Service Specification
Pharmacy Needle & Syringe Exchange
1Introduction
1.1This service specification is for the provision of a needle exchange scheme to be undertaken within pharmacies across NHS Ashton, Leigh and Wigan.
1.2Any injecting drug user can access this service.
1.3The primary aim of the service is to make sterile injecting equipment available to those who require it and provide a safe route of disposal for used equipment.
1.4The provision of this service will be open to any willing provider who has suitable facilities and who is subsequently approved as a provider of this service by NHS Ashton, Leigh and Wigan and the Substance Misuse Service.
1.5This service must be provided during all core and supplementary hours once the pharmacy is approved as a provider.
2Service description
2.1Pharmacies will provide access to sterile needles and syringes, and sharps containers for return of used equipment as provided by Greater Manchester West NHS Foundation Trust.
2.2Pharmacies will offer a user-friendly, non-judgmental, client-centred and confidential service.
2.3Used equipment is normally returned by the service user for safe disposal and this will be promoted by the pharmacy. Failure to return used equipment should not stop pharmacies issuing new supplies.
2.4The service user will be provided with appropriate health promotion materials.
2.5The pharmacy will provide support and advice to the user, including referral to other health and social care professionals and specialist drug and alcohol treatmentservices where appropriate.
2.6The pharmacy will promote safe practice to the user, including advice on sexual health and STIs, HIV and Hepatitis C transmission and Hepatitis B immunisation.
3Aims and intended service outcomes
3.1To assist service users to remain healthy until they are ready and willing to cease injecting and ultimately achieve a drug-free life with appropriate support.
3.2To protect health and reduce the rate of blood-borne infections and drug related deaths among service users:
- by reducing the rate of sharing and other high risk injecting behaviours;
- by providing sterile injecting equipment and other support;
- by promoting safer injecting practices; and
- by providing and reinforcing harm reduction messages including safe sex advice and advice on overdose prevention.
- To improve the health of local communities by preventing the spread of blood-borne infections by ensuringthe safe disposal of used injecting equipment.
- To help service users access treatment by offering referral to specialist drug and alcohol treatment centres and health and social care professionals where appropriate.
- To help service users access other health and social care and to act as a gateway to other services when the person feels they require these services.
- To maximise the access and retention of all injectors, especially the highly socially excluded.
4Service outline
4.1The part of the pharmacy used for provision of the service provides a sufficient level of privacy, safety and confidentiality acceptable to the client.
4.2The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service.
4.3Pharmacists providing this enhanced service must have completed the CPPE package – Substance use and misuse (pharmacist package) and should keep uo to date as this pack is reviewed.
4.4Staff to whom the pharmacist delegates supply must have received training in harm reduction and be aware of the issues faced by thosewho are injecting and when to refer to the pharmacist.
4.5Pharmacists and staff participating in the service must ensure they have appropriate insurance cover.
4.6Please note, this service cannot be provided solely by trained pharmacy staff. At all times, including during exchange,a pharmacist who has completed the CPPE pack must be present and accountable, except when a locum is covering annual leave or sick leave. Regular locums must complete the CPPE pack. Overall accountability and responsibility will remain with the pharmacist.
4.7Locum pharmacists must sign the Locum Agreement Form in each pharmacy they provide the service if they have not completed the CPPE training pack.
4.8All pharmacists providing this service must supply NHS Ashton, Leigh and Wigan with a copy of their certificate of completion of the relevant CPPE pack.
4.9The pharmacy contractor must have appropriate standard operating procedures in place for the service. If pharmacy staff are to provide this service the SOP must make reference to their role and responsibilities, highlighting steps in the procedure where referral to the pharmacist is necessary.
4.10The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service are aware of and operate within the standard operating procedures and any local protocols.
4.11The pharmacy will allocatea safe place to store equipment and returns for safe onward disposal. The storage containers provided by the Greater Manchester West NHS Foundation Trust commissioned, clinical waste disposal service will be used to store returned used equipment.
4.12The pharmacy contractor should ensure that staff are made aware of the risks associated with the handling of returned used equipment and the correct procedures to be followed to minimise those risks. A needle stick injury procedure must be in place.
4.13Appropriate protective equipment, including gloves, overalls and materials to deal with spillages, should be readily available close to the storage site.
4.14Staff involved in the delivery of this service will be offered immunisation for Hepatitis B.
4.15The pharmacy should clearly display the national scheme logo or a local logo indicating participation in the service.
4.16Clients will present to the pharmacy and request supplies. Pharmacy staff will provide the client with up to 6 ‘packs’ per consultation. Packs consist of syringes, needles and swabs, clients may request needles other than those in the packs, pharmacy staff may alter the packs to meet client requirements. Clients can also request filters, citric acid and Dani-cups as necessary. Clients should be provided with a sharps bin at every consultation. All equipment will be provided by Greater Manchester West NHS Foundation Trust.
4.17Pharmacy staff should accept returned sharps in a sharps bin, a bin should be provided at the time of return if necessary. If clients do not return sharps they should be encouraged to do so in the future.
4.18Pharmacy staff should check that the client is not experiencing any difficulties and verbal and written harm reduction advice should be provided to the client where possible. This should be supplemented by referral to a service that can provide treatment and further advice and care where appropriate.
4.19The pharmacy must maintain appropriate records to ensure effective ongoing service delivery and audit and where software is made available do this electronically. For every consultation the Pharmacy Record Form must be completed and retained securely in the pharmacy where the consultation took place until submission at the end of the month.
4.20Pharmacists will share relevant information with other health care professionals and agencies, in line with locally determined confidentiality arrangements.
4.21Greater Manchester West NHS Foundation Trust will provide the exchange packs and associated materials and will commission a clinical waste disposal service for each participating pharmacy.
4.22Greater Manchester West NHS Foundation Trust may arrange at least one contractor meeting per year to promote service development and update the knowledge of pharmacy staff if they believe it is necessary.
4.23Greater Manchester West NHS Foundation Trust will provide a framework for the recording of relevant service information for the purposes of audit and the claiming of payment.
4.24NHS Ashton, Leigh and Wiganwill provide details of relevant referral points which pharmacy staff can use to signpost service users who require further assistance.
4.25Should Greater Manchester West NHS Foundation Trust or NHS Ashton, Leigh and Wigan produce health promotion material relevant to the service users pharmacies providing this service will be expected to display material or take an active role in any public health campaign.
5Quality Indicators
5.1The pharmacy has appropriate PCO provided health promotion material available for the user group and promotes its uptake.
5.2Providers will review their standard operating procedures and the referral pathways for the service when there are any major changes in the law affecting the service or in the event of any dispensing incidents. In the absence of any of these events they will be reviewed every 2 years.
5.3The pharmacy can demonstrate that pharmacists and staff involved in the provision of the service have undertaken CPD relevant to this service.
5.4The pharmacy can demonstrate that the rate of return of used equipment meets locally agreed targets.
5.5The pharmacy participates in an annual organised audit of service provision if required by Greater Manchester West NHS Foundation Trust or NHS Ashton, Leigh and Wigan.
5.6The pharmacy co-operates with any locally agreed PCO-led assessment of service user experience.
6Payment mechanism
6.1All payments will be made on a quarterly basis on submission of the Pharmacy Record Form(s).This should be sent to:-
Business Support Team
Wigan and Leigh Substance Misuse Service
17A Silk Street
Leigh
WN7 1AW
6.2Greater Manchester WestNHS Foundation Trust will make the payments to pharmacies.
6.3Claims should be submitted monthly, no later than the 6thday of the following month to which the claim relates. At the end of each payment quarter late submissions will not be processed until the next quarter. Submissions at the end of the financial year must be received before the end of June or payment may be refused, in all other cases claims will be paid up to 6 months in arrears although late submission is discouraged.
6.4NHS Ashton, Leigh and Wiganand Greater Manchester WestNHS Foundation Trust reserve the right to verify claims in accordance with ethical guidelines.
7Current Funding
7.1The Payment schedule is as follows:
£1.05per client transaction
7.2Payments can only be made to pharmacies that have signed up to this scheme and meet the service specifications outlined above. Payments are made to the pharmacy contractor not individual pharmacists.
8Termination of service
8.1Greater Manchester West NHS Foundation Trust, NHS Ashton, Leigh and Wigan and the contractor should give 3 months notice of their party’s desire to terminate the service.
8.2Where contractors stop providing this service, then they should inform the Medicines Management Team and the Substance Misuse Service and endeavour to re-engage in the service as soon as possible.
9Service review
9.1This service will be reviewed on a bi-annual basis.
9.2The service specification will be reviewed bi-annually.
9.3Next review: January 2013.
National scheme logo: /Produced by Wigan and Leigh Substance Misuse Service Jan 2011. Review date Jan 2013