• Introduction
• Background
• GP Perspective
• NHS Contract – Next Steps
• Conditions and Treatments
• Delivering the Service
• PharmOutcomes Demonstration
• Q&A

Lundbeck UK and Teva UK

Jasmeen Islam
Mark Green
Sarah Boyd-Short
Nicola Bradley
Nick Thayer
Kevin Noble
Deputy Head of Medicines Management, NWCSU
GP, St Hilary Brow Group Practice
Commissioning Support Manager
– Contracts &
Delivery
Community Pharmacy Manager for the Wirral Minor
Ailments Scheme
Community Pharmacist, Well Pharmacies, Eastern
Cheshire
Pinnacle Health Partnership LLP

Melanie Carrol
Contractor support and Service Development Pharmacist
Community Pharmacy Cheshire and Wirral

• West Wirral Minor Ailments Service
• Opportunities to work together
• Urgent Care Board Paper

• Merger of LPC’s
• Merger of CCG’s
• NHS contract

CCG Ian Stewart, Sarah Boyd-Short
GP Hannah McKay
CSU Nicola Bradley, Jasmeen Islam
LPC Melanie Carrol
LPN Suzanne Austin
Others stakeholders when needed

• NHS Contract
• Service Specification
• Level 1 Protocols
• Level 2 PGD’s

Jasmeen Islam
Deputy Head of Medicines
Management
NWCSU
March 2015

Five Year Forward
View
•Investing in building the public’s understanding that pharmacies can help them deal with coughs, colds and other minor ailments
Community Pharmacy
Manifesto
• 5 pledges
• Encourage patients to think ‘pharmacy first’, and use pharmacy to help relieve pressure on
GPs and emergency departments
Community Pharmacyhelping provide better quality and resilient urgent care -NHSE
• Better integrate pharmacy into the urgent and emergency care system
• self-management of minor ailments

Example mapping of prescribing: fever & pain in children

Example mapping of prescribing: hayfever

• There is currently one pharmacy for every
3,402 residents, which compares extremely favourably to the national average of one pharmacy for every 5,000 resident population.

The cost of treating a patient with a minor ailment in an A&E department is a) Twice as high b) 3.5 times as high c) 5 times as high than the cost of treating the patient in a pharmacy

The cost of treating a patient with a minor ailment in an A&E department is five times higher than the cost of treating the patient in a pharmacy
Coughs and sore throats cost the NHS an extra £1.1 billion a
year when patients are treated in Emergency Departments or
GP surgeries
(source: RPS)
Patient experience is high on the agenda nationally and locally

• Nigel Mathers, the honorary secretary of the
Royal College of General Practitioners:
‘“sensible” that community pharmacists, and not over-stretched GPs, should be the first port of call for common ailments.
Such a move .. would take pressure off the demand for a GP appointment and leave more time for doctors to deal with more complex consultations’

• National Minor Ailment Service – much discussion…
• National exploration of co-commissioning of community pharmacy services: potential for future years
• RCGP / RPS collaboration
• RPS video – Minor Ailments

Sarah Boyd-Short
Commissioning Support Manager –
Contracts & Delivery
0151 651 0011 (ext 1790) sarahboyd2@nhs.net

GOVERNANCE AND REGULATORY
Full Legal Name
Address
Is this the Principal Address
Is this the Registered Address
Company Number
Authorised Signature
Provider’s Information Governance Lead
Provider’s Caldicott Guardian
Provider’s Senior Information Risk Owner
Provider’s Accountable Emergency Officer
Provider’s Safeguarding and Prevent Lead
Addresses for service of Notices
Provider Representative
YES/NO
YES/NO
Name [
Email: [
Tel: [
Name [
Email: [
Tel: [
Name [
Email: [
Tel: [
Provider: [
Address: [
Email: [
Title [
Address: [
Email: [
Tel: [
Name and Title [
Email: [
Tel: [
]
]
Name [
Email: [
Tel: [
Name [
Email: [
Tel: [
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]
]

• 2 distinct levels:
• Level 1 Service
• Patient assessment - accredited pharmacist
• Provision of P or GSL medicine or appliance
• Advice on condition
• Renumeration:
• £4.50 per consultation
• Formulary tariff for medicines provided

• Level 2 Service
• Patient assessment - accredited pharmacist
• Provision of a Prescription Only Medicine
• Patient Group Direction
• Specified conditions
• Specified Criteria
• Communication to patient’s registered GP to advise treatment provided
• Renumeration:
• £8.20 per consultation
• Formulary tariff for medicines provided

• 24 Level 1 Treatment Protocols
• Adapted from those used in:
–
West Cheshire, East Cheshire, Vale Royal, and South
Cheshire
• Definition
• Inclusion/Exclusion criteria
• Treatment Choice
• Counselling and Advice
• Referral

• Clinical Knowledge Summaries http://cks.nice.org.uk/
• Summary of Product Characteristics www.medicines.org.uk
• Patient.co.uk
http://www.patient.co.uk/doctor/

Acne Vulgaris(mild)
Acute Bacterial Conjunctivitis
Allergy
Athlete’s Foot
Cold Sores
Constipation
Cough
Cystitis
Dermatitis / Eczema (mild)
Diarrhoea
Genital Thrush
Haemorrhoids
Headache, Pain (including Dental
Pain)
Hay fever (Seasonal Allergic
Rhinitis)
Head lice
Indigestion and Heartburn
Mouth Ulcers
Nappy rash
Nasal Congestion
Oral candidiasis
Scabies
Sore throat
Threadworm
Warts and verrucae

• Cough – Simple linctus
• Cystitis – Lifestyle advice, analgesia
• Dental Pain – Ibuprofen, Paracetamol
• Head lice – Bug busting kit
Hedrin 4% (Second line)

• Adapted from those used in:
–
West Cheshire, East Cheshire, Vale Royal, and South
Cheshire
• NICE Good Practice Guidance GPG2
(September 2013) https://www.nice.org.uk/guidance/mpg2/res ources
• Competency framework: For health professionals using Patient Group
Directions

Patient Group Directions (PGDs) provide a legal framework that allows some registered health professionals to supply and/or administer a specified medicine(s) to a pre-defined group of patients, without them having to see a prescriber.

NICE Competency Framework: For health professionals using Patient Group Directions
Domains
The patient consultation
Safe and effective
PGDs in context
Competency areas
Knowledge
Options
Shared decision-making
Safe
Governance
Always improving
Information
The healthcare system
Collaboration

–a statement that gives a general overview of what the competency area covers
–a list of individual competencies, referenced to relevant good practice recommendations, where applicable.

Individual health professionals need to consider:
– how they will use the competency framework
– how each competency applies to their scope of practice and individual responsibilities
– what evidence can be collected and documented to demonstrate competency e.g. case studies

Acute Bacterial Conjunctivitis Fusidic Acid Eye Drops
Chloramphenicol Eye drops/ointment
Trimethoprim 200mg Uncomplicated Urinary Tract Infection in Women
Hay fever (allergic rhinitis)
Impetigo
Migraine
Oral candidiasis in infants <2 years
Beconase nasal spray
Fucidic acid 2% Cream
Sumatriptan 50mg tablets
Nystatin oral suspension

Diagnosis of UTI - Quick Reference Guide for
Primary Care https://www.gov.uk/government/publications/urinary-tractinfection-diagnosis
CPPE Antibacterial resistance - a global threat to public health: the role of the pharmacy team

Severe or ≥ 3 symptoms of UTI:
• Urgency
• Polyuria
• Dysuria
• Frequency
• Suprapubic tenderness
NO vaginal discharge or irritation

Nick Thayer
Well Pharmacy
Eastern Cheshire

Kevin Noble
Pinnacle Health Partnership LLP

Sarah Boyd-Short
0151 651 0011 (ext 1790) sarahboyd2@nhs.net
Nicola Bradley
0151 643 5319 nbradley1@nhs.net
Melanie Carrol
0752 305 6986 melanie.cpcw@gmail.com