Current Prescribing Arrangements

Current prescribing arrangements

Pharmacies currently provide5 weeks NRT medication to clients undertaking a quit attempt. Clients normally require medication for up to a period of 12 weeks. After the initial 5 weeks NRT is supplied via a prescription from the individual’s GP but the 1:1 intervention continues to be delivered through the Smokefree Specialist within the Pharmacy

Proposed change

It is proposed that from 1 April 2014 that the complete course of NRT medication for up to 12 weeks quit attempt is supplied through the pharmacy. This will bring it in line with Cambridge CAMQUIT programme and align across the Peterborough and Cambridgeshire CCG area. The respective GP surgery will no longer be required to provide a prescription.

Proposed schedule

Initial assessmentNo NRT supplied

PreQuit appointment1st supply of NRT, 1week

*prescription charge per item if applicable (letter to GP to inform NRT issued)

Weekly follow up x4 AFTER Quit date

FU 1 week post quit1 week NRT supply

FU 2 weeks post quit1 week NRT supply

FU 3 weeks post quit1 week NRT supply

FU 4 weeks post quit2 weeks NRT supply

*prescription charge per item if applicable.

4 week outcome recorded and CO verified.

Letter to GP re outcome of quit attempt.

FU 6 weeks post quit2 weeks NRT supply

FU 8 weeks post quit2 to 4 weeks NRT supply as appropriate

*prescription charge per item if applicable

FU 10-12 weeks post quit as required complete episode on QuitManager

*NB If clients are exempt from NHS prescription charges then there is no charge to the client for the supply of NRT through this scheme

Clients who are not exempt from prescription charges will be required to pay one prescription charge for each product type for every 4 week cycle of NRT supplied i.e. patch and gum would incur 2 charges.

If the quit attempt is not successful at the 4 week stage (see criteria for 4 week quit) there should be no further supply of NRT. This should be assessed on an individual basis i.e. one lapse in week 3 or 4 continue with current quit attempt (but record 4 week outcome as not quit), or if returned to regular smoking the client can restart another quit attempt when appropriate.

Rationale

• The pharmacy will be involved in supporting the full quit attempt without the need to involve other health care professionals in the supply function.
• The pharmacy will be fully reimbursed for the medications supplied for up to 12 weeks with an additional £1 per NRT product supplied from 6-12 weeks.
• The pharmacy/client will not have to involve their GP and the inconvenience of acquiring a prescription after 5 weeks
• The process will be simpler with less administration and more continuity of care for the client as the GP surgery will no longer have to supply the prescription request from the Phamacy.
• It will reduce the possibility of delaying the prescription

Contract change

Under the existing contractual arrangements a variation of contract can be made as the due process is undertaken. Please refer to B1.1 – B1.3 for details of variation criteria. The contract change must be agreed and signed by all GP and Pharmacy Providers who have an existing Public Health contract to supply a Smokefree service. New providers coming onto the scheme will sign up to this arrangement from commencement of their contract.

Signatures

The person set out below is authorised from the Commencement Date to act on behalf of the Provider on all matters relating to this Contract (the Provider Representative).

Name:…………………………………………………………………………………

Title:………………………………………………………………………………….

Contact Details:…………………………………………………………………………………..

Signed by (on behalf of Peterborough City Council):

Name:…………………………………………………………………………..

Title:……………………………………………………………………………

Contact Details:……………………………………………………………………………