Morecambe Bay Pct

SERVICE LEVEL AGREEMENT FOR

ACCESS TO

PALLIATIVE CARE MEDICINES

Specification and Agreement

Agreement From – 1st August 2009

To be reviewed – 1st August 2010

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Contents

1. Service Description
2. Aims of the Service
3. Service Outline
4. Suggested Quality Indicators
5. Payment Details
6. Sign up and Termination
7. Clinical Governance Issues
8. Information Governance
9. Signature sheet

This service is aimed at the supply of palliative care medicines, the demand for which may be urgent and/or predictable. The pharmacy contractor will stock a locally agreed range of specialist medicines for inclusion in a ‘Just in Case’ box as per attached protocol.The contractor will make a commitment to ensure that users of this service have prompt access to these medicines during opening hours.

The pharmacy will also 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.

The aim of the service will be to improve access to palliative care medicines when they are required by ensuring patients have the medicines in their own homes in advance of need..It will also provide support to patients, carers and clinicians by providing them with up to date information and advice and referral where appropriate.

• The pharmacy holds the specified list of medicines required to deliver this service and will dispense these in response to NHS prescriptions presented

• The pharmacy contractor has a duty to 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

• The pharmacy should maintain appropriate records to ensure effective ongoing service delivery and audit

• The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service are aware of and operate within local protocols

• The 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

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

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

• The 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.

• The pharmacy should review its standard operating procedures and the referral pathways for the service on an annual basis.

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

• The pharmacy participates in any PCT organised audit of service provision

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

• The pharmacy agrees for their details to be included in the protocol for distribution to practitioners

Payments will be made by the PCT. A payment of £220 will be made at the start of the scheme and, if rolled forward, on an annual basis to ensure that all drugs are kept in date. The payment will be reviewed in line with the annual DDRB uplift.

Pharmacies and pharmacists may only provide this service by full completion of the sign up form and must agree to the terms of service contained within this service level agreement.

Participating pharmacies may withdraw from the scheme at any time and the PCT may also terminate provision from a pharmacy. Any such intention must be made in writing to the same individual who receives the sign up forms, and a notice period of 28 days applies.

Change of ownership will require re-application to provide the service. Staff changes (i.e. new manager or regular locum) will necessitate further applications for these individuals to provide the service.

As with any new service, initial and ongoing evaluation is necessary to ensure it is working correctly, meets the needs of patients, healthcare professionals and the NHS and to check whether any improvements could be made.

It is anticipated that periodic audits will be provided for pharmacists to complete. This could comprise short sets of questions to provide feedback, more detailed data collection for a defined brief period, or questionnaires to provide to patients to complete and return to the PCT. More detail will be provided as these are produced.

The completion of these occasional evaluations is included in the reimbursement for the service.

Pharmacies must run their own internal complaints procedures consistent with the NHS’ requirements and apply the standard NHS complaints procedure, if required by a patient. Refer to service specification 2.1.5 of essential service 8

Pharmacists and their staff clearly owe a duty of confidentiality to their patients. The following quote is taken from Medicines, Ethics and Practice:

“The public is entitled to expect Pharmacists and their staff to respect and protect the confidentiality of information acquired in the course of their professional duties. The duty of confidentiality extends to any information relating to an individual, which pharmacists or their staff acquires in the course of their professional duties. Confidential information includes personal details and medication, both prescribed and not prescribed.”

Patients often do not perceive pharmacists to have the same duty of confidentiality as other healthcare professionals and some groups, especially younger patients, are not always aware of the strict confidentiality rules that apply to all healthcare staff. This duty applies regardless of age. It is therefore of the utmost importance to reassure patients of this and the pharmacist should inform each client about they confidentiality they are able to offer, and its limits, at the beginning of the consultation.

Any explicit request by a patient that information should not be disclosed to particular people, or indeed to any third party, must be respected save in the most exceptional circumstances, for example where the health, safety or welfare of someone other than the patient would otherwise be at serious risk.

Pharmacists should ensure that all their staff have confidentiality clauses within their contracts and that they are aware of what these mean. Advice on appropriate wording can be obtained from the PCT if necessary.

Finally pharmacists must adhere to service specification 2.7.2, 2.7.3 and 2.7.4 of essential service 8 that deals with information governance issues.

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

Practices providing this enhanced service must complete and return this Service Level Agreement, which constitutes commitment to the service plan. As commissioner of this enhanced service the PCT needs to satisfy itself that the practice meets all of the criteria as part of its duty of care role i.e. ensures that commissioned services are of high quality, safe and are cost effective.

Signature on behalf of the Pharmacy:

Signature on behalf of the PCT:

Pharmacy Stamp or address:

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