Gateshead / South Tyneside / Sunderland

(delete those which do not apply)

PRIMARY CARE TRUST

LOCAL ENHANCED SERVICE
SEASONAL INFLUENZA IMMUNISATION PROGRAMME 2011/12

FOR LOCAL COMMUNITY PHARMACY

Contents:

1. Finance Details

2. Signature Sheet

3. Service Aims

4. Targeted Population

5. Criteria

6. Accreditation

7. Ongoing Measurement & Evaluation

8. Integrated Governance

9. Information Management/Requirements

10. Funding & Payment Method

11. Contract Management

12. Review, Variation and Re-commissioning Process

13. Termination of Agreement

14. Disputes – Conciliation, Arbitration and Appeals

1. Financial Details

1.1This agreement is to cover the twelve months period commencing 1stApril 2011 – 31st March 2012.

1.2The community pharmacy (contractor) must submit a claim form for each at-risk patient to who the (contractor) has administered an influenza vaccine. The form should be forwarded to Directorate of Public Health, South Tyneside PCT c/o Mrs Cath Clark, Clarendon, Hebburn, NE31 1AT, email This claim would include the date of birth, sex, name of his/her GP, and relevant clinical condition, and the date of immunisationof the at-risk patient who has been immunised. Only one payment will be made per vaccine given regardless of whether the patient is included in one or more of the at-risk groups identified at section 4.1.

1.3A claim must be made for each at-risk patient immunised in the period detailed in section 4.

1.4For payment purposes the immunisation programme will cover the period from 1st December 2011 – 31 January 2012.

1.5On agreeing a service plan with the PCT for the two months, thecontractor will receive:-

  • A fee of £15.50 for each at risk patient immunised. This would cover vaccine cost and administration (including VAT), waste collection for sharps, relevant documentation and reporting.

1.6Payment arrangements under this scheme will apply to all at-risk patients who are immunised during the two month period 1st December 2011 – 31st January 2012.

1.7The eligible groups “clinical at-risk groups” are described in section 4.

1.8 It is for each contractor to identify the patients concerned (repeat prescription

scheme) and this should be consistent with the patient’s record in their relevant

GP register.

1.9 Payment will only be made upon receipt of contractor signature sheet.

2. Signature Sheet

2.1This document constitutes the agreement between thecommunity pharmacy (contractor) and the PCT in regards to this local enhanced service.

Signature on behalf of the Contractor:

Address:

Signature / Name / Date

Nominated Flu Campaign Lead for Pharmacy: ______

Signature on behalf of the PCT:

Signature / Name / Date

Please sign this form and forward it to Directorate of Public Health, South Tyneside PCT c/o Mrs Cath Clark, Clarendon, Hebburn, NE31 1AT, email , by 1st December 2011.

3. Service Aims

3.1The purpose of the local enhanced services is to cover the provision of seasonal influenza immunisations for patients with clinical conditions, which put them more at risk from the effects of flu (clinical at risk groups). This is to reduce the serious morbidity and mortality from influenza infections by immunising those most likely to have a serious or complicated illness should they develop influenza infection. This can avert the need for the patient to be hospitalised.

3.2Despite our relatively high uptake by national and international comparisons,

NHS South of Tyne and Wear has nonetheless fallen short of the World Health

Organization (WHO)recommendations.Significantly improving uptake in the

clinical risk groups will be challenging.

3.3The purpose of the Local Enhance Service for Seasonal Influenza Immunisation

Programme 2011/12 is to commission local community pharmacy to provide influenza immunisation service in addition to the current arrangement with local GP practicesunder Directed Enhanced Services.

3.4The community pharmacy (contractor) will be an additional provider supplementing local GP practices’efforts in targeting those at high risk patients who have difficulty in accessing influenza immunisation services.

3.5The contractor must put in place a system for recording and maintaining a register of all at-risk patients to whom it offered and delivered influenza vaccine injection.

3.6This service will go live on 1st December 2011 – and continue until 31stJanuary

2012.

4. Targeted population

4.1Patients will be eligible to receive their flu vaccination from a contractorif he/she is suffering from an underlying medical condition (s), as specified below, and who has not received a flu vaccine via his/her GP or any other provider within the last 6 months.

  • chronicrespiratory disease (including asthma),
  • chronic heart disease,
  • chronic kidney disease,
  • chronic neurological disease,
  • diabetes,
  • immunosuppression.

For further details please see Annex A(see footnote)[1]

5. Criteria

5.1The contractor must have a robust approach and assessment for identifying eligible patients as defined in section 4.1, and accurate recording if they are participating.

5.2The contractor must offer immunisations against influenza infection to at risk patients;

  1. to concentrate the immunisation programme on eligible patients having difficulties in accessing seasonal influenza immunisation service.
  2. to make that offer during the period from 1st December 2011 to 31st January 2012.

5.3The contractor must develop and implement a proactive and preventative strategy for offering these immunisations to clinical at-risk patients with the aim of;

  1. maximising the uptake in the interests of at-risk patients,
  2. meeting any public health targets in respect of such immunisations.
  3. informing patients about its immunisation programme with the aim ofraising awareness and improve uptake to those at-risk patients about immunisation.
  4. written information should be provided by the contractor where appropriate.

5.4The contractor must nominate a named person(s) within the community pharmacy who will be responsible for the administration of the influenza campaign and advise NHS South of Tyne and Wear of the name of this person (s).

5.5The contractor must ensure that the vaccine is given following protocols laid out in the NHS South of Tyne & Wear Patient Group Direction for Influenza Vaccine, a signed copy of which must be kept in the pharmacy.

5.6 The contractor must ensure that:

  1. their pharmacy makes their own arrangement with suppliers to ensure they have sufficient vaccine for their needs;
  2. all vaccines are stored in accordance with the manufacturer’s instructions;

c.all refrigerators in which vaccines are stored have a maximum/minimum thermometer and that readings are taken and recorded from that thermometer on all working days;

d.have appropriate resuscitation equipment and anaphylactic kit available for use by healthcare professionals providing services under this specification in case of anaphylactic reactions.

5.7The contractor must report all significant events relating to services provided under this specification to NHS South of Tyne and Wear in accordance with the Risk and Incident Reporting Policy across Gateshead PCT, South Tyneside PCT and Sunderland TPCT.

5.8 The contractormust record any relevant information and in particular include:

  1. any refusal of an offer of vaccination;
  2. where an offer of vaccination was accepted;

a)details of the consent to the vaccination or immunisation;

b)the batch number, expiry date and name of the vaccine;

c)the date of administration of the vaccine;

d)the route of administration and the injection site of vaccine;

e)any contraindications to the vaccination or immunisation;

f)any adverse reactions to the vaccination or immunisation.

5.9The contractor must take all reasonable steps to ensure that the lifelong medical records held by an at-risk patient’s general practitioner are kept up-to-date with regard to their immunisation status, this would involve copying the details of the vaccinations that are provided to the at risk patients to GP practices in a timely manner (within two working days).Pleasesee Annex B This is important for clinical reasons (e.g. if there are any adverse events) and also means that these vaccinations will be included in the vaccine uptake data collections.

5.10The service can only be provided in an approved pharmacy, which must have a suitable area for consultation with the patient. This suitable area

  • must bea quiet area within the shop where it is cordoned off and not be accessible to other members of the public.
  • must be clear of any items placed there for storage.
  • must have impermeable flooring for Health and safety reasons.
  • must have a chair for patients to sit in following the flu jab; it must likewise have impermeable seating, which is able to tolerate a chlorine releasing agent for disinfection purposes.
  • must also have facilities for patients to be able to lie down in the event of a simple faint or an anaphylactic reaction.
  • Must have a dedicated hand washing facilities with liquid soap and disposable paper towels in a wall mounted paper towel dispenser and foot operated pedal bin. Ideally this should be in the consultation area. Where it is not, infection control procedures and hand hygiene procedures must be followed rigorously.
  • must have vomit bowls available in the vaccination area.
  • must have a sharps bin and a sharps collection and disposal procedure in place and in compliance with NHS South of Tyne and Wear Sharp disposal policy.

6. Accreditation

6.1The contractor must satisfy the PCT it is capable of meeting its obligations under these arrangements including under any plan agreed under those arrangements and, in particular, has the necessary facilities, equipment and properly trained and qualified health care professionals and staff to carry out those obligations.

6.2The contractor must ensure that any health care professional who is involved in administering a vaccine has:

a)attended a formal immunisation program and has the necessary competencies, skills and documented evidence with regard to the administration of the vaccine (this includes ensuring that training and skills are maintained and regularly updated at least every year );

b) training with regard to the recognition and initial treatment of anaphylaxis (at least every year);

c)training with regard to the maintenance of the cold chain and infection control measures.

7. Ongoing Measurement & Evaluation

7.1The contractor must supply NHS South of Tyne and Wear with influenza uptake information (Annex C) as it may reasonably request for the purposes of monitoring the contractor’s performance of the influenza immunisations service and processing the payment.

7.2The contractor is encouraged to undertake patient’s satisfaction survey with a view to assess the quality of the service (Please see Annex D for further detail).

8. Integrated Governance

8.1Clinical Governance

Governance is a mechanism to provide accountability for the way an organisation manages itself. Clinical Governance (CG) is a system through which healthcare organisations are accountable for continuously improving the quality of their services and safe-guarding high standards of care, by creating an environment in which clinical excellence will flourish. CG should be integrated into the organisation’s whole governance arrangements. Integrated Governance (IG) is a collection of systems, processes and behaviours by which healthcare organisational objectives, safety and quality of service and in which they relate to patients and carers, the wider community and partner organisations. The contractor is required to have, or adopt, a system of IG, that incorporates key elements of CG and organisational learning, to ensure that there is the safe delivery of the services to patients.

8.2 Equity of Access

All contractors providing the service will:

  • Not discriminate between patients on the grounds of age, sex, sexuality, ethnicity, disability, or any other non medical characteristics.
  • Comply with the requirements of the Race Relation Act 1976, Race Relation Act (Amended) 2000, Disability discrimination Act 1995, the Sex Discrimination Act 1975, the Sex Discrimination Act (Amended) 1986 and the Equal Pay Act 1970 and shall not discriminate against any person or organisation, or supplier on the ground of race, gender, sexual orientation, disability or culture. The Commissioner would expect the provider to be able to demonstrate evidence of accessibility.
  • Implement Royal National Institute for the Blind and Royal National Institute for the Deaf guidance as amended from time to time to ensure patients who have relevant disabilities and/or communications difficulties are able to receive the Services.
  • Offer to all non English speaking users professional translation services during consultations.
  • Be expected to be proactive in identifying and delivering the service to eligible patients who have difficulties in accessing seasonal influenza immunisation service, including but no limit to the following:
  • those who do not understand written or spoken English;
  • those who cannot hear or see, or have other disabilities;
  • working single parents;
  • asylum seekers or refugees;
  • black or minority ethnic communities;
  • those who have mental illnesses;
  • those who misuse alcohol or illicit drugs; and
  • those who belong to a lower socio-economic class, or who are unemployed.

8 .3 Patient Dignity & Respect

The contractor will:

  • ensure that the provision of influenza vaccine and the contractor premises

protect and preserve patient dignity, privacy and confidentiality;

  • ensure that contractor staff behaves professionally and with discretion towards all

patients and visitors at all times.

8.4Informed Consent

The contractor will comply with NHS requirements in relation to obtaining informed consent from each patient prior to commencing treatment including the following as amended from time to time:

  • Immunisation against infectious diseases (Green Book), Chapter Two.
  • Department of Health Good Practice in Consent Implementation Guide: Consent to Examination or Treatment 2002;
  • Health Service Circular HSC 2001/023; and
  • Seeking Patients' Consent. The Ethical Consideration: GMC November 1998.

8.5 Confidentiality

The contractor and their staff will not disclose to any person other than a person authorised by the PCT and relevant GP, any information acquired by them in connection with the provision of the services which concerns:

  • The identity of any patient;
  • The medical conditions of, or the advice received by, any patient.

8.6Audit

The contractor will allow the PCT’s internal and other nominated auditors access to all or any papers and service records relating to this Agreement for the purposes of audit and consent to the disclosure of relevant information for the purpose of fraud prevention, detection and inspection.

The contractor is to undertake an audit of the service as defined by the PCT.

8.7Complaints

  • The contractor is required to have a system in place for the handling of complaints in line with NHS South of Tyne and Wear complaints procedure.
  • The contractor is required to ensure patients are informed they have the right of complaint to PALS (Patient Advice and Liaison Service) at the PCT. All information shall be provided to the patient in order for them to access the NHS South of Tyne and Wear complaints procedure.
  • Complaints in relation to the service are to be notified to the PCT.

8.8Significant Event Reporting

In the event of any ‘adverse incident’ or ‘near miss’ relating to the provision of

this service, the contractor will complete the appropriate incident reporting form

and forward a copy to the PCT.

8.9Equality Statement

  • The contractor shall at all times comply with the requirements of the following
  • Race Relations Act 1976,
  • Race Relations Act (Amended) 2000,
  • Disability Discrimination Act 1995,
  • the Sex Discrimination Act 1975,
  • the Sex Discrimination Act (Amended) 1986, and
  • the Equal Pay Act 1970,
  • The contractor shall not discriminate against any person or organisation, or supplier on the grounds of race, gender, sexual orientation, disability, age or religious preference.

8.10Obligations of the Contractor

  • The contractor is responsible for the delivery of the service as detailed in the service level agreement.
  • The contractor has a duty to ensure that staff involved in the provision of the service has attended a recognised immunisation training programme, and has the relevant qualification (with documented evidence) knowledge and skills for the operation of the service.
  • The contractor has a duty to ensure and demonstrate that all staff involved in the provision of the service is aware of and act in accordance with local protocols and national guidance as appropriate.
  • The contractor is responsible for ensuring the PCT is informed of the details of any external agency providing the service on behalf of the contractor.
  • The contractor is required to maintain appropriate records to ensure effective ongoing service delivery and audit.
  • Overall responsibility for ensuring the eligibility of patient and suitability of the vaccine provision to the patient, in accordance with local procedures and National guidance (CMO letter dated 25 May 2011), lies with the contractor.
  • The contractor will be responsible for ensuring promotional materials provided by or on behalf of the PCT are utilised appropriately in the promotion of the service.
  • The contractor will have standard operating procedures in place to support the service.

8.11Obligation of the PCT

  • The PCT will ensure that appropriate systems are in placeto ensure the contractor is supported in the delivery of the service as defined in the SLA.
  • The documentation required to deliver the service will be provided by the PCT.
  • The PCT will provide any framework for the recording of relevant service information for the purpose of audit and the claiming of payment.
  • The service will be reviewed annually by the PCT.
  • The PCT will ensure prompt payment.

8.12Care Quality Commission

The contractor will be required to provide information requested by the PCT in relation to assessments and or special reviews as specified by the Care Quality Commission.

8.13Indemnity

The contractor must notify their professional indemnity insurers and maintain adequate insurance cover for their participation in this service.

9. Information Management / Requirements

9.1The contractor will maintain appropriate records as specified in the Service Specifications to ensure effective service delivery and audit. Records will be confidential and should be stored securely and retained for a period of eight years.

9.2All contractors must be available on request for inspection by the PCT or its agents for the purpose of audit.

9.3The contractor must have a system for collecting data on adverse incidents, which should be aligned to the relevant guidance contained in NHS South of Tyne and Wear Incident Reporting Policy. (The PCT will provide a copy of the policy upon request and training can be arranged). Adverse incidents should include, but are not limited to, incidents relating to: