Dear Northland Prescriber
From 1 July 2012 “Close Control” is being replaced by the “Dispensing Frequency Rule”.
This change is a consequence of the new Pharmacy Services Agreement that changes the community
pharmacy contract from a fee-for-dispensing model to a patient-centred service with a focus on those
patients with long-term conditions (LTC) who need adherence support and monitoring to enable optimal
medication self-management.
This service specification within the new agreement is entirely new and there will be a 3-year transition
period to allow pharmacy to re-engineer their clinical and business processes to meet the full potential
that the new framework allows. In the first 7 months (July 2012 to January 2013) community
pharmacists will be assessing patients for eligibility to register for the LTC service - it is expected that
about 150,000 to 200,000 patients nationally will be eligible. If patients meet the LTC criteria, their
pharmacist will provide adherence and compliance services to support them. Any health professional is
able to refer a patient to their pharmacist for assessment.
What does this mean for you as a prescriber?
From 1 July 2012 “close control” will no longer be a relevant annotation on prescriptions.
Your patients currently on close control will continue to receive their current dispensing frequency until
their pharmacist has assessed them for LTC – you need not worry that any individual will receive a
lesser service until their needs have been assessed.
As the tools for assessing eligibility are a work-in-progress and pharmacists themselves will only be
getting to grips with the LTC assessment in the next 4 to 6 weeks, we do not envisage you being
inundated with phone calls or other communications in the immediate future. Pharmacists will contact
you if and when any change is being proposed to ensure all relevant factors are considered, e.g.
overdose risk, medication safety, clinical control, etc.
To effect a smooth transition as patients are assessed over the next 6 months, the NCPO (Northland
Community Pharmacy Organisation), NDHB and PHOs will be working together to develop an
appropriate communication strategy between pharmacy and prescribers to ensure that everyone
remains fully informed and any concerns can be raised regarding a specific patient’s medication
management plan as it is developed.
Attached are several documents which provide more detail on the “Dispensing Frequency Rule”.
Prescribers may still endorse prescriptions defining periods of supply for trial periods or when patient
safety is a concern, e.g. potential for overdose. Pharmacists are being given more responsibility for
defining the appropriate period of supply based on the level of adherence and compliance support
required.
Please bear with us while community pharmacy transitions to the new model of care. If you have any
questions please do not hesitate to contact:
Jillian Sutherland
Pharmacy Professional Adviso r, NDHB
09 430 4101 ext 7533 or 021 873 080
or
Sharon Scott
Pharmacy Facilitator, Manaia PHO
021 213 4067
Regards
Jillian Sutherland
Pharmacy Prof Advisor
NDHB
Sharon Scott
Pharmacy Facilitator
Manaia PHO
John Munn
Secretary
NCPO
Kyle Eggleton
Clinical Director
Primary Care, Northland