SCHEDULE 2 – THE SERVICES
A.
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
No.
Service
Substance Misuse Supervised Consumption
Commissioner Lead
Adrian Roche/David Neale
Provider Lead
Primary Care Pharmacist
Period
April 2015 – March 2016
Date of Review
October 2015
1.
Population Needs
1.1
National/local context and evidence base
2.
Outcomes
2.1
NHS Outcomes Framework Domains & Indicators
Domain 1
Domain 2
Domain 3
Domain 4
Domain 5
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
2.2
Local defined outcomes
3.
Scope
3.1
Aims and objectives of service
√
√
1. To ensure compliance with the agreed treatment plan by:
 Dispensing in specified installments (Doses may be dispensed for the
patient to take away to cover days when the pharmacy is closed, as
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
specified by the prescriber on the prescription)
Ensuring each supervised dose is correctly consumed by the patient
for whom it was intended
2. To reduce the risk to local communities of:
 Over-usage or under-usage of medicines;
 Diversion of prescribed medicines onto the illicit drugs market;
 Accidental exposure to the supervised medicines.
3. To provide service-users with regular contact with health care professionals
and to help them access further advice or assistance.
4. The service-user will be referred to specialist treatment centers or other
health and social care professionals where appropriate.
3.2
Service description/care pathway
This service will require the pharmacist to supervise the consumption of prescribed
medicines at the point of dispensing in the pharmacy, ensuring that the dose has
been administered to the patient. Pharmacies will offer a user-friendly, nonjudgmental, client-centered and confidential service.
The pharmacy will provide support and advice to the patient, including referral to
primary care or specialist centers where appropriate. The medicines which may
have consumption supervised are methadone and Buprenorphine used for the
management of opiate dependence.
3.3
Population covered
Clients prescribed substitute Opioid medication by Walsall’s specialist substance
misuse treatment services
3.4
Any acceptance and exclusion criteria and thresholds
Dependent on assessment by a clinical consultant at The Beacon and other medical
support staff
3.5
Interdependence with other services/providers
CRi
The Beacon
4.
Applicable Service Standards
4.1
Applicable national standards (eg NICE)
Drug Misuse and Dependence UK Guidelines on Clinical Management
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4.2
Applicable standards set out in Guidance and/or issued by a competent body
(eg Royal Colleges)
4.3
Applicable local standards
1. The pharmacist will show evidence of Continuing Professional Development
by accessing local Public Health training events or those delivered by
external providers. The pharmacist is responsible for the costs of sending
staff on training.
2. A Centre for Pharmacy Postgraduate Education (CPPE) open learning
programme provides pharmacists with the necessary knowledge to
underpin the provision of this enhanced service:
 CPPE Substance Use and Misuse (Pharmacist Version)
The Pharmacist must complete the above learning programme within six
months of starting to provide a Supervised Consumption Service and a record of
completion of this programme must be kept and a copy sent to the Primary
Care Contracts & Procurement Officer at Walsall CCG for full accreditation.
3. Local Authority / Public Health Commissioned training.
Attendance at a training event is a prerequisite in order for Pharmacists to
provide a Supervised Consumption service. Knowledge of local service should
be provided by reference to the Local Authority / Public Health’s service
specification.
4. Summary of Assessment and Accreditation
Each pharmacist must be undertaking or have successfully completed the
required assessment for

CPPE Substance Use and Misuse (Pharmacist Version) open learning
programme
Temporary accreditation for the first six months may be achieved by written self
declaration to the Local Authority stating that the CPPE training pack has been
commenced and will be completed within six months.
5. Re-accreditation
Updates are recommended every two years which may be in the form of a self
declaration of competency or other method of assessment as considered
appropriate by the accrediting the Local Authority. Where there are concerns
regarding poor performance, this should be addressed separately as a clinical
governance matter.
6. Cross-accreditation
Accredited pharmacists must be advised by the accrediting Local Authority that
if they wish to provide this enhanced service to another Local Authority, they
should contact that Local Authority for further information.
•
GPhC standardsStandards of conduct, ethics and performance
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•
•
Standards for registered pharmacies
Standards for continuing professional development (CPD)
5.
Applicable quality requirements and CQUIN goals
5.1
Applicable Quality Requirements (See Schedule 4 Parts [A-D])
5.2
Applicable CQUIN goals (See Schedule 4 Part [E])
6.
Location of Provider Premises
The Provider’s Premises are located at:
Named registered pharmacy premises within the borough of Walsall
7.
N/A
Individual Service User Placement
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B.
Activity Planning Assumptions
1. The Local Authority will undertake an annual review of the service operated
within the pharmacy.
2. Recording of service information for the purposes of audit and claiming
payment will be made via the PharmOutcomes platform (help desk number is
01983 216699).
3. The pharmacy will review its own Standard Operating Procedures and referral
pathways on an annual basis.
4. The pharmacy will participate in an annual audit of the service facilitated by
the Local Authority.
5. The pharmacy will participate in any locally-agreed, Local Authority-led
assessment of user experience.
C.
Essential Services
1. The pharmacist will provide an appropriate environment that ensures that
the confidentiality and safety of the service-user and others is maintained.
2. The pharmacist will dispense the medication in a suitable receptacle and
provide the service user with a glass of water to facilitate administration and
prevent doses being held in the mouth.
3. Terms of agreement are set up between the Prescriber, Key Worker,
Pharmacist and Patient (a four-way agreement) to agree how the service will
operate, what constitutes acceptable behavior by the client, and what action
will be taken by the prescriber and pharmacist if the user does not comply
with the agreement.
4. The pharmacy contractor has a duty to ensure that pharmacists and staff
involved in the provision of the service have relevant knowledge, are
appropriately trained in the operation of the service, and are aware of the
Standard Operating Procedure within the pharmacy and the Guidelines. All
qualified staff, including locum staff, will have read and signed to abide by
the SOP.
5. The pharmacy should maintain appropriate records to ensure effective
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ongoing service delivery and audit.
6. Pharmacists will share relevant information with other health care
professionals and agencies as set out in the four-way agreement.
7. The pharmacy contractor will either collect prescriptions from The Beacon
unless otherwise agreed.
8. The pharmacy contractor will inform the prescriber of prescription serial
numbers of those prescriptions not dispensed.
9. The pharmacist will notify the prescriber if a client does not collect their
medication for three days or more.
D.
Exit Arrangements
If the accredited pharmacist leaves the pharmacy, the pharmacy must notify the
commissioner and the pharmacy must arrange for the new pharmacist to accredit
themselves.
E.
Safeguarding Policies
The pharmacy contractor has a duty to safeguard vulnerable adults & children, and
should have robust safeguarding policies and procedures in place. The Pharmacy
contractor should also comply with the policies, practice and protocols and Walsall
safeguarding adults and children boards.
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SCHEDULE 3 – PAYMENT
A. Local Prices
Enter text below which, for each separately priced Service:





identifies the Service;
describes any agreement to depart from an applicable national currency (in respect of
which the appropriate summary template (available at:
http://www.monitor.gov.uk/locallydeterminedprices) should be copied or attached)
describes any currencies (including national currencies) to be used to measure activity
describes the basis on which payment is to be made (that is, whether dependent on
activity, quality or outcomes (and if so how), a block payment, or made on any other
basis)
sets out any agreed regime for adjustment of prices for the second and any subsequent
Contract Year(s).
Payment for this enhanced service will be £2.50 (Methadone) per supervised
consumption, £3.50 (Buprenorphine). Payment will not be given for unsupervised
doses or non-attendances.
All activity and claims will be made via the PharmOutcomes platform. Provided the
Pharmacy/Contractor has ensured that PharmOutcomes is maintained and updated
at the time of each supply, the system will automatically extract the required
information to generate the payment. Handwritten or separate claims are no longer
required and will not be accepted. PharmOutcomes must be updated by the 1st of
every month for upload on the 2nd. Payments will be made to the participating
pharmacy, itemising the payment made for that month and the bank account.
Contractors are advised to retain a copy of the claim.
Claims will be processed and paid on a monthly basis. Claims must be sent on a
monthly basis. Claims for payments MUST be received within 3 months of the
consultation. Claims received after this time period WILL NOT be paid.
Where Contractors fail to deliver the scheme in line with this specification or fail to
ensure that PharmOutcomes is kept updated, they will not being paid for those
supplies.
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