CPAF - advanced service – new medicine service NMS

Community pharmacy assurance framework - advancedservice –new medicine service

Service description

The new medicine service is provided to patients who have been prescribed for the first time, a medicine for a specified long term condition[1], to improve adherence. The NMS involves three stages, recruitment into the service, an intervention about fourteen days later, and a follow up after a further fourteen days.

Aims

The underlying purpose of the service is to promote the health and wellbeingof patients who are prescribed a new medicine or medicines for certain long term conditions, in order—

(a) as regards the long term condition—

(i) to help reduce symptoms and long term complications, and

(ii) in particular by intervention post dispensing, to help identification of problems withmanagement of the condition and the need for further information or support; and

(b) to help the patients—

(i) make informed choices about their care,

(ii) self-manage their long term conditions,

(iii) adhere to agreed treatment programmes, and

(iv) make appropriate lifestyle changes.

Completion of this form is required by NHS England. It covers matters that can be self-assessed, and apart from random checks for verification purposes, avoids the need for these matters to be covered during visits. Pharmacy contractors might find it helpful to refer also to the Contract Workbook published by the Pharmaceutical Services Negotiating Committee, when completing the questionnaire.

NB: References to ‘Dir’ are to the paragraph in the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2013 which contain the stated requirement. The Directions can be found in Part VIC of the Drug Tariff.

Please complete the column headed Pharmacy Response and return the form to by 26 July 2013.

Name of contractor: / ODS code:
Address of premises (including postcode):
Service indicator andDirections reference / Pre-visit questions / NHS England Area Team (AT)
comment / explanation / Pharmacy response / AT verification
AS-NMS-1
The contractor has notified NHS England or the relevant PCT of its intention to provide services as part of a New Medicine Service, in the form approved for that purpose by NHS England.
Dir 6(3) / Have you notified NHS England(or the relevant preceding PCT) of your intention to provide the NMS? / The approved form[2] must be used. / Yes
No
AS-NMS-2
The contractor is satisfactorily complying with their obligations in respect of the provision of essential services and an acceptable system of clinical governance.
Dir 6(4) / Are you complying with your terms of service as set out in Schedule 4 of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 including having an acceptable system of clinical governance? / (A) Yes
(B) No
(C) Further actions still required before fully compliant
AS-NMS-3a
Only a registered pharmacistwith an MUR certificatemay perform services as part of a New Medicine Service.
Dir 6(5) / Do all registered pharmacists providing the NMS have an MUR certificate? / Whilst some paperwork and administration (such as booking appointments) can be carried out by other members of staff, the only persons permitted to provide the services are pharmacists. / Yes
No
AS-NMS-3b / List all registered pharmacists who have an MUR certificate, whoprovide or will provide the NMS. / Note: MUR certificates need not be sent to the AT unless the pharmacist also intends to provide the MUR service (in the case of MURs, there is a pre-condition requirement that a copy of MUR certificate is sent to the AT).
During the monitoring visit, the AT may ask to see the pharmacy’s copies of the MUR certificate, to check that they have copies of the MUR certificates for each registered pharmacist who undertook NMS. / List:
AS-NMS-4
If contractor is a registered pharmacist—
(i) the contractor completes in the approved manner the approved form warranting that the contractor is competent to perform services as part of a New Medicine Service, or
(ii) if the contractor intends to employ or engage a registered pharmacist to perform services as part of a New Medicine Service, that registered pharmacist completes in the approved manner the approved form warranting that they are competent to perform services as part of a New Medicine Service.
If the contractor is not a natural person, any registered pharmacist the contractor intends to employ or engage to perform services as part of a New Medicine Service completes in the approved manner the approved form warranting that they are competent to perform services as part of a New Medicine Service.
Dir 6(6) / Have all the above registered pharmacists completed the approved form warranting that they are competent to perform the NMS? / The approved form[3] must be used.
Note: the forms should not be sent to the AT, but should be stored so that they can be produced if required.
During the monitoring visit, the AT may ask to see the pharmacy copies of each pharmacist’s form, to check that they have copies for each registered pharmacist who undertook NMS. / Yes
No
AS-NMS-5
The contractor has in place a standard operating procedure, at the pharmacy at or from which services as part of a New Medicine Service is to be delivered, for delivery of the service—
(a) which has been notified to the pharmacy staff;
(b) which explains the service, eligibility criteria for it and the roles that pharmacy staff may be required to perform as part of it; and
(c) about which staff have received appropriate training, if there is any role that they may be asked to perform as part of the service.
Dir 6(7) / Do you have an SOP for NMS which meets these requirements? / Having an SOP is a mandatory condition for providing this service.
During monitoring visits the AT may ask to see that there is an SOP for the service. / Yes
No
AS-NMS-6
The contractor must have notified providers of primary medical services in their locality of their intention to provide services as part of a New Medicine Service
Dir 6(8) / Have you notified providers of primary care medical services in the locality of your intention to provide NMS? / In order to ensure that GP practices with many local pharmacies are not overwhelmed by requests for meetings, LPCs and LMCs have a role in facilitating discussions and ensuring that GP practices are aware of the service and its aims. LPCs will be able to help co-ordinate which GP practices have received information about the service.
Community pharmacies will need to show evidence that they, or their representatives, have been in touch with the local GP practices. This could include copies of letters and information exchanged with practices. Alternatively where local meetings are held for GP practices and community pharmacies copies of agendas, presentations and information circulated along with copies of sign-in sheets could be kept on file. / Yes
No
AS-NMS-7
The second and third stage services provided as part of the New Medicine Service are provided at an acceptable location. This means an area for confidential consultations at the contractor’s pharmacy, which is-
a)Clearly designated as an area for confidential consultations;
b)distinct from the general public areas of the pharmacy;
c)in an area where both the person receiving services as part of the New Medicine Service andthe registered pharmacist providing those services are able to sit down together and talk atnormal speaking volumes without being overheard by any other person (includingpharmacy staff)
Dir 6(9) / Is there a consultation area available for the service that meets the requirements stated within the Directions? / The AT may arrange to visit the pharmacy to ensure the consultation area is appropriate and meets the requirements.
(a) and (b) do not apply when the pharmacy is closed to other members of the public. / Yes
No
AS-NMS-8
A registered pharmacist who is, or who is employed or engaged by, a contractor may provide secondand third stage services as part of a New Medicine Service other than at the acceptable location at the contractor’s pharmacy if that registered pharmacist does so—
(a) by telephone to a particular patient on a particular occasion;
(b) with the agreement of that patient, that patient having expressed a preference for thatcontact to be by telephone on that occasion; and
(c) in circumstances where—
(i) the registered pharmacist is at the contractor’s pharmacy, and
(ii) the telephone con-versation cannot be over-heard (except by someone whom thepatient wants to hear the conversation, for example a carer).
Dir 6(10) / Do you have appropriate procedures to ensure that second (intervention) and third (follow up) stage services, if carried out by telephone, comply with the requirements in the Directions? / The AT may wish to check procedures and facilities to ensure that telephone consultations are appropriate. / Yes
No
AS-NMS-9a, 9b
The contractor maintains and keeps under review its standard operating procedure, at the pharmacy ator from which services as part of a New Medicine Service are to be delivered, fordelivery of those services, and—
(i) any changes to it are notified to the pharmacy staff,
(ii) the procedure explains the service, eligibility criteria for it and the roles thatpharmacy staff may be required to perform as part of it, and
(iii) staff receive appropriate training about the service, if there is any role they may beasked to perform as part of the service;
Dir 7(1)(d) / Do you have a SOP, which meets these requirements? / It is mandatory to maintain and keep under review, an appropriate SOP. The AT may request to see the SOP. / Yes
No
When was the SOP last reviewed? / Date:
Direction 7(1)(e) to (j) sets out the requirements for this service and these should be included in the SOP.
AS-NMS-10a / Do your procedures ensure that the NMS is provided only to persons who have been prescribed, for the first time, a particular NMS medicine in the circumstances set out in the Directions? / The AT may request to see the SOP. / Yes
No
AS-NMS-10b / Does your SOP include offering a time and location for the second stage (Intervention), providing the patient with information about the NMS, obtaining their signed consent (using the approved wording) and as appropriate providing advice about the medicines over and above that which would be required under the terms of service? / The AT may request to see the SOP. / Yes
No
AS-NMS-10c / Does your procedure include arrangements to discontinue the NMS if the patient refuses or withdraws consent? / The AT may request to see the SOP. / Yes
No
AS-NMS-10d / At the second stage of the service, does your procedure include discussion with the patient about consent, assessment of adherence of the patient and identification of problems? / The AT may request to see the SOP. / Yes
No
AS-NMS-10e / At the second stage of the service, does your procedure include agreement with the patient of next steps, (which could include referral to the GP) and about the making of arrangements for the third stage of the service (Follow up)? / The AT may request to see the SOP. / Yes
No
AS-NMS-10f / Does your procedure include providing advice relevant to the objectives of the NMS, where appropriate, and which is information over and above the advice that would be given under the essential services? / The AT may request to see the SOP. / Yes
No
AS-NMS-10g / At the third stage of the service, does your procedure include discontinuing the service, if the patient has missed the second stage of the service (Intervention), where reasonable steps have been made to rearrange the second stage? / The AT may request to see the SOP. / Yes
No
AS-NMS-10h / At the third stage of the service, does your procedure include assessment of adherence of the patient, identification of new or continuing problems, referral to the patient’s GP if appropriate, and providing advice relevant to the objectives of the NMS, where appropriate, and which is information over and above the advice that would be given under the essential services? / The AT may request to see the SOP. / Yes
No
AS-NMS-11
The contractor ensures that a written record (which may be an electronic record) of each consultationcarried out by or on behalf of the contractor as part of the NMS is prepared by theregistered pharmacist who carried out the consultation and includes the approved data(“approved” for these purposes means approved by NHS England).
Dir 7(1)(l) / Do you keep records of the NMS, in the form approved by NHS England[4]? / The AT may request to see the records. As the patient has given consent to the pharmacy to share information with the AT, there is no need to anonymise any information before it is produced to the AT. / Yes
No
AS-NMS-12
The contractor provides information from those records to NHS England (or the preceding PCT) or the Secretary ofState, on request, in the manner approved for this purpose, and for the purposes approved,by NHS England.
Dir 7(1)(m) / Have you provided the specified information in the approved manner to the AT/precedingPCT as required? / The information that must be submitted on a quarterly basis is set out in a nationally approved spreadsheet. This should preferably be provided electronically.
The Secretary of State has released the format[5] in which this information is to be provided.
Note for the future: the AT letter of May 2013 confirmed that this information is requested, and should preferably be submitted by email. / Yes
No
AS-NMS-13
The contractor keeps a copy of the record for at least 2 years from thedate on which the service intervention is completed or discontinued.
Dir 7(1)(n) / How long do you keep your records of NMS? / The records must be kept for at least two years. / Months:

I declare that the information given in this form is true and complete.

Signature
Name / GPhC registration number
Position / Date
Phone number in case of queries

1

[1]For the purposes of this service an NMS medicine is a drug listed in the BNF subsections referenced in Schedule 2 of the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2013. A detailed list of the generic drug names covered by the service is available at

[2]The approved form is available on the New Medicine Service section of the PSNC website

[3]The approved form is available on the New Medicine Service section of the PSNC website

[4]The details of what the ‘approved data’ consists of is available from the PSNC’s website

[5]The approved format is available from the PSNC’s website