Enhanced Service ForEmergency Access to Medicines:Community Pharmacy Services Extended hours

Service Level Agreement (SLA) 2016-2020

1.Introduction

2.Signatures

3.Aims and Objectives

4.Service Specification

5.Process - Pharmacy Contractors

6.Quality Indicators Pharmacy Contractors

7.Quality Indicators PTC......

8.Financial Details

9.Monitoring Arrangements

10.Termination of Contract

Appendix A –Emergency Access to Medicines Drugs Scheme List of Drugs stocked

Appendix B – Claim Form for Retainer.

AppendixC – Claim Form for Supplies for Emergency Access to Medicines Provision

  1. Introduction

This agreement set outs the framework to ensure availability for the dispensing of emergency access drugs during extended hours from a community pharmacy, and has been agreed with the Swindon & Wiltshire Local Pharmaceutical Committee. The implementation, administration, monitoring and review of this agreement is the responsibility of NHS Wiltshire Clinical Commissioning Group, or any organisation that takes over the functions of NHS Wiltshire Clinical Commissioning Group.

  1. Signatures:

This document constitutes the agreement between the pharmacy contractor and NHS Wiltshire Clinical Commissioning Group in regards to the above Service Level Agreement for 1stApril 2016 to 31st March 2020. We agree to abide by the conditions laid out in the agreement:

Name of the Pharmacy contractor:
Signature of behalf of the Pharmacy contractor / Name (please print) / Date
Signature of behalf of NHS Wiltshire Clinical Commissioning Group / Name (please print) / Date:
  1. Aims and Objectives

This service aims to ensure that palliative care and emergency medicines are available during the full extended opening hours of the participating pharmacy.

  1. Service Specification
  2. Community Pharmacists – owners or managers agree that their name be included in a list of names maintained by NHS Wiltshire CCGand provided to all pharmacies, GPs, nurses, palliative care providers and community teams/services.
  3. The pharmacists included in this scheme will be contracted to hold a minimum stock of an agreed range of palliative care and emergency medicines as outlined in Appendix A.This is the stock available from all participating pharmacies.
  1. Process- Pharmacy Contractors
  2. The pharmacist will
  3. Where requested, the pharmacist will provide advice to the health care professional regarding the prescribing or dosage of medicines that should be administered to a patient.
  4. Agree to participate in any audit of the scheme as necessary to ensure stocks are available as stated.
  5. In circumstances where they are unable to supply promptly the items(s), the pharmacist will direct the patient or carer to the next nearest Commissioned Provider checking first that they have the supply in stock.The contractor will inform NHS Wiltshire CCGif they have been unable to supply the medication.
  6. Submit the dispensed prescription to the NHSBSA in the normal way.
  7. Ensure they are familiar with the local palliative care guidelines and will undertake any other training as appropriate to meet their own CPD needs.
  8. Use his/her professional judgement and take sole responsibility for any supply made outside the specification set out in this service level agreement.
  1. Quality Indicators Pharmacy Contractors

6.1. The pharmacy contractor can demonstrate that pharmacists and staff involved in
the provision of the service have undertaken CPD relevant to this service and are
aware of and operate within local protocols.There is a CPPE distance learning course on
Palliative Care that can be undertaken to assist in fulfilling this quality indicator.

6.2. The pharmacy contractor can demonstrate that stock levels are maintained as agreed, and that Wiltshire CCG is informed of any stock availability problems on a quarterly basis in line with quarterly retainer fee’s.

6.3 The pharmacy contractor reviews its Standard Operating Procedures and the
referral pathways for the service on an annual basis.

  1. Quality Indicators NHS Wiltshire Clinical Commissioning Group
  2. NHS Wiltshire Clinical Commissioning Group will:
  3. Select pharmacies to provide this service based on opening hours and accessibility
  4. Ensure all pharmacies, GPs, nurses, palliative care providers andcommunity teams/services within the locality are made aware of the pharmacies providing the Enhanced level of service.
  5. Supply local palliative care guidelines.
  6. Undertake to reimburse the pharmacy at the cost for the original (set up) stock of medicines included in the agreed Emergency Access to Medicines stock list and those which have become time expired provided normal stock rotation procedures have been followed within the pharmacy.
  7. Highlight stock availability problems to palliative care teams
  1. Financial Details
  2. A quarterly £52.50retainer feewill be paid to the pharmacy contractor participating within the scheme. Payments will be made in April, July, October and January.
  3. For pharmacies that join the service part way through the financial year, contracts will commence at the beginning of each quarter.
  4. . Payment will follow receipt of confirmation that the list of drugs stocked is present and in date on a quarterly basis(Appendix A). Alternative and if available, payment will follow completion of data added to PharmOutcomes regarding confirmation of batch numbers and expiry date of all the required stock – as detailed in Appendix A.
  5. NHS Wiltshire Clinical Commissioning Group will pay for the cost of the initial supply of the medications listed in Appendix A, not already stocked by the pharmacy contractor, on submission of a claim form listing the total costs of the mediation. This will be paid with the quarterlypro rata retainer fee. This stock will remain be the property of the pharmacy contractor.
  6. The retainer can be claimed on submission of a Claim Form (Appendix B).
    Alternatively and if available tThe retainer will be paid automatically, each quarter, on completion of data added to PharmOutcomes regarding confirmation of batch numbers and expiry date of all the required stock – as detailed in Appendix A.
  7. For any date expired stock the pharmacist will submit a Claim Form (Appendix C) giving details of the items expired, for the attention of Out of Hospital Directorate NHS Wiltshire Clinical Commissioning Group. Alternatively and if available, data will be submitted to PharmOutcomes with details of the items expired.
  1. Monitoring Arrangements
  2. NHS Wiltshire Clinical Commissioning Groupwillreview the quarterly submission of data and may periodicallyspot-check the stock levels held by pharmacies. The pharmacy contractor will email confirmation that the list of drugs stocked is present and in date on a quarterly basis(Appendix A). where PharmOutcomes is not available.
  3. NHS Wiltshire Clinical Commissioning Group will also monitor any
    claims for date expired stock.
  1. Termination of Contract

This agreement will run until 31st March 2020. However, during this period, it may be terminated by either party by giving three months written notice. Wiltshire CCG may terminate the agreement, giving three months written notice, should the pharmacy contractor regularly not be able to supply specific drugs.

Appendix A – Emergency Access to Medicines Drugs Scheme List of Drugs stocked

Name of Pharmacy:

Contractor Code:

This is important to ensure payments are processed efficiently

Emergency Access to Medicines

Stock Confirmation

Drug / Quantity / Price
(Sept 2015) / In Stock / In Date
Alfentanil 500mcg/ml (1mg/2ml) (Rapifen) / 10x2ml / £6.34
Ceftriaxone Injection 250mg (for use in case of Pelvic Inflammatory Disease) / 2x1 / £4.80
Cyclizine 50mg/ml Inj / 10x1ml / £8.65 (5)
Dexamethasone 3.8mg/ml / 10x2ml / £19.99
Diamorphine 100mg inj / 5 / £42.39 (5)
Diamorphine 10mg inj / 5 / £15.04 (5)
Diamorphine 30mg inj / 5 / £14.59 (5)
Diazepam 10mg Rectal Tubes (5mg/2.5ml) / 5 / £5.85
Diazepam 5mg/ml Inj / 10x2ml / £5.25
Diclofenac 100mg Suppositories / 10 / £3.64
Domperidone 30mg Suppositories / 10
Fentanyl 100 Patch (prescribe by brand as Mezolar) / 1x5 / £34.60
Fentanyl 12 Patch (prescribe by brand as Mezolar) / 1x5 / £7.53
Fentanyl 25 Patch (prescribe by brand as Mezolar) / 1x5 / £10.77
Fentanyl 50 Patch (prescribe by brand as Mezolar) / 1x5 / £20.13
Fentanyl 75 Patch (prescribe by brand as Mezolar) / 1x5 / £28.07
Furosemide 40mg tablets / 1 x 28 / £0.85
Glycopyrronium Bromide 200mcg/ml inj / 10x1ml / £8.11
Haloperidol 5mg/ml inj / 10x2ml / £8.65 (10)
Hyoscine Butylbromide 20mg/ml inj / 10x1ml / £2.92
Hyoscine Hydrobromide 400mcg/ml inj / 10x1ml / £32.57
Levomepromazine (Methotrimeprazine) 25mg/ml inj / 10x1ml / £20.13
Metoclopramide 5mg/ml inj / 10x2ml / £3.23
Midazolam 2mg/ml inj (Hypnovel) / 10x5ml / £7.11
Morphine sulphate 10mg/ml inj / 1x10 / £9.63
Morphine sulphate 15mg/ml inj / 1x10 / £8.95
Morphine sulphate 30mg/ml inj / 1x10 / £8.84
Naloxone 400mcg/ml inj / 10x1ml / £41.00
Octreotide 100mcg/ml / 5x1ml / £27.97
Octreotide 50mcg/ml inj / 5x1ml / £14.87
Ondansetron 8mg tablets / 1 x 10 / £3.52
Oramorph Oral Solution 10mg/5ml / 1x100ml / £1.89
Oxycodone 10mg/ml 1ml inj / 1x5 / £8.00
Oxycodone 10mg/ml 2ml inj (20mg/2ml) / 1x5 / £16.00
Oxycodone liquid 5mg/5ml / 1x250ml / £9.71
Phenobarbital sodium 200mg/ml inj / 10
Sodium chloride 0.9% inj / 10x10ml / £2.96
Water for injection / 10x10ml / £2.45

Please return this form to:

Appendix B – Claim Form for Retainer

Claim for Retainer Fee

Emergency Access to Medicines

Retainer Fee for (please provide dates of specific quarter)

…………………………………………………………..

Please provide contact details for the out of hours period

Name of Pharmacist to Contact:

Telephone number:

I claim £52.50retainer fee for the provision of the above enhanced service for the datesdetailed above, and understand that confirmation of this claim may be sought or investigated by the NHS Counter Fraud unit.

Signed Date

Print NamePosition

Signature:Name:Date:

Office use only

Payment authorised by:Date:

Please return this form to:

Appendix C – Claim Form for Supplies for Emergency Access to Medicines Provision

Claim for Reimbursement of

Expired Stock for the

Emergency Access to Medicines Service

Details of Expired Stock / Batch Number / Expiry Date / Amount Payable
£
£
£
TOTAL CLAIM* / £

Please attach a copy of wholesalers invoice for replacement stock.

I claim payment of I confirm that the information given on this form is true and complete. I understand that if I provide false or misleading information I may be liable to prosecution or civil proceedings. I understand that the information on this form may be provided to the Counter-Fraud and Security Management Service, a division of the NHS Business.

Signature:Name:Date:

Office use only

Payment authorised by Date

Please return this form to: