Service Level Agreement for

Pharmacy Needle Exchange Scheme2016/17

Pharmacy Name
Requirement
1.Service Description
This service level agreement relates to the delivery of a pharmacy based needle exchange service. (Note, the service name needle exchange relates to the provision all injecting paraphernalia).
Pharmacy based needle exchanges (hereafter PNXs) are an important element of North Somerset’s approach to reducing the harm associated with illicit drug use.
The key elements of the pharmacy based needle exchange scheme are listed below:
  • PNXs swill only be available to individuals aged 18 and over. Injecting drug users aged under 18 should access the specialist needle exchange at Addaction in the company of a parent or appropriate adult e.g. a specialist young person’s drug worker or youth offending officer.
  • The service will be provided to adults injecting illicit substances, e.g. heroin, amphetamines, cocaine, and non-prescribed anabolic steroids and other performance and image enhancing substances.
  • Provision of packs of sterile injecting equipment and safe disposal bins
  • Provision ofwritten and verbal safer use and harm reduction information.
  • Take in and safely store (until collected for disposal) used injecting equipment.
  • Provision of service in a friendly, non-judgmental, and confidential manner
  • Provision of general health advice and support; in particular in relation to blood borne viruses (HBV,HCV, HIV) and sexual health.
  • Where appropriate, consensual referrals will be made to specialist drug and or alcohol treatment services or primary care.
  • Where users of the needle exchange service are already engaged with specialist drug treatment pharmacy staff will discuss treatment effectiveness, and where possible they will liaise, with service user consent, with the treatment provider.
The Council will develop and maintain an arrangement for the provision of consumables (packs) and the collection of used equipment. Consumables will be provided to and PNX related waste removed at no cost to the Provider. However, it will be the responsibility of the Provider to request additional consumables from the agency providing this service.
Any questions or problems relating to the supply of needle exchange paraphernalia or the removal of injecting related waste should be directed to Frontier Group, tel: 01495 235840
Pharmacy based needle exchange services:
  • Can advise on a range of issues including drug related death, overdose prevention, blood borne viruses, oral health, sexual health and contraception, nutrition, minor infections, nicotine replacement therapy and wound dressing.
  • Can offer extended opening hours compared with needle exchanges based within specialist drug treatment services.
  • Can offer an alternative to needle exchanges hosted by specialist drug services.
  • Can expand the locations from which needle exchange services can be accessed.
  • Can become a gateway into treatment.
  • Can maximise engagement with injecting drug users who are treatment naïve and/or hard to reach.
In addition to providing an essential service to local injecting drug users, Pharmacy needle exchanges will provide important information on local need and trends amongst the drug using population.
2. Aims
  • To support the Council’s initiatives to reduce drug related harm.
  • To protect the health of North Somerset’s population, especially in relation ot the spread of HCV.
  • To collect and report information on the local drug injecting population for use in performance monitoring and commissioning.
  • To reinforce safer injecting practices.
  • To encourage service users to seek further assistance or advice from health care professionals or specialist services.
  • To assist service users to remain healthy until they are ready and willing to cease injecting.

3. Service requirements
  • All staff involved in the provision of the service will operate within the SLA requirements.
  • All staff involved in the provision of the service will have received training on all associated activities. Staff will be proficient in assessing and responding to the injecting related needs of service users; they will provide correct and up to date advice on safer injecting practices, and they will be able to minimise the risk associated with the handling of returned, used injecting equipment and the correct procedures..
  • The provider will havea needle stick injury procedure will be in place.
  • PharmOutcomes (online web system) will be used to record all relevant information. Service users will be registered using an ID number allocated by the pharmacy (this will be unique amongst the service users within the pharmacy but may be duplicated by other pharmacy based needle exchanges), date of birth and first four digits of his/her postal code.
  • Invoices will be produced by PharmOutcomes.Pharmacy staff, where appropriate, will share relevant information with other health care professionals and agencies. Any information sharing will comply with locally determined confidentiality arrangements.
  • The Provider will on occasion and at the request of the Council distribute additional material designed to improve the health and social functioning of service users.
  • The international needle exchange symbol will be displayed by the Provider. Staff involved in the delivery of this service should be offered immunisation for Hepatitis B (cost to be covered by pharmacy).
  • Appropriate protective equipment, including gloves, overalls and materials to deal with spillages, will be available close to the storage site.

4. Additional requirements
  • Appropriate injecting and general health related information must be available at all time and staff must promotethe utilisation of this.
  • The Providerwill routinely review the standard of its needle exchange service, including service promotion and onward referrals.
  • The needle exchange related skills and knowledge of staff will be routinely assessed and any areas requiring improvement will be addressed.
  • The Provider will support any Council audit of service provision assuming at least 48hours notice has been given.
  • The Providerwill participate in any locally agreed assessment of service user experience assuming at least 48 hours notice has been given.

5. Background Informationand related guidance
  • Relevant guidance:
Needle and syringe programmeNICE. PH 52. 2014
Best practice for commissioners and providers of pharmaceutical services for drug users – service specification (tier 2 or 3). National Treatment Agency for Substance Misuse. 2006.
  • CPPE Training which may support this service:
Substance use and misuse (May 2012)
6. Review
This document will be reviewed at least once per annum.
7. Remuneration.
Payment for this service is calculated from the monthly activity returns produced by the Provider (submitted via PharmOutcomes).
Payments will be made as follows:
  • Quarterly payment for offering the service(retainer payment) will be paid at the following level (payment made in arrears):
  • Less than 7 packs per quarter – 0 payment
  • 7 – 56 packs per quarter - £80 per quarter
  • 57 or more packs per quarter - £45 per quarter
  • £1.50 (one pound and fifty pence)forevery pack issued to a service user.This payment will relate to the provision of any type of PNX pack (at the time of writing PNXs provide three different packs).
  • Payments will be made quarterly (every three months) in arrears.
  • Claims can be made up to 6 months after the end of the quarter being claimed for.
The above rate will be reviewed annually.The Provider may withdraw from this service by notifying the Council in writing at least 2 months prior to the date of cessation. The Councilreserves the right to cease the service at any time provided that 3 month’ notice is issuedin writing. In the context of service cessation, final payments will be calculated on a pro-rata basis.
8. Acceptance of this SLA
The Provider is requested to sign and return this pro forma to confirm acceptance. Please note that no payment can be made until this form is completed, signed and returned to the Council
Name of Lead Pharmacist
Signed on behalf of the pharmacy
Please print name
Signature
Dated
Please return this completed and signed form to:
Community Safety and Drug Action Team, North Somerset Council, First Floor, Post Point 16, Town Hall, Weston-super-Mare, BS23 1UJ

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