Palliative Care Scheme

Agreement

2006-07

AGREEMENT FOR THE PROVISION OF PALLIATIVE CARE MEDICINES

BY COMMUNITY PHARMACISTS

  1. This is an agreement between to contractor;

……………………………………………………………………………………………………… and Greenwich Teaching Primary Care Trust (the Trust) for the period of April 1st 2006 to March 31st 2007.

  1. This Service Level Agreement sets out the arrangements for the supply of emergency palliative care medicines by the above participating pharmacy and the payment by the Trust to the participating pharmacy for the service provided.
  1. The participating pharmacy agrees to hold in readiness the drugs listed in Appendix 1. In order that the participating pharmacies are not out of pocket, the PCT agrees to reimburse the pharmacy for the cost of expired drugs on the production of a receipt for the replacement drug. The pharmacy at Queen Elizabeth hospital has agreed that drugs, which are asterisked, may be exchanged with them provided that there is at least 6 months’ shelf life remaining and the pack is unopened. Contact names and numbers are on Appendix 1. Dispensed items will be replenished from the wholesaler as normal. The cost of maintaining stocks will be the responsibility of the participating pharmacy.
  1. The Trust reserves the right to alter the contents of drugs on Appendix 1 after consultation with the Bexley, Bromley and Greenwich Local Pharmaceutical Committee.
  1. This agreement cannot be transferred or sub contracted to any other pharmacy contractor without prior written approval of the Trust.
  1. The Trust will pay participating pharmacies a retainer fee of £200 per year to keep the drugs listed on Appendix 1.
  1. A call out fee of £80 will be paid to the pharmacist to attend the call for palliative care medicines out of hours. If a call out exceeds 2 hours then there will be an extra payment of £40 per hour (or part of).
  1. An Urgent Fee of £15.00 will be paid for each call out Prescription Form, as previously paid by the PPA.
  1. The Palliative Care team, District Nursing team, GRABADOC doctors and the Woolwich police will hold the list of participating pharmacists. This list is strictly confidential and is not for general circulation. It is marked accordingly.
  1. The pharmacist responsible for providing the service must have evidence supporting Continuing Professional Development in the area of Palliative Care.
  1. The Trust has provided each participating pharmacy a copy of ‘Palliative Care formulary 2nd edition.’ This formulary will be returned to the Trust when the pharmacy ceases to take part in the scheme.
  1. The participating pharmacy will notify the Trust of any changes to its pharmacist and his or her telephone number so that the list of contact names and telephone numbers of participating pharmacies is kept up to date.
  1. A notice period of 30 days must be given in writing to the Trust for the participating pharmacy to withdraw from the scheme.
  1. Acceptance of Service Level Agreement

I wish to participate in the provision of palliative care medicines scheme in the London Borough of Greenwich, and agree to comply with the conditions set out above.

Name of Pharmacist______

Pharmacist Registration No.______

Name of Pharmacy______

Address______

______

______

______

Signed (Contractor/

Pharmacist Manager) ______

Date (DD/MM/YY)______

APPENDIX 1

Oral Drugs

Levomepromazine 25mg tablets

Cyclizine 50mg tablets

Metoclopramide 10mg tablets

Lorazepam 1mg tablets

Dexamethasone 2mg tablets

Co-danthramer capsules*

Co-danthramer strong capsules*

Diazepam liquid 2mg in 5ml

Rectal preparations

Diclofenac 50mg and 100mg suppositories

Domperidone 30mg suppositories

Diazepam 10mg suppositories

Glycerin suppositories (adult)

Injections

Metoclopramide 10mg in 2ml

Cyclizine 50mg in 1ml

Glycopyrronium 0.2mg/ml in 3ml

Haloperidol 5mg in 1ml

Levomepromazine 25mg in 1ml

Hyoscine butylbromide 20mg in 1ml

Hyoscine hydrobromide 400mcg in 1ml

Midazolam 10mg in 2ml

Dexamethasone 4mg in 1ml

Water for injection 10ml

Controlled drugs

Diamorphine Injection 10mg, 30mg and 100mg

Morphine sulphate oral solution 10mg in 5ml

Morphine sulphate Injection 10mg and 15mg (Added June 2005)

*This indicates drugs that may be exchanged at the Pharmacy at Queen Elizabeth’s hospital, provided that there is at least 6 months’ shelf life remaining and the pack is unopened.

Please contact the Principal Pharmacist, Patient Services (020 8836 4945) or the Principal Technician for Purchasing (020 8836 4942).

APPENDIX 2

How the scheme will work

a)A member of the palliative care team or the GP will assess the patient. The patient requires a drug that is on the list of palliative care medicines in appendix 1. A FP10 is written for the drug.

b)During working hours, the patient’s carer will go to the participating pharmacy and the drug is dispensed without delay. The cost of the drug is claimed back through the Prescription Pricing Authority.

c)Out of hours, the district nurse, palliative care nurse or doctor will contact a pharmacist on the list of participating pharmacists. There is no rota so the pharmacist chosen will be based on the nearest distance from the patient’s home and will be fairly random. The health professional and the pharmacist will arrange for a point where the prescription can be picked up.

d)The pharmacist will telephone for a taxi provided under contract by Greenwich Teaching PCT. While waiting for the taxi, the pharmacist will telephone Woolwich police station to tell them that the pharmacy will be open at an unusual time.

e)The taxi will take the pharmacist to pick the prescription up, and then go back to the pharmacy to dispense the drug/s, take the pharmacist and the medicines to the patient’s home and then take the taxi back home.

f)In case of problems, the taxi will radio for the police who will have already been alerted that the pharmacy is open.

g)To reduce the cost of taxi fares the pharmacist will live within 30 minutes drive from their pharmacy.

Notes to prescribers of controlled drugs

Controlled drugs are medicines subject to prescription requirements of the Misuse of Drugs Regulations 2001.

The principle legal requirements governing the prescribing of controlled drugs are that prescriptions for CDs (schedule 2 and 3) must:

Be in ink or otherwise indelible

Be signed in the prescriber’s own handwriting and dated (NB date does not have to be handwritten)

Specify the prescriber’s address

State the name and address of the patient (and age if under 12 years)

State the name and form of the drug (e.g. capsules), even if only one form exists. This includes MR or SR

State the strength of the preparation, where more than one strength is available

State to dose, ‘As directed’ is not sufficient. This is important when a prescriber may not know the exact dose required in advance such as when opiates are set up in a syringe driver.

State the total quantity of the preparation, or the number of dose units, in both words and figures (except temazepam)

NB All details, except for the signature, no longer have to be handwritten.

A Pharmacist is not allowed to dispense a controlled drug unless all the information required by law is given on the prescription.

A Pharmacist is not allowed to dispense a controlled drug unless the prescription for the controlled drug is in his/her possession. The pharmacist is not allowed to dispense a controlled drug from a faxed prescription.

When presented with an incorrectly written controlled drug prescription, the pharmacist will have to refer the prescription back to the prescriber, resulting in unnecessary delays to the patient, and incur further expense in dispensing the controlled drug.

Pharmacists have to check the authenticity of a prescription for a controlled drug, before dispensing it.

GREENWICH TEACHING PRIMARY CARE TRUST

EMERGENCY PALLIATIVE CARE CALL OUT CLAIM

Pharmacist’s name and pharmacy address
Name and designation of health care professional requesting the call out

Patient’s name and address

Date and time of delivery

I confirm the receipt of medicines at the time and date indicated by the above pharmacist.

Signature______Date______

Name______

I confirm the above delivery

Signature of Pharmacist______Date______

Name______

Please return to:

Joanne Kiangala, Community Pharmacy Lead

Greenwich Teaching PCT,

Pharmacy Team,

51-53 Burney Street,

Greenwich,

London,

SE10 8EX.

Tel. no: 020 8293 6970

E-mail:

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