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Local Enhanced Service for Supply of Palliative Care and Urgent Care Medicines Services by Community Pharmacists– Normal Working Hours 2008/09
Contents Page
1 Service Aims 2
2 Standards 2
2.1 Standards for Better Health 2
2.2 Clinical Audit 2
2.3 Indemnity 2
2.4 Training 3
2.5 Confidentiality 3
2.6 Untoward Incidents 3
2.7 Complaints 3
3 Service Specification 4
3.1 Information Requirements for Pharmacies Offering the Palliative and Urgent Care Service…………………………………………………………………………………………5
3.2 Identification Requirements for the Supply of Controlled Drugs 5
3.3 Record Keeping Requirements 5
3.4 Quality Service Indicators 6
3.5 Variations 6
3.6 Disputes Resolution 6
3.7 Reasonable Endeavours 6
3.8 Adjudication………………………………………………………………………………….. 7
3.9 Termination 7
4 Performance Management 7
5 Palliative/Urgent Care Formulary 7
6 Service Provision Localities/Service Provider Selection Process 7
7 Finance Details 8
8 Signature Sheet 9
9 Appendix 1 Eastern and Coastal Kent PCT Palliative Care Medicines Service Formulary ……………………………………………………………………………………………………10
10 Appendix 2 Eastern and Coastal Kent PCT Urgent Care Medicines Service Formulary ………………………………………………………………………………………………...12
11 Appendix 3 Palliative and Urgent Care Medicines Service Localities 13
1 Service Aims
The aim of this service will be to provide an integrated Palliative Care and Urgent Care Medicines service across primary and secondary care in Eastern & Coastal Kent PCT. The Enhanced Service will be to:
· Improve and ensure the availability of palliative care and urgent care medicines from community pharmacies during normal opening hours.
· Provide community pharmacists and healthcare professionals with contact details of pharmacies in their locality who have committed to stock the full range of palliative care and urgent care medication as per the Eastern and Coastal Kent PCT Palliative Care and Urgent Care Formulary.
· Support and provide up to date information and advice on prescription writing and dispensing in order to reduce the number of difficulties experienced by carers and relatives in obtaining supplies.
2 Standards
All providers will be expected to adhere to the standards as laid out in sections 2.1 to 2.7
2.1 Standards for Better Health
Providers must comply with Standards for Better Health as set out in Annex A of ‘National Standards, Local Action: Health and Social Care Standards and Planning Framework 2005/2006–2007/2008’ (July 2004) and be able to evidence compliance on an annual basis as set out by the PCT. Achieving standards required through the PCT monitoring of the Pharmaceutical Services Contract will provide evidence of compliance with SFBH.
Additionally all new providers will be required to undergo a “provider assessment” with the Quality and Assurance Directorate before any service may commence.
2.2 Clinical Audit
The provider must agree to participate in any PCT-led clinical audits associated with this enhanced service.
2.3 Indemnity
The provider will maintain personal indemnity insurance for services carried out as part of this SLA.
The provider will set up and maintain indemnity insurance against all costs, claims, demands, liabilities and damages incurred or suffered by them as a result of any act or omission of the provider, its staff or agents (unless due to the negligent, careless or reckless act or default of the PCT or employees in relation to this agreement).
The provider will maintain Public Liability Insurance for the Practice premises.
2.4 Training
The provider will ensure that all staff involved in providing any aspect of care under this scheme has the necessary training and skills to do so.
The provider will ensure sufficient members (including locums) of staff are trained to ensure provision of service in the event of unforeseen absence or termination of employment.
2.5 Confidentiality
The provider (this term includes its employees, agents and all others authorised by it) shall respect the confidentiality of all information relating to patients, carers or other users of the service. They will comply with The Confidentiality and Disclosure of Information: General Medical Services, Personal Medical Services and Alternative Provider Medical Services Directions 2004, Caldecott, the Data Protection Act 1998 and all other relevant legislation.
This requirement does not preclude appropriate sharing of information where proper legal authority for such sharing exists.
2.6 Untoward Incidents
It is a condition of being a service provider that practitioners will give notification to the PCT Clinical Governance lead of all emergency admissions or deaths of any patient covered under this service, where such admission of death is or may be due to usage of the drug(s) in question or attributable to the relevant underlying medical condition. This must be reported within 72 hours of the information becoming known to the practitioner. This is in addition to a practitioner’s statutory obligations.
2.7 Complaints
In the event of a complaint being made by a member of public regarding the provider (this term includes its employees, agents and all others authorised by it) then the provider will deal with the complaint under their own complaints procedure.
Details of such complaints will be made available to the PCT on a quarterly basis to the clinical governance lead detailing any sentential events.
3 Service Specification
· Times of normal working 0900-1730 Monday-Friday, Saturday 0900-1300.
· This service will be available to any patients with a valid NHS prescription, including housebound patients .This does not specifically have to relate to EKC PCT patients only.
· This service is aimed at the prompt supply of palliative care and urgent care medicines, the demand of which may be urgent and/or unpredictable.
· The pharmacy will stock the complete quota of palliative care and urgent care formulary drugs.
· Pharmacies are required to dispense promptly and accurately all NHS prescriptions presented in accordance with the Eastern and Coastal Kent PCT Palliative Care and Urgent Care Formulary. This may include telephoning suppliers to confirm delivery of extra stock.
· When a pharmacy has insufficient stock to fulfil the NHS prescription, the pharmacy should supply sufficient medication to last for the period that re-stocking will take. If this is not possible then patients/carers and/or relatives requiring medication must be informed of other pharmacies participating in the Palliative Care and Urgent Care Service, where they can obtain their medicines.
· Pharmacies must ensure that stocks of palliative care and urgent care drugs are maintained at the minimum stated stock level on the formulary and that they are in date. The pharmacy must have a stock rotation process and record. The bi-monthly audit information must be provided to the Pharmacy Contracts Manager in order to claim the second enhanced service payment.
· Any stock issued must be replaced within a 24 hour working period. In the event of a delay in replacing stock, then the palliative care and urgent care pharmacy must ensure that this is documented on the bi-monthly audits. The Eastern and Coastal Kent Pharmacy Contracts Manager must also be informed.
· The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of this service have relevant knowledge and skills and are appropriately trained in the operation of this service. This will include locum pharmacists.
· The pharmacy contractor has a duty to ensure that all pharmacists and staff involved in the provision of this service are aware of and operate within local protocols.
· The pharmacy contractor must ensure that Standard Operating Procedures are readily available for all staff (including locums) involved in operating under this scheme.
· The pharmacy will maintain appropriate records to ensure effective ongoing service delivery and audit.
· The pharmacy will provide audit data, as requested, to the Pharmacy Contracts Manager to receive final retainer payment as agreed.
· The pharmacy will keep patients or their representatives fully informed regarding the supply of medicines.
· The pharmacy will plan in advance for increased demand of medication supplies, particularly for weekends and public holidays. This will include working closely with prescribers to identify requirements and ensure sufficient stocks of palliative care and urgent care drugs.
· No controlled drugs should be supplied without the production of appropriate identification by the patient/carer and/or relatives who are collecting the prescribed medication.
3.1 Information Requirements for Pharmacies Offering the Palliative and Urgent Care Service
· An up to date list of pharmacies offering the Palliative Care and Urgent Care Medicines Service and their opening hours.
· Contact details for clinician service providers who may need to access the Palliative Care and Urgent Care Medicines Service as applicable. This will aid pharmacies to contact prescribers if necessary.
· Ensure all staff and locum pharmacists are aware of the arrangements under the scheme to avoid any unnecessary delays with the provision of the service.
3.2 Identification Requirements for the Supply of Controlled Drugs
· Pharmacists should be aware of the identification requirements that patients/carers or relatives will have to produce before controlled drugs can be released by the pharmacy.
3.3 Record Keeping Requirements
· Complete and maintain accurate records, either on computer or paper and these must be available when requested by the PCT.
· All legal requirements for Controlled Drugs must be adhered to at all times. All pharmacies are required to keep abreast of new developments in this area post Shipman.
3.4 Quality Service Indicators
· The palliative care and urgent care pharmacies must have reviewed their standard operating procedures to ensure that these are adequate for this service.
· The pharmacy can demonstrate that all staff involved in the provision of this service has undertaken relevant CPD.
· The pharmacy participates in the bi-monthly audits requested by Eastern and Coastal Kent PCT; this will ensure adequate payment for the scheme at the end of the year.
· The pharmacy co-operates with any locally agreed PCT led assessment of the service and attends annual updates provided by Eastern and Coastal Kent PCT.
3.5 Variations
All variations to this agreement must be formally agreed with the PCT and the provider and confirmed in writing between the points of contact.
3.6 Disputes Resolution
In the event that the provider fails to provide the service as laid out in the specification then the PCT will refer the service faults in writing to the provider’s point of contact within ten working days of the service failure being identified.
The point of contact will, within ten working days from receipt of notification, either rectify the fault or confirm agreed action in writing.
In the event of a fault not being rectified reasonable endeavours come into action.
3.7 Reasonable Endeavours
In the event of a disagreement or dispute not being resolved as above, then the Senior Partner of the provider and the Director of Clinical Services of the PCT will meet and use reasonable endeavours to resolve the dispute without resorting to adjudication.
3.8 Adjudication
Such disputes should be addressed directly to either the FHSAA(SHA), 30 Victoria Avenue, Harrogate HG1 5PR or where appropriate the local Strategic Health Authority.
3.9 Termination
Termination to this agreement may be made giving no less than 3 months notice in writing to the point of contact.
4 Performance Management
The PCT and the provider will hold review meetings on an annual basis, and will cover the strategic planning of the service and performance management.
As part of this review, the provider may be asked to provide information. Details of the information requirements will be made no later than four weeks in advance of any performance meeting.
5 Palliative /Urgent Care Formulary
The Palliative Care Formulary has been agreed by a number of clinicians including hospices, pharmacists, GPs, OOH suppliers, LMC and LPC. A copy of the Palliative Care Formulary is shown in Appendix 1
The Antibiotic Formulary has been agreed with the microbiologists, public
health, pharmacists, OOH suppliers, LMC and LPC. A copy of the antibiotic
formulary is shown in Appendix 2
6 Service Provision Localities/Service Provider Selection Process
The PCT will select two pharmacies to offer the service in each locality (shown in Appendix 3). In addition existing dispensing practices will be given the opportunity to provide the service within rural areas and will be governed by the same regulations already applied to them as a dispensing practice.
Each applicant will be expected to complete a questionnaire. Applications will be assessed against the answers given on the questionnaire. Any applications scoring less that 70% will be rejected.
Contracts will be awarded for a period of one year and reviewed annually.
7 Finance Details
This agreement is to cover a period of one year from 1st April 2008 until 31st March 2009.
A £250 retainer will be paid to all pharmacies operating under this scheme at the beginning of the financial year and another payment of £250 will be made at the end of the financial year providing all audit information and stock information requested has been provided to the PCT Pharmacy Contracts Manager on a bi-monthly basis and requirements as laid out in this document have been met.
All pharmacies operating under this scheme are expected to hold at least the minimum quantities of stock for the complete Palliative Care and Urgent Care Formulary.
The PCT will supply additional CD kits, as required, for the destruction of out of date palliative care drugs. The cost of re-stocking of out of date palliative care and urgent care drugs will be met by the PCT.
The initial stocking of the palliative care and urgent care drugs to offer this service will be met by the PCT. The re-stocking of palliative care and urgent care drugs to replace dispensed drugs will be met by the Pharmacy as reimbursement for the items dispensed will come from the Prescription Pricing Division.
8 Signature Sheet
This document constitutes the agreement between the provider and the PCT in regards to this enhanced service.
Name of provider………………………………………………………………….
Address of provider……………………………………………………………….
……………………………………………………………………………………….
……………………………………………………………………………………….
……………………………………………………………………………………….
Signature on behalf of the provider:
(The signatory is also agreeing that he/she is authorised by the provider to sign on their behalf)