Pharmacy Handbook
Dear Colleague
This information pack has been developed by the Greater Manchester Area Team (AT) to support and
assist you with the national pharmacy contract.
The team will be communicating with contractors via email - if the pharmacy have not supplied us with
one and wish to do so, please contact the team to be included on the distribution list.
Please refer to Appendix 1 for Pharmacy Team Contact details.
Contract Monitoring Process
The AT will undertake a contract monitoring process once a year to community pharmacies to ensure
compliance with the pharmacy contract. The Pharmacist/pharmacy manager or relevant member of staff
will be required to complete the Community Pharmacy Assurance Framework (CPAF) self-assessment
form, for the AT to review and identify the pharmacies to be prioritised for a visit. A report will be
generated following the visit in which any non- compliance issues will be highlighted and a time frame
given to ensure that the pharmacy meets their contractual requirements.
Essential Services
The Essential Services listed below are offered by all pharmacy contractors as part of the NHS Terms of
Service (the ‘pharmacy contract’).
Dispensing Medicines/Appliances
Pharmacies are required to maintain a record of all medicines dispensed, and keep records of any
interventions made which they judge to be significant and the Pharmacist is required to ensure
appropriate advice is given to the patient to enable them to utilise the medication or appliance and to
meet their personal need for general information on the item and the pharmacy’s Standard Operating
Procedures (SOPs) ought to reflect the process for staff to follow.
Pharmacists may regularly dispense appliances in the course of their business, they may dispense such
prescriptions infrequently, or they may have taken a decision not to dispense them at all. Whilst the
terms of service requires a pharmacist to dispense any (non-blacklisted) medicine ‘with reasonable
promptness’, for appliances the obligation to dispense arises only if the pharmacist supplies such
products ‘in the normal course of his business’. If not they will need to give details to the patient of a
supplier, please refer to Appendix 2 for a list of Greater Manchester Dispensing Appliance
Contractors (DACs).
Repeat Dispensing
Repeat dispensing is the process by which patients can obtain supplies of their repeat medicines over a
defined period of time, without the need to contact their GP practice. People with chronic conditions that
are likely to remain stable for the duration of the repeat prescription are most likely to benefit from repeat
dispensing services.
The Pharmacist providing this service will need to ensure they have undertaken the relevant training and
are certified prior to commencing the service.
Disposal of Unwanted Medicines
Pharmacies are obliged to accept back unwanted medicines from patients households (including
residential homes), but cannot accept any back from nursing homes. When the medicines are returned
to the pharmacy, it is recommend that pharmacy has Standard Operating Procedures (SOPs) in place to
ensure there are no items in the returns which the pharmacy cannot safely dispose of; for example
chemicals or non-medical products.
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The AT has two designated waste management contractors - SRCL and PHS to remove waste
medicines from the pharmacies.
The AT is under no obligation (as per the terms of service), to remove waste as a result of any pharmacy
private services and any expired ‘Over the Counter’ stock; this will be the responsibility of the pharmacy
to arrange their own waste provider in these instances. Please refer to Appendix 3 for relevant
details of your waste provider. If a pharmacy requires an extra collection please contact the AT by
email and include the reason why this collection is needed.
The pharmacy must ensure that they are provided with a consignment note at every collection and that
these are retained for at least 3 years. No waste can be stored for longer than six months and it should
not exceed 5 cubic metres in volume at any time.
The pharmacy contractor will need to ensure they have CD Denaturing kits available and have registered
with the Environment Agency for a ‘T28’ exemption. This can be completed online at www.environmentagency.gov.uk.
If pharmacy is collecting patient returns from households they are deemed as waste carriers and are
required to purchase the relevant licence and follow the legal environmental health obligations
Promotion of Healthy Lifestyles
Each year the pharmacy will be required to participate in up to six Health Promotion campaigns at the
request of the AT and pharmacies will need to ensure they are recording information and advice given
out on the relevant audit sheets. These record logs will need to be kept on the premises which may be
viewed by the AT as part of contract monitoring.
Please refer to Appendix 4 Health Campaign Record Tally sheet. It will be the responsibility of the
pharmacy to ensure staff are briefed and that promotional materials are available and on display at the
appropriate time.
Signposting
Pharmacies have been provided with lists of care and support services within their locality. Pharmacies
will be expected to help people who ask for assistance by signposting them to the most appropriate
source of help. Pharmacies will need to ensure they maintain a record of advice given and these are
available upon request by the AT as part of contract monitoring. Please refer to Appendix 5
Signposting Directory (area specific) and Appendix 5a for a sample record sheet.
Support for Self Care
Pharmacies will help manage minor ailments and common conditions by the provision of advice and,
where appropriate, the sale of medicines. This includes dealing with referrals from NHS Direct/NHS 111.
Records should be kept where the pharmacist considers it relevant to the care of the patient. Please
refer to Appendix 6 for a Support for Self-care sample record sheet.
Clinical Governance
The clinical governance (CG) requirements of the NHS Terms of Service cover a wide range of quality
indicators as listed below:
 Audit – A clinical audit involves improving the care of patients by looking at what is being done,
learning from it and if necessary changing practice. Pharmacies will be required to undertake
two audits each financial year, one pharmacy-based audit and one other audit agreed with the
AT
 Chaperone Policy - It is not mandatory to have in place a chaperone policy, but pharmacy
contractors may wish to consider the adoption of such a policy in order to protect patients and
staff
 CG Lead - Each pharmacy is required to have a clinical governance lead who will act as the main
contact on such matters between the pharmacy and the AT
 Complaints – Each pharmacy is required to have a complaints record log and these need to be
submitted on an annual basis to the AT. Patient complaints should be directed to the NHS
complaints team on 0300 311 2233
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Confidentiality – Each pharmacy is required to ensure their staff and employees are complying
with legal obligations on data protection and confidentiality. It is required that pharmacies ensure
staff are aware of the NHS Code of Practice for Confidentiality
CPPQ (patient satisfaction survey) - Each pharmacy must undertake a patient satisfaction
survey annually.
The results must be published via the pharmacy either by leaflet, poster, on the pharmacy’s
website, or NHS Choice profile. Survey templates and more information are available via the
PSNC website (www.psnc.org.uk)
Patient Safety Incident Reporting – Each pharmacy must report patient safety incidents to the
National Reporting and Learning system (NRLS). The NRLS allows staff members to report the
incidents that they are involved in or witness in confidence and anonymously. The pharmacy
also needs to have an incident reporting system, together with arrangements for analysing and
responding to incidents
Practice Leaflets – Each pharmacy must ensure they have a practice leaflet with the required
information for patients. A list of the required information is available via the PSNC website
Whistleblowing - Each pharmacy must ensure they have a whistle blowing policy to enable staff
to raise concerns
Advanced Services
There are four Advanced Services within the NHS Community Pharmacy Contractual Framework.
Community Pharmacies can choose to provide Advanced Services as long as they meet the
requirements set out in the National Directions and are compliant with their Essential Services
Medicine Use Reviews (MURs)/Prescription Intervention Service
The MUR service is a structured review that is undertaken by a pharmacist to help patients to manage
their medicines more effectively. An MUR is not usually conducted more than once a year. National
target groups have been agreed in order to guide the selection of patients to whom the service will be
offered. The MUR involves the pharmacist reviewing the patient’s use of their medication, ensuring they
understand how their medicines should be used and why they have been prescribed, identifying any
problems and then, where necessary, providing feedback to the prescriber.
A Prescription Intervention service is simply an MUR which is triggered by a significant adherence
problem which comes to light during the dispensing of a prescription. It is over and above the basic
interventions, relating to safety, which a pharmacist makes as part of the dispensing service.
The Pharmacists providing this service will need to ensure they have completed the relevant
accreditation prior to commencing. They need to notify the AT that they intend to provide this service,
submit a copy of their accreditation and complete a PREM1 form (available from the PSNC website).
If the pharmacy is requesting to undertake an MUR off-site they need to seek approval from the AT and
submit the relevant form (PREM2). If approval is given they will be required to have a DBS check and
ensure they gain consent from each individual patient before providing the service. .
Pharmacies providing MUR’s must complete the national quarterly return template and submit via email
to the AT. A copy of the template and the required submission dates, along with the PREM1 and PREM2
forms, can be found on the PSNC website.
New Medicine Service (NMS)
The NMS is designed to provide early support to patients who have been newly prescribed a medicine in
one of the following conditions/therapy areas asthma & COPD, type 2 Diabetes,
antiplatelet/anticoagulant therapy and hypertension.
In March 2013 NHS England agreed to extend the service for a further six months. This means that
community pharmacies can continue to recruit new patients to the service up until September 30th 2013
and will receive payment for these patients even where the service is completed in October or November
2013.
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The Pharmacists providing this service will need to ensure they are accredited to undertake MUR’s and
make a declaration to the contractor.
The contractor needs to notify the AT that they intend to provide this service using the NMS Declaration
Form available on the PSNC website. As with MUR’s, the NMS quarterly returns need to be submitted to
the AT via the email using the national template.
Appliance Use Reviews (AURs)
AURs can be carried out by a pharmacist or a specialist nurse, in the pharmacy or at the patient’s home.
AURs should improve the patient’s knowledge and use of any ‘specified appliances’.
The pharmacy must notify the AT that it intends to provide this service and submit the required
notification form (APPL01) to the AT. The form can be downloaded via the PSNC website.
Stoma Appliance Customisation Service (SAC)
The SAC involves the customisation of a quantity of more than one stoma appliance, based on the
patient’s measurements, to ensure proper use and comfortable fitting.
The pharmacy must notify the AT that it intends to provide this service and submit the required
notification form (APPL02) to the AT. The form can be downloaded via PSNC website.
Additional Information
GPhC Inspectors
The GPhC currently employs a number of inspectors across Great Britain. The inspectors are divided
into three regional groups: the Northern, Central and South-Eastern region. Each region is managed by
a Regional Lead Inspector.
The inspectors have two main roles:
 Inspection visits
To inspect registered pharmacy premises in order to monitor and secure compliance with relevant legal
requirements and professional standards.
 Investigations
To investigate complaints and allegations involving registered pharmacists or registered pharmacy
technicians.
Please refer to the GPhC website for further information and to contact your local inspector.
Alerts
If the pharmacy contractor wishes to raise an alert due to a fraudulent or stolen prescription, unusual
activities, or patient behaviour please contact the AT.
Fraudulent Prescriptions/Reward Scheme
The scheme allows pharmacists to claim a financial reward when they have identified a fraudulent
prescription form and thereby either prevented fraud or contributed with valuable information to the
investigation of fraud.
The Drug Tariff contains information on Reward Scheme – Fraudulent Prescription forms and eligibility to
claim a reward under the scheme via NHS Protect England.
Safeguarding
Safeguarding means protecting people’s health, wellbeing and human rights, and enabling them to live
free from harm, abuse and neglect. It is fundamental to creating high-quality health and social care. The
pharmacy staff should undertake relevant training and should be aware of the local guidance and contact
details for safeguarding leads.
If the pharmacy wants to raise any concerns or issues about a child or vulnerable adult, contact your
local safeguarding lead (please refer to Appendix 7).
Opening Hours
A pharmacy has 40 core contractual hours (or 100 for those that have opened under the former
exemption from the control of entry test), which cannot be amended without the consent of NHS
England, together with supplementary hours, which are all the additional opening hours, and which can
be amended by the pharmacy subject to giving 90 days’ notice.
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Pharmacies wishing to amend the distribution of their core contractual hours must apply to the AT.
Relevant national templates are available via the PSNC website.
Pharmacies that are open for 100 hours per week must submit their monthly hours declaration to the AT
(please refer to Appendix 8).
Closures
The pharmacy contract requires that pharmacies are open for all of your contracted hours.
If a pharmacy is unable to open for any reason, they must inform the AT immediately or as soon as
practicable. During office hours, this contact should be by telephone, outside of office hours, ‘Notification
of unplanned temporary suspension of services’ (please refer to Appendix 9), needs to be completed
and submitted to the AT via fax or email.
Electronic Prescription Service (EPS)
The EPS enables prescriptions to be sent electronically from the GP surgery, to the pharmacy and then
on to NHS BS for payment. The patient nominates where their prescriber will electronically send their
prescription. The pharmacy will need to ensure they are following NHS England national guidance for
capturing nominations and utilising the ‘EPS Patient Nomination request’ form (as per good practice),
please refer to Appendix 10.
Before operating EPS, a pharmacy should undertake the relevant system training and have been issued
with a smart card with sufficient access rights. When the pharmacy is able to operate EPS, pharmacies
can submit a claim for the £200 a month EPS payment by completing an ‘ETP Monthly Allowance’ claim
form (previously known as PPAETP1), available on the PSNC website, to the AT. If at a later date the
pharmacy is unable to operate the service, they must let the AT know in writing immediately.
When EPS is resumed the pharmacy contractor must complete another ‘ETP Monthly Allowance’ claim
form and this will need to be resubmitted to the AT. If the pharmacy undergoes a change of ownership
and its contractor (PPD) code changes, the £200 a month payments will cease, it is the contractor’s
responsibility to ensure they complete a new ‘ETP Monthly Allowance’ claim form and submit this to the
AT to begin to receive payments again.
Further information for EPS and the relevant claim forms can be found at Health & Social Care
Information Centre (previously known as Connecting for Health) via the website www.hscic.giv.uk. For
details of your local EPS project manager, please refer to Appendix 10a.
For any smart card issues please refer to Appendix 11.
Pre-registration training grants
The Pre-Registration Training Grant is set out in Part XIII of the Drug Tariff. Payment is made by NHS
England in arrears. The pharmacy contractor needs to apply to the AT for payment and PSNC has
devised a template form which can be used for submission.
Certificate of Conformity (COC)/Certificates of analysis (COA)
The pharmacy contractor must stamp, date, initial and endorse the COA/COC with the invoice price
(minus discount) and prescriber details. At the end of the month the contractor shall send a copy of the
appropriately endorsed COC/COA to the AT. Please ensure all patient identifiable information is
removed.
NHS Email Accounts
Pharmacies experiencing any problems with their NHS email accounts or requesting a new NHS email
account, should contact their local organisational administrator (LOA) via their locality IT helpdesk,
please refer to Appendix 12.
Stationery Supplies
The pharmacy can order stationery such as FP57 and dispensing tokens via Preston Primary Care
Support (formally LaSCA). These orders can be placed on-line via www.lasca.nhs.uk and the
pharmacy’s contractor code will be required.
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Please note: pharmacies will not be charged for this order, even though the costs are displayed.
Pharmacies located within Tameside & Glossop and Manchester localities should continue to order their
supplies as follows:
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Tameside & Glossop – Millennium House, Denton, M34 2GP Jackie Thompson email:
Jacqueline.thompson@nhs.net Telephone No: 0161 304 5486
Manchester – The Supplies Team (Cityworks), NHS England, Primary Care Support Services –
Manchester, Greater Manchester Area Team, Parkway three, Parkway Business Centre,
Princess Road, Manchester, M14 7LU. Fax No: 0161 220 9016
Ian Deveney/Ian Williams Telephone No: 0161 765 6518/765 6519
Drug Tariff and BNF
These are automatically delivered to pharmacies; Drug Tariffs are sent on a monthly basis and BNFs are
sent during March/April and September/October every year. These are also available online via
www.bnf.org and www.drugtariff.co.uk .
Pharmaceutical Services Negotiating Committee (PSNC)
PSNC promotes and supports the interests of all NHS community pharmacies in England. They are
recognised by the Secretary of State for Health as the body that represents NHS pharmacy contractors.
They work closely with Local Pharmaceutical Committees (LPCs) to support their role as the local NHS
representative organisations, please refer to Appendix 13. It is the role of PSNC to liaise with the
Department of Health and representatives of the NHS in England to negotiate the contractual terms for
the provision of NHS community pharmacy services.
PSNC provide a very useful website for guidance, information and any relevant templates/forms
(www.psnc.org.uk)
Newsletters
The AT produces a monthly newsletter via email to update community pharmacies on the latest
developments and enable the sharing of useful information.
I hope the information and guidance supplied within this handbook is beneficial. Please do not hesitate to
contact a member of the team should you require more advice.
Published by the Optometry and Pharmacy Team
NHS England Greater Manchester Area Team
Published Date: October 2013
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