Appendix 1.
The purpose of this Locally Commissioned Service Specification is to:

Support the delivery of the Adults at the End of Life New Delivery Model in North
Manchester provided by Pennine Acute NHS Hospitals Trust whose aim is to
move end of life care from hospital into the community.

Help prevent a crisis and an emergency hospital attendance or admission arising
due to lack of access to medications.

Equip the commissioner (NHS North Manchester CCG), service providers and
practitioners (community pharmacists) with the necessary knowledge, service and
implementation details to safely deliver this service.
The CCG is looking two pharmacies/pharmacists to be available out of hours.
2.
Outcomes
2.1
NHS Outcomes Framework Domains & Indicators
Domain 1
Domain 2
Domain 3
Domain 4
Domain 5
2.2
Preventing people from dying prematurely
Enhancing quality of life for people with long-term
conditions
Helping people to recover from episodes of ill-health or
following injury
Ensuring people have a positive experience of care
Treating and caring for people in safe environment and
protecting them from avoidable harm
Local defined outcomes
Preventative Treatment, Reducing Complications
The opening of the pharmacy premises outside the normal working hours will allow for
greater access to pharmaceutical care for palliative and end of life patients being cared for
out of hospital.
Reducing Health Inequalities
The scheme is available across Manchester from registered community pharmacies.
More Effective Care
The number and location of pharmacists who have volunteered to dispense from their
premises allows for emergency access to pharmaceutical care.
True Partnerships, Professionals, Patients and the Public
The community pharmacist works closely with the out-of-hours service providers, in
particular the GP Out of Hours service and the District Nursing night team.
The OOH service providers will hold a list of pharmacist’s name, home address and
telephone number and will make contact, initially, with a pharmacist nearest to the patient‘s
North Manchester CCG Community Pharmacy LCS Service Specification - February 2015
home.
Keeping Viable
The service is intended to contribute to a reduction in accident and emergency attendance,
admissions and emergency out-of-hours treatment for patients with palliative and end of life
care needs.
3.
Scope
3.1
Aims and objectives of service
The aim of the service is to increase the access to pharmaceutical services at a time when
pharmacies are normally closed and hence access to prescriptions and healthcare advice is
limited.
3.2
Service description/care pathway
The pharmacist would be contacted by the GP out of hours (OOH) service provider and
agree to attend the pharmacy to dispense a prescription.
If the pharmacist receives such a call and is unable to attend the pharmacy then the GP
OOH service provider would contact the next pharmacist on the list until a pharmacist is
available. The volunteer pharmacist agrees to attend the pharmacy and informs the GP
OOH provider.
If a patients representative or carer is unable to travel to the pharmacy out of hours, for
whatever reason, then the OOH provider is responsible for taking the prescription from the
patient’s house to the community pharmacy by using the OOH driver. The prescription
would be dispensed and any relevant instructions provided in a written format to the patients
representative or OOHs driver before returning to the patient’s home with the medication.
The OOH doctor will provide all necessary instruction to the patient.
On first contact the GP OOH provider would supply the pharmacist with the following patient
details as follows:
 Patient name and address
 Patient telephone number
 Date of birth
 Name of drug prescribed
 Patient prescription charge exemption (if applicable)
 Prescribing doctor name and contact details for any queries
The pharmacist must stock the agreed list of Palliative Care Drugs in the formulary and
medicines must be delivered back to the patient within 3 hours of the initial contact from the
OOHs provider.
The service will operate during the “out of hours” period which is defined as:



3.3
Monday to Saturday between 12pm (midnight) to 6.30am.
Saturday 12pm (midnight) to 10am Sunday.
Sunday 12pm (midnight) to 6.30am Monday.
Population covered
This service is available from a registered community pharmacy on the pharmaceutical list of
NHS England providing services to patients receiving palliative and end of life care
registered to a GP within the Clinical Commissioning Group.
North Manchester CCG Community Pharmacy LCS Service Specification - February 2015
3.4
Any acceptance and exclusion criteria and thresholds
Essential criteria
To be accepted onto the CCG’s out of hours scheme pharmacies/pharmacists must be :



3.5
Registered with the General Pharmaceutical Council
Meeting the core contractual obligations required by NHS England’s Area Team.
Included on one of the Manchester CCGs Locally Commissioned Services list for
the provision of palliative care drugs during normal working hours.
Interdependence with other services/providers
The service may only be accessed by the GP OOH provider or, the District Nursing service
via the GP OOH services by contacting the community pharmacist at home.
4.
Applicable Service Standards
4.1
Applicable national standards (e.g. NICE)
Usual standards apply
4.2
Applicable standards set out in Guidance and/or issued by a competent body
(e.g. Royal Colleges)
Usual standards apply
4.3
Applicable local standards
4.3.1 Record Keeping
The CCG is responsible for maintaining a list of volunteer pharmacists and informing the
OOH providers, GPs and the community nursing teams which pharmacists have been
commissioned to provide this service.
The pharmacist must complete and return a claim form supplied by the CCG within five
working days of completing an out of hours supply of medicines.
The pharmacist must maintain a record of:




The name of the person requesting the call out
The name of prescriber
The items dispensed
The time and date that the item was dispensed.
These records should be made available to the CCG for inspection if requested to do so.
The pharmacist should comply with the Data Protection Act and keep all records
confidential.
4.3.2 Information Collection
All claims will be logged for audit purposes.
4.3.3 Training and Accreditation
No specialist training or accreditation is required over and above the normal requirements
for a pharmacist providing dispensing services.
North Manchester CCG Community Pharmacy LCS Service Specification - February 2015
Training schedules or relevant continuing professional development records should be made
available to the commissioner on request.
The appropriate qualifications and registration with professional bodies for the service
provided must be maintained and copies of such should be provided to the commissioner if
requested.
All staff should be aware are that the pharmacy is part of the scheme and ensure stock is
maintained at appropriate levels.
4.3.4 Adverse Incidents
The pharmacist should record all adverse incidents via the Yellow Card procedure or the
CCG incident reporting scheme as appropriate.
4.3.5 Governance

The pharmacy contractor should ensure that only appropriately qualified staff,
including locums should provide the service to the required professional and ethical
standards of care and treatment as to the dispensing of medicines and giving advice
to patients.

The contractor is required to comply with all relevant legislation and have regard to
all relevant guidance issued by the CCG including the current Safeguarding Children
and Vulnerable Adults Policy.

As part of this, the practice is required to have regard to the Department of Health’s
‘Code of Confidentiality’ and the CCG’s safeguarding issues for Children &
Vulnerable Adults including referral processes and sharing of information. This
requirement is outlined in the CCG’s Child Protection Guide

The contractor should ensure that Counter Fraud and Security Management
arrangements are in place.

The contractor to agree a plan with the Commissioner to achieve level 2
compliance against all requirements in the relevant NHS information governance
toolkit as per the provider’s core contract with NHS England.

The CCGs Medicines Management team may undertake a random check of stocks
held by the contracted pharmacists.
4.3.6 Key Performance Indicators
The contractor will be performance managed against the following:






Meeting their core contractual obligations with NHS England Area Team.
All medicines from the agreed list of drugs for Palliative Care (appendix 1) are in
stock when prescribed for patients out of hours.
All calls out of hours to be answered by a pharmacist from the list.
All patients receive prescribed drugs from the agreed list of drugs (appendix 1) for
Palliative Care out of hours.
All patients receive their prescribed drugs within three hours of initial contact.
All claim forms submitted within five days of supplying medicine out of hours.
North Manchester CCG Community Pharmacy LCS Service Specification - February 2015
5.
Applicable quality requirements
5.1
Applicable quality requirements (See Schedule 4 Parts A-D)
The named pharmacist should ensure the following:
 All goods used in the performance of the agreement should be of a satisfactory
quality and be fit for the purpose for which they are used;
 Reviews the standard operating procedures on an annual basis;
 The pharmacist has undertaken CPD relevant to this service;
 The pharmacy has a complaints procedure for monitoring the procedures
provided;
 Co-operation with any review of the client experience.
6. Complaints and Termination
6.1 Complaints
Complaints would be looked at individually to understand the circumstances. The CCGs
medicines management lead would be the first point of contact to discuss any issues
arising from this service specification.
6.2 Termination of the Contract [as at February 2015]
The service specification sets out contract termination process:




Either party can agree in writing to terminate the contract with an agreed date with a
minimum termination notice of 30 days.
The provider must notify the CCG in writing immediately if any incident occurs which
adversely affects delivery of the service eg:- absence of an accredited pharmacist,
adverse incident, long term sickness, issues with premises etc..
The CCG will notify the provider in writing if there is failure to meet any contractual
obligations allowing the provider to take specified actions to correct the breach in a
specified timescale eg: unable to supply specified medicines.
If the breach is not remedied the CCG is entitled to terminate the contract
immediately by written notice.
The CCG has the right to vary the contract giving the provider 30 days notice in writing .
7. Financial Details
Payments are made to the pharmacy contractor as per the following schedule:
A fee of £300 per call out requiring the pharmacist to attend the pharmacy to dispense a
prescription form the formulary in appendix 1, which is either delivered and collected by the
patients representative or, the OOHs provider.
The definition of out of hours is:



Monday to Saturday between the hours of 12pm (midnight) to 6.30am
Saturday 12pm (midnight) to 10am Sunday
Sunday 12pm (midnight) to 6.30am Monday
North Manchester CCG Community Pharmacy LCS Service Specification - February 2015
The payment will be made in regard to reported activity and submission of invoice in
accordance with the current reporting arrangements.