Signposting

When may a pharmacist refer?

• Consultation can’t be completed and patient requires further advice/treatment

• Red Flags

• Competence

• Boundaries of Care

When may a pharmacist signpost?

• If the consultation can’t be completed and that the patient requires further advice/treatment

Why must a pharmacist signpost?

• Its a contractural requirements for all pharmacies

What framework is signposting a part of?

• NHS Community Pharmacy Contractual Framework Essential Service

What is the directory of Services?

• It is a database of NHS services in England.

What does Directory of Services (DoS) work with?

• NHS Pathways

• The decision support system behind 111 and some 999 proividers

Why do we use the directory of services?

• To provide real time information for patients about the right place to go

List me the 4 primary legislation

• Medicines Act 1968

• Misuse of Drugs Act 1971

• Health and Social Act 1999

• Consumer Protection Act 1987

List the European Community Law

• Criteria for determine products which should be available on prescription only - Directive 92/26/EEC

List the secondary legislation ?

• Human Medicines Regulations 2012

• Misuse of Drugs Regualtions 2001

• Misuse of Drugs (Amendment) Regulations 2012

Why is Safety netting essential?

• Helps manage uncertainty in the diagnosis and management of patients by providing information for patients and organizing follow up after contact with a health professional.

What is the European Pathways Association (EPA) and when was it founded?

• The worlds largest Clinical Pathway (CPW) organisation

• Founded in 2004

What is the aim of the EPA?

• The aim to support the development of, implementation and evaluation of clinical/care pathways in Europe

How many countries are members of the EPA?

• More than 50

What is the care pathway ?

• The sequence of health and social care services a patient in the UK receives after entering the system during a particular episode of care

What is the Clinical Pathway?

• A standardized interdisciplinary care plan for a specific diagnosis , guiding treatment from admission to discharge

What is the benefits of clinical pathways?

• Improves communication

• standardizes care

• reduces costs and hospital stays

• Enhances patient satisfaction.

Where and when was the health pathways developed?

• In 2008 in Canterbury , New Zealand

What is a health pathway?

• They are local best-practice agreements where healthcare professionals collaborate on patient care plans

What does Quality Statement 3 focus on?

• Integrating community pharmacy services into local care and referral pathways.

Why is integrating community pharmacy services important?

• It ensures people have access to convenient, effective care

• reduces duplication of work

• eases pressure on the wider healthcare system.

What role do community pharmacies play in this integration?

• They support local populations’ health and wellbeing and guide people to other healthcare or community services when necessary.

How is progress in integration measured?

• By collecting local data on collaboration, referral pathways, and agreed performance indicators (KPIs).

How is success evaluated?

• Through surveys measuring the satisfaction of pharmacy team members with the availability of referral pathways.

What benefits does this integration provide?

• Improved service accessibility,

• reduced workload duplication,

• better collaboration between health and social care providers.

What is the numerator?

• The number in the denominator stats is fixed with availability of referral pathways

What is the denominator?

• The number of community pharmacy team members

What is NHS Pathways?

• It’s a telephone triage system that supports remote patient assessments for urgent and emergency services like NHS 111 and 999.

Who owns and manages NHS Pathways?

• It is owned by the Department of Health and Social Care and managed by NHS England.

What settings use NHS Pathways?

• NHS 111, 999, NHS 111 Online, and Integrated Urgent Care Clinical Assessment Services.

How does NHS Pathways ensure quality care?

• It translates clinical guidelines into step-by-step care plans to standardize and guide treatment for specific conditions.

Who maintains NHS Pathways?

• A team of registered practitioners with experience in urgent and emergency care.

Why is NHS Pathways important?

• It improves the efficiency and accuracy of patient assessments, ensuring evidence-based care while reducing pressure on healthcare services.

List the pathway of a patient

• admission

• Transfer

• Referral

• Discharge

• Home

What is the NHS e-Referral Service (e-RS)?

• It is a system that helps manage patient referrals to healthcare services.

What are the two main types of referral processes in e-RS?

1. Directly Bookable Service: Patients must book an appointment before the referral continues.

2. Triage/Assessment Service: The referral is reviewed first without an appointment being pre-booked.

What is the purpose of the advice and guidance service?

• It allows referrers to get specialist advice before or instead of making a formal referral.

What are the three referral options available in e-RS?

1. Advice and Guidance.

2. Referral Assessment Service.

3. Directly Bookable Service.

How does the advice and guidance service benefit referrers?

• It helps them decide on the best course of action for the patient, potentially avoiding unnecessary referrals.

What does the RTT framework ensure?

• It ensures patients receive timely access to NHS services, with treatment starting within 18 weeks of a GP referral.

What is the maximum waiting time for treatment under the NHS Constitution?

• 18 weeks from GP referral to treatment.

What happens if the NHS cannot meet the 18-week waiting time?

• The NHS must take reasonable steps to offer alternative providers.

What is the RTT Rules Suite?

• It’s a set of guidelines that define how waiting time clocks start and stop to ensure fair and consistent tracking of waiting times.

How can patients understand their rights regarding waiting times?

• By referring to the NHS guide on waiting times, which explains their rights and options.

Who publishes the RTT rules?

• The Department of Health.