ENHANCED SERVICE agreement for the provision of a
Not Dispensed Service via Community Pharmacy Contractors
Section 1: Parties to the Agreement
This document represents the Enhanced Service agreement between Community Pharmacy Contractors and the PCT for the following service.
1.1 The Service: / A Not Dispensed service to be provided by Community Pharmacy Contractors1.2 Type of Agreement: / Cost per case
1.3 Agreement Date: / 1st December 2006
1.4 Party 1:
The commissioner of the Service hereinafter detailed as “the PCT” in this SLA / Leicestershire County and Rutland PCT
Lakeside House
4 Smith Way
Grove Park
Enderby
Leicester
LE19 1SS
1.5Designated
PCT contact: / Name
1.6Party 2:
A provider of the Enhanced Service hereinafter detailed as the “provider” in this SLA / Contractor:
Address:
1.7Designated provider
contact: / Mr/Mrs
Section 2: The Service To Be Provided - Aims and Objectives
AIM - To reduce prescribing waste and over ordering of repeat items. Prescription
items directed to be taken, or to be used,as required account for a considerable
number of prescribed items. Examples of these variable use items include reliever
inhalers, blood testing strips, and analgesics.
Importantly, these items tend to accumulate, expire and are ultimately wasted.
SERVICE OBJECTIVE – Pharmacists or appropriately qualified staff should discuss such repeat prescription items with the patient, to check if they need to be dispensed or supplied that month. If an item is not needed possibly because the patient has sufficient at home, then it is NOT DISPENSED.
Section 3: Operational Outline of Service – what the provider will doThe following points should be incorporated into a Standard Operating Procedure
(SOP) to be developed by the provider and adhered to support the delivery of
this Enhanced Service
4.1Ensure all appropriately qualified staff, including locums involved in the dispensing process are aware of the service, the SOP, and their role in it.
4.2Ensure all appropriate patients presenting repeat prescriptions with such variable use items (in the opinion of the pharmacist) are asked if they require all such items as ordered on the prescription.
4.3Ensure that Repeat Dispensing service patients are excluded from the service.
4.4Ensure that the prescription, which is the subject of the Not Dispensed intervention, is clearly and indelibly endorsed Not Dispensed or ND.
4.5Ensure that all necessary information is fully entered on the Claim Form.
4.6Ensure that the provider retains a photocopy of all completed claim forms.
4.7Ensure that original copies of completed claim forms are sent to:
Not Dispensed Service
Medicines Management Department
Leics County & Rutland PCT
Lakeside House
4 Smith Way, Grove Park
Enderby, Leicester
LE19 1SS
4.8Ensure original claim forms correspond to calendar month periods, and are posted to the PCT within 5 working days of the end of the respective calendar month.
4.9Ensure that robust communication systems are adopted by the provider to ensure GP Practices are promptly informed of all items Not Dispensed, and to include reasons why.
A Not Dispensed GP Communication Slip has been produced to facilitate such communications. Other methods such as annotating a photocopy of the ND-endorsed prescription are acceptable alternatives.
Section 5: Operational Outline – what the PCT Commissioner will doProcesses will be developed and adhered to by the commissioner to support service delivery, facilitate audit, and to inform review of this service.
5.1To create a process to ensure providers are promptly paid for the services as evidenced by fully completed claim forms.
5.2The commissioner and the providers will work collaboratively to monitor and evaluate the service as set out in this SLA.
Section 6: Quality Assessment Framework
The principles of Essential Service 8 (Clinical Governance) of the Community
Pharmacy Contract fully apply where appropriate to this commissioned service.
6.1Pharmacy providers are required to assess themselves against their respective Quality Framework to ensure compliance with the requirements set out within this Enhanced Service at the outset, and also on an ongoing basis to identify areas for development which the provider needs to address.
6.2Any aspect of the Enhanced Service identified as requiring attention or development will inform development discussions between the PCT and the provider, and may thus inform changes to the SLA, as appropriate.
Section 7: Monitoring Service Delivery
The PCT and the providers will work collaboratively to monitor and evaluate the
service as set out in this Enhanced Service.
7.1 For the purposes of monitoring performance and service delivery, the provider will provide information as reasonably and justifiably required to allow the Enhanced Service to be analysed and monitored as appropriate.
7.2Information from the monthly claim forms, submitted by the provider will be recorded for the purpose of monitoring and evaluating service delivery.
7.3The PCT reserves the right to make random checks of the claim forms via GP Practices and via the PPA to confirm that items have been not dispensed. Each entry therefore on the claim form must contain the corresponding Prescription Serial number found at the bottom of the prescription form.
7.4Any suspicion of fraudulent claims arising as a result of such random checks will, after reference to the provider concerned, be referred to the local NHS counter fraud team.
7.5The provider has the opportunity to self-audit this service and the PCT would encourage this as good practice.
Section 8: Review of Service Level AgreementReports on the activity, Quality Framework and any relevant audit information will
inform future reviews of the Enhanced Service.
8.1The Enhanced Service, including the Contract Price (Section 20) will be reviewed one Month before the end of the Term of this Agreement, and periodically thereafter.
Section 9: Non-Compliance with the SLA
This SLA is binding on both the PCT and the provider.
9.1In the event of non-compliance with the terms of this Enhanced Service on the part of either party, a meeting will be instigated within 2 weeks to seek to resolve the matter. The purpose of this meeting will be to resolve the issue and where necessary devise a recovery plan to be implemented immediately. Should non-compliance continue and be identified through activity, quality or audit monitoring, either party can invoke the notice period for the termination of the Enhanced Service as stated in Section 16.
9.2The PCT may serve notice in writing on the provider terminating the Enhanced Service forthwith or with effect from such date as may be specified in the notice if:
9.2.1The provider has breached the terms of the SLA and the PCT considers that as a result of that breach, the safety of patients is at serious risk if the Enhanced Service is not terminated; or
9.2.2The financial situation is such that the PCT considers that it is at risk of material financial loss.
Section 10: In year variances
10.0This agreement may be updated to reflect any new Department of Health guidance on primary care Enhanced Services.
10.1One month’s notice will be required by either the PCT or the provider to vary any part of this Enhanced Service except where both parties are in full agreement of the proposed variations. This clause is excluding any immediate action following patient / clinical complaint or significant clinical event. In all such cases this will involve the provider being informed verbally and then a follow up written communication within 14 days of the event or receipt of the written complaint.
Section 11: IndemnityThe provider must have professional indemnity cover in place, and adhere to the
quality standards and guidelines of their professional body and local standards
developed by the PCT.
Section 12: Dispute Resolution
12.1In the event that there is a dispute between the PCT and the provider in connection with any provision of this Enhanced Service, the dispute shall first be discussed between the authorised provider & the PCT contact to ascertain the exact nature of the dispute and possible approaches to its resolution.
12.2In the event that the provider and the PCT are unable to reach a decision then the dispute shall be referred to PCT Primary Care Contracts Panel to make all reasonable efforts to resolve the dispute in good faith.
Section 13: Term of Agreement
13.1The Term of this Agreement shall be from the date the Authorising Signatures were applied (Section 21) until 31st March 2007.
13.2At the end of the Term, the Agreement shall become a one-month rolling Agreement, subject to notice period and Termination detailed in Section 14.
Section 14: Termination
14.0Either party may terminate the Enhanced Service, subject to Section 9, during the Term of the Agreement (Section 13)and is required to give one months written notice to the other party.
14.1After the Term of the Agreement when a rolling Agreement may apply, either party may terminate the Enhanced Service giving one months written notice to the other party.
Section 15: Provider Risk Management Systems, Complaints,
Incidents and Serious Adverse Events
Provider risk management systems and processes must be in line with local
and national guidance, and in accordance with the NHS Pharmaceutical
Contractual Regulations 2006 (Statutory Instrument No. 552) as amended.
Section 16: General Terms and Conditions
The PCT and provider acknowledge the key principles of the NHS, and will
operate within all NHS standards, guidance, protocols and mandates. The
standard NHS terms and conditions as set out on
reformsapply to this Enhanced Service.
Section 17: Entire Agreement
This SLA constitutes the entire agreement between the parties with respect to its
subject matter.
17.1 This SLA supersedes any prior agreements, promises, conditions or representations, whether written or oral, and the parties confirm that
they did not enter into the SLA on the basis of any representations that
are not expressly incorporated into the SLA. However, nothing in this
SLA purports to exclude liability on the part of either party for fraudulent
misrepresentation.
Section 18: Compliance with Legislation and Guidance;
Law and Jurisdiction
The provider shall comply with all the relevant legislation and have regard to all relevant guidance and policy issued by the PCT, the relevant Strategic Health Authority or the Secretary of State for Health.
18.1 This SLA shall be governed and construed in accordance with English
Law.
Section 19: No Subcontracting or Assignment
The provider shall not give, sell, assign, subcontract or otherwise dispose of the
benefit of any of its rights or obligations under this SLA without express
permission in writing from the PCT.
Section 20: The Contract Price and Payment Method
Remuneration is calculated on a cost per unit of service basis, and consists of a
flat-fee component for the activity, a lost income reconciliation component, and an incentive component.
20.1The flat fee component for each unit of service is £3.00. For every valid ‘Not Dispensed’ intervention the Provider will receive this payment.
20.2The lost income reconciliation component is 10% of the value of the prescription items not dispensed. This consideration also includes the incentive payment.
20.3Payments will be calculated by the PCT based on submission of completed claim forms received from the provider on a calendar month basis.
20.4The unique prescription serial number at the bottom of each FP10 must be transcribed and correspond with each entry on the claim form. Failure to provide this number will invalidate the claim corresponding to that item.
20.5The provider will be responsible for financing the costs associated with returning the completed claim forms.
20.6The LES agreement will be reviewed by the PCT at the end of the Term of Contract at Section 14.
Section 21: Authorised Signatures
Signed on behalf of the Contractor
Signature------
Print Name:------
Position:------
Date------
Signed on behalf of the Commissioner
Signature------
Print Name:------
Position:------
Date------
Acknowledgements:
i) Coventry PCT
ii) CPFC at Hinckley & Bosworth PCT
Leicestershire County & Rutland PCT acknowledges the pilot schemes, and the practice research project led by the Community Pharmacy Framework Collaborative (H&B CPFC), the outcomes evidence of which has informed the development of this Enhanced Service.
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Leicestershire County and Rutland PCT Service Level Agreement – ‘Not Dispensed’ Enhanced Service - November 2006