LOCAL ENHANCED SERVICE

EL3a: On Demand Availability of Specialist Drugs (Availability of Palliative Care Medicines)

SERVICE LEVEL AGREEMENT 2010-11

PLEASE INSERT PHARMACY STAMP HERE (if available)

Contents

  • Provision of Enhanced Service
  • Financial Details
  • Service Description

Appendix 1: List of drugs to be stocked

Appendix 2: Claim form – replacement for date expired stock

  • Signature Sheet

Summary of Scheme

  • To enable the prompt supply of specialist palliative care medicines, the demand for which may be urgent and/or unpredictable.
  • The pharmacy contractor is commissioned to stock a locally agreed range of palliative care medicines and makes a commitment to ensure that users of this service have prompt access to these medicines at all times agreed with the PCT.
  • The pharmacy also provides information and advice to the user, carer and clinician. They may also refer to specialist centres, support groups or other health and social care professionals where appropriate.

Provision of Enhanced Services

This enhanced service will only be commissioned from pharmacies who are providing the full range of Essential Services as defined by the Pharmacy Contract and who operate a minimum 6-day opening policy.

Financial Details

Annual Fee £135.00 per pharmacy

The initial cost of purchasing any listed medication not currently stocked by the pharmacy will be met by the PCT. The cost of replacing medication that passes its expiry date will also be met by the PCT. Medication costs will be reimbursed at Drug Tariff price plus VAT.

Agreement Period

The agreement will commence on 1st April 2010 until 31st March 2011. It will be subject to renewal if agreed by all parties.

Payment Terms

The annual fee will be paid to automatically to pharmacy contractors who have returned a signature sheet and when the pharmacist has attended the required session. This will normally be at the end of Quarter 1 of the Financial Year

NHS Community Pharmacy Contractual Framework

Enhanced Service EL3a– On Demand Availability of Specialist Drugs (Availability of Palliative Care Medicines)

1.Service description

1.1This service is aimed at the supply of specialist medicines,the demand for which may be urgent and/or unpredictable.

1.2The pharmacy contractor will stock a locally agreed range of palliative caremedicines and will make a commitment to ensure that users of this service have prompt access to these medicines at all times agreed with the PCT.

1.3The pharmacy will provide information and advice to the user, carer and clinician. They may also refer to specialist centres, support groups or other health and social care professionals where appropriate.

2.Aims and intended service outcomes

2.1To improve access for people to these specialist medicines when they are required by ensuring prompt access and continuity of supply.

2.2To support people, carers and clinicians by providing them with up to date information and advice, and referral where appropriate.

3.Service outline

3.1The pharmacy will hold the specified list of medicines required to deliver this service and will dispense thesein response to NHS prescriptions presented by patients, carers or clinicians.

3.2The pharmacy will maintain appropriate records to ensure effective ongoing service delivery and audit.

3.3The pharmacy contractor will ensure that pharmacists and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service.

3.4The pharmacy contractor will ensure that the pharmacist responsible for providing the service attends one annual training session organised by the PCT.

3.5The pharmacy contractor will ensure that pharmacists and staff involved in the provision of the service are aware of and operate within local protocols.

3.6The PCT will provide locally agreed induction and ongoing training for participating pharmacies.

3.7The PCT will agree with local stakeholders the medicines formulary and stock levels required to deliver this service.The PCT will regularly review the formulary to ensure that the formulary reflects the availability of new medicines and changes in practice or guidelines.

3.8The PCT will agree a system with the pharmacy which deals with the financial implications of date expiry of the medicines in the formulary.

3.9The PCT will provide a framework for the recording of relevant service information for the purposes of audit and the claiming of payment.

3.10The PCT will provide details of relevant referral points which pharmacy staff can use to signpost service users who require further assistance.

3.11The PCT will disseminate information on the service to other pharmacy contractors and health care professionals in order that they can signpost patients to the service.

4.Suggested Quality Indicators

4.1The pharmacy reviews its standard operating procedures and the referral pathways for the service on an annual basis.

4.2The pharmacy can demonstrate that pharmacists and staff involved in the provision of the service have undertaken CPD relevant to this service.

4.3The pharmacy participates in an annual PCT organised audit of service provision.

4.4The pharmacy co-operates with any locally agreed PCT-led assessment of service user experience.

Appendix 1

Palliative Care Drug Formulary to be held in Selected Community Pharmacies

Drug to be stocked / Quantity / Comments
Cyclizine Injection 50mg/ml / 5
Diamorphine Injection 10mg / 5
Diamorphine Injection 30mg / 5
Diamorphine Injection 100mg / 5
Haloperidol Injection 5mg/ml / 5
Hyoscine Butylbromide Inj
20mg/ml / 10
Hyoscine Hydrobromide Inj 400mcg/ml / 10
Levomepromazine Injection
25mg/ml / 10
Metoclopramide Injection
5mg/ml / 10
Midazolam Injection 10mg/2ml / 10
Normal Saline 0.9% IV Infusion Bag (500ml) / 5
Normal Saline 0.9% IV Infusion Bag (1 litre) / 5
Water for Injection 10ml miniplasco ampoules / 10

Appendix 2

Claim Form(2010-11)

Palliative Care Drugs Formulary –Replacement Stocks for Out of Date items

Drug to be stocked / Stock Quantity / DT Price plus VAT / Quantity ordered / Value (£)
Cyclizine Injection 50mg/ml / 5
Diamorphine Injection 10mg / 5
Diamorphine Injection 30mg / 5
Diamorphine Injection 100mg / 5
Haloperidol Injection 5mg/ml / 5
Hyoscine Butylbromide Inj
20mg/ml / 10
Hyoscine Hydrobromide Inj 400mcg/ml / 10
Levomepromazine Injection
25mg/ml / 10
Metoclopramide Injection
5mg/ml / 10
Midazolam Injection 10mg/2ml / 10
Normal Saline 0.9% IV Infusion Bag (500ml) / 5
Normal Saline 0.9% IV Infusion Bag (1 litre) / 5
Water for Injection 10ml miniplasco ampoules / 10
Total Claimed

I declare that the information given on this claim form is true and correct to the best of my knowledge. I understand that action may be taken against me if I make an incorrect claim. I consent to the disclosure of relevant information on this form for the purposes of fraud prevention, detection and investigation.

Signed …………………………………………………………………………………. Date ………………………..
Name of Pharmacist…………………………………………………………………………………………………….
Address of Pharmacy…………………………………………………………………………………………………
…………………………………………………………………………………………………………………………….

Please return completed forms to: -

East Riding of Yorkshire PCT:Jackie Lyon, Health House, Grange Park Lane,

Willerby, Hull HU10 6DT

SIGNATURE SHEET

EL3a: On Demand Availability of Specialist Drugs (Availability of Palliative Care Medicines) (2010-11)

This document constitutes the agreement between the pharmacy and the PCT in regards to this enhanced service.

Signature on behalf of the Pharmacy Contractor:

On behalf of the pharmacy I confirm that the information detailed within this service level agreement is accurate and reflects how the pharmacy approaches the provision of this service. In addition I confirm that the pharmacy will comply with the data reporting and audit requirements of the scheme.

Signature / Name / Date
Pharmacy Address

Signature on behalf of the PCT:

Signature / Name / Date

PAYMENT WILL ONLY BE MADE UPON RECEIPT OF PHARMACY SIGNATURE SHEET

PHARMACY – PLEASE RETAIN A COPY FOR YOUR RECORDS

EL3a

Page 1 of 7