Community pharmacy contract

Before 2005

-quantity over quality

-no funding for pharmacy services

After 2005

-less money for dispensing, more for services

Global sum

Total money available for funding for a community pharmacy

CPCL

Collaborative lead that brings together other reps of pharmacies within same cluster to talk about how to collab with other healthcare profs

Updated collaborative working (2)

Engage with cluster meetings arranged by CPCL OR meetings with other healthcare profs e.g. discuss UTI service

England- advanced services: NMS (new medicines service) purpose

-helps patients that have been prescribed a new medication for certain conditions Like asthma, diabetes, hypertension.

England advanced services: administration of MeB vaccine - purpose, who is it for, how is it transmitted?

Prevents MenB, has eligibility criteria - mainly for y13s, MenB transmitted due to close proximity.

England advanced services: Lateral flow device service - purpose, who for?

Tests patients for Covid-19 who are at risk of becoming seriously ill

-not same list of people for Covid-19 vaccine

-take home lateral flow test kits

England advanced services: Hypertension case-find service - who for, purpose, aims

Pts are worried about their BP, can do a BP check and can act accordingly - refer, home bp monitoring etc. (will probably be lower at home)

-finds pts with high bp as asymptomatic and getting them into GP

England advanced services: Smoking cessation service - who for(2)

-for patients just discharged from hospital to continue nicotine patches etc or patient asking to change life around in pharmacy

England essential services - what are they?

Everyday services we have to do in the pharmacy - many examples

England advanced services: Pharmacy contraception service - who can provide?

-pharmacy/pharmacy technician can provide oral contraception

England advanced services: Childhood flu vaccination service (nasal) - who for (3)

-aged 2-3, pre-school (if older, should be given vaccine at school)

-clinically at risk: 4-17 as some schools vaccinate late. From 1st December, all children, even those not at risk

Welsh clinical services: seasonal flu vaccination - who for, aim

-patients at risk come into the pharmacy for a free flu vaccination

Wales essential services - same as england, differences:

-do not have DMS- discharge medicines service or healthy living pharmacies

-DMReview instead of DMS

England vs Wales prescribing services

-Wales have PIPS(pharmacist independent prescribing service), with huge coverage for prescribing - 27 common conditions

-England - no national service yet, but this month(oct), new rules for pharmacy first (5 new pathways like otitis externa, acne) and contraception. 7 common conditions. (More info on what’s done in ss)

Wales CCPS services (3) - what does it stand for, services provided

-clinical community pharmacy service

-CAS(common ailments service), contraception service, EMS(emergency medicines supply)

Wales CAS - stands for, aim, examples

-common ailments service

-treats common ailments in service, no need for appointment, get treated for certain conditions

-e.g’s - uti’s, sore throat test and treat

-can give POMs

Wales EMS - stands for, purpose

-emergency medicines supply service

-pts can get medicines when its easier than getting a prescription from doctor

Wales contraception service - what is it for, aim

-emergency contraception

-can also talk about ongoing contraception to avoid pregnancy

Wales advanced services: DMR service - what does it stand for and include

-discharge medicines review service

-each letter stands for something that happens within the service(see ss of what each stage entails):

D- discharge service registration

M- medicines reconciliation (part 1)

R- review adherence (part 2)

Why was DMR introduced

Help reduce number of patients who experience problems after discharge from hospital

How much are pharmacies paid per DMR

£51.45

DMR consists of..

Part 1 and 2

DMR part 1

Medicines reconciliation - does medication on 1st Rx after discharge match advice from hospital

When does part 1 of DMR happen?

Within 4 weeks of discharge

Part 2 of DMR

Adherence support - compliance check and exploring problems

When does part 2 of DMR happen

4 weeks after part 1

Eligibility of DMR

Patients discharged from ‘care’ setting AND:

• meds changed during their stay

• Take 4 or more meds

• Needs meds dispensed into multi compartment compliance aid (blister packs)

• Pharmacist believes in their professional judgement that pt will benefit from service

DMR - successful?

Yes, a review in 2014 showed a saving was made of £3m from NHS. DMRs made permanent the same year

In 2022, how did DMRs change

No longer limit of 140 DMRs per pharmacy

Quality and safety scheme - purpose and examples of things done

Improve quality across community pharmacies

-staff training, mental health awareness

CPCF - what does it stand for and what is it

Community pharmacy contractual framework, governs how community pharmacies operate and get paid

What’s included in the quality scheme (wales)