Service Level Agreement For
Solihull CT
Service Level Agreement for
Pharmacy Access Scheme to supply Nicotine Replacement Therapy
SLA between:
Service Provider:
(Community Pharmacies in Solihull)
Commissioner:
Solihull CT
Date of Development:
August 2009
Due for review:
August 2010
Solihull LPC Endorsement:
This Service Level Agreement was endorsed by Solihull Local Pharmaceutical
Committee on ……………………….
1. Purpose
1.1 This agreement enables Pharmacies to work in partnership with the Solihull Stop Smoking Service (SSSS) in order to:
• Facilitate the accessibility and availability of Nicotine Replacement Therapy (NRT) within the community setting in accordance with Solihull Stop Smoking Service Protocol for the Supply of Nicotine Replacement Therapy (NRT)
1.2 The SSSS currently supports a number of pharmacies to deliver an enhanced Stop Smoking Service whereby pharmacists may offer a comprehensive stop smoking service. This access scheme is in addition to the full stop smoking service currently offered by some of our pharmacies to support the Solihull Stop Smoking Service Protocol for the Supply of Nicotine Replacement Therapy (NRT) 1 The vouchers will be redeemable at local participating pharmacies across Solihull.
1.3 Pharmacies are ideally placed to advise people on how to stop smoking and/or to facilitate the supply of Nicotine Replacement Therapy (NRT). The contribution pharmacists can make to improving the health of the population has been recognised in ‘A vision for pharmacy in the new NHS’ (DH, 2003) and is supported by ‘Choosing health through pharmacy: a programme for pharmaceutical public health 2005-2015’ (DH 2005)
1.4 Tobacco use is the single biggest cause of premature death, killing over 84,000 people in the UK every year. In Solihull, smoking is responsible for the
deaths of around 305 people per year.
2. The contract price and payment method
2.1 NRT will be reimbursed at agreed drug tariff price + VAT at 5% (see enclosed invoice sheet) + supply fee of £2 for each 2 weeks worth of NRT product Appendix 1, NRT Supply Recommendation form).
2.1.1 Contributions made by the client (i.e. prescription charges) will be deducted from the final payment.
2.1.2 The drug tariff price has been agreed until April 2010 when it will be reviewed.
E.G. if drug tariff is £10 :-
2.1.3. Patient who is exempt from prescription charge will not pay, therefore invoice to SSSS will be £10 x 12 weeks + handling charge of £2.00 x 6 = £132.00
2.1.4. Patient who pays prescription charge: pays 6 x £7.20p to the pharmacy*
12 weeks of NRT = £120
6 x £2 handling charge = £12
Total £132.00
(-6 x 7.20p = £43.20) £43.20
Total to claim £82.80 (due to pharmacy retaining prescription charge).
* = assuming this is current prescription charge
2.1.5 Patient who is advised to use combination therapy will be required to pay two prescription charges. Pharmacists can claim for 2 x handling fee in these instances.
Per voucher with combination therapy patient will pay 2 x £7.20 to the pharmacy*
2 weeks worth of NRT at £9.97 = £19.94
2 weeks worth of NRT at £8.89 = £17.78
Total = £37.72
2 x £2 handling charge = £4
£41.72
(-2 x £7.20 = £14.40) -£14.40
Total to claim £25.32 (due to pharmacy retaining prescription charge x 2).
* = assuming this is current prescription charge
2.2 In order for payment to be facilitated as swiftly as possible, all paperwork (i.e. NRT Supply Request forms) collected, will need to be returned on a monthly basis in supplied envelopes from Solihull Stop Smoking Service.
2.4 Payments will be generated following an agreed process on the basis of information submitted by the Solihull Stop Smoking Service to the Care Trust.
2.5 If and when the CT introduce an IT based claim system and community pharmacies will be trained and expected to use once it is available.
2.6 The provider will be responsible for financing other operational aspects of the service from within the agreed payment value. This will include all telephone costs, stationary costs and miscellaneous costs associated with the delivery of the service. Postage costs will be supported from the Stop smoking service.
2.7 Details of support materials available from the Solihull Stop Smoking service will be made available to pharmacy providers.
2.8 An initial £50 will be paid to each pharmacy when signing up to the scheme in June 2010.
3. Parties to the Contract
3.1 The Contract is between the Commissioners namely, Solihull CT and the providers who will be designated primary care providers located within the
Solihull CT area.
3.2 Pharmacy Contractors must be compliant with all other Essential Services in the Pharmacy contract.
3.3 Please note that a copy of this SLA must be signed and returned to
Alison Trout , Tobacco Control & Stop Smoking Services Manager, Solihull CT, 6th Floor, Mell House, 46, Drury Lane, Solihull, B91 3BU.
Payments for services will not be made until this SLA has be signed &
returned.
4. Quality Indicators
4.1 The pharmacy has appropriate Care Trust provided health promotion material available for the user group and promotes its uptake.
4.2 The pharmacy contractor or a designated deputy must attend training provided by the Care Trust before the service is provided.
4.2 The pharmacy contractor or a designated deputy has a duty to ensure that pharmacists and staff involved in the provision of the service are aware of and operate within the local protocols.
4.3 The pharmacy can demonstrate that pharmacists and staff involved in the provision of the service have undertaken continuing professional development/training relevant to this service.
4.4 The pharmacy should maintain appropriate records to ensure effective ongoing audit.
4.5 The pharmacy participates in an annual Care Trust organised audit of service provision if requested to do so.
4.6 The pharmacy co-operates with any locally agreed Care Trust-led assessment of service user experience
5. Term of the Contract
5.1 The Contract shall commence with effect from the date signed on behalf of the provider and will continue until further notice, or otherwise as provided for in Clause 7 (Termination)
6. Service to be Provided
6.1 The “voucher” is intended to maintain patient motivation to stop smoking by providing access to medication in a safe and timely manner from a qualified healthcare professional using the existing network of community pharmacies.
6.2 This scheme will enable participating pharmacies to supply NRT to those clients who are currently enrolled in the Solihull Stop Smoking Service, upon receipt of an NRT supply recommendation form (Appendix 1).
6.3 Following a consultation with the Specialist Stop Smoking Advisor, clients will be given a ‘Solihull Stop Smoking NRT Supply Recommendation Form’ voucher (Appendix 1) stating the type, dose and frequency of NRT, which will be signed by the Named Stop Smoking Advisor included in the SSSS Protocol 1. The pharmacist will be asked to supply NRT based on the recommendation.
6.4 Vouchers will be redeemable at any pharmacy across Solihull involved in the scheme. Clients will not have to attend the same pharmacy to redeem subsequent vouchers in the same course, although it may be recommended for consistency.
6.5 Solihull Stop Smoking Advisors will screen the clients at their appointment or group session to assess nicotine dependency, motivation and readiness to quit smoking. Each Stop Smoking Advisor will have discussed all available NRT products with the client. A risk assessment will have been carried out to ensure there are no contra-indications for use of NRT and the type, dose and quantity of NRT to be supplied will be written on the voucher.
6.6 If there is no preference for a particular brand of NRT this part will be left blank.
6.7 The use of the chosen NRT product will have been completed by the Stop Smoking Advisor and should be reinforced by staff on supply at the pharmacy.
6.8 In line with NICE guidance, NRT should be supplied on a 2 weekly basis. It will not be common practice to recommend more than 2 weeks supply of NRT, however exceptions may be applicable in some conditions for example to allow for holidays, the standard 2-week supply may be exceeded on a discretional basis if specialist advisors are confident that diversion or wastage will not occur. If a request is made for 2 types of NRT in combination for 2 weeks supply pharmacists will receive £2 for each 2 weeks of an NRT product so pharmacists will receive £4 for a 2 week voucher with 2 products to use in combination. If a request is made for 4 weeks of NRT pharmacists will receive £2 for every 2 weeks issued so will receive £4 for a 4 week voucher, Once the client has received 8 weeks worth of Nicotine replacement it may be appropriate to continue treatment to 12 weeks as recommended on product licence. In this instance a further 2 or 4 week supply request may be made. The maximum supply will be 12 weeks of NRT per client.
6.9 Vouchers will be valid for 14 days from the issue date.
6.10 One week after ‘quit day’ the client will be issued with a voucher for a further 2 weeks. 4 weeks after ‘quit day’ the client will be assessed by the Specialist Stop Smoking Advisor for abstinence from smoking using a CO monitor. If there is evidence they are still smoking, no further vouchers will be issued.
6.11 If their abstinence is verified, vouchers to complete the course will be issued.
6.12 Thus a client will typically present four vouchers for an 8 week course or 6 for a complete 12 week course of treatment where the maximum duration of any voucher will be two weeks. If a client presents four vouchers for 8 weeks of NRT and the last 4 weeks is requested from one voucher this will mean they typically present with 5 vouchers and the final 4 week voucher will be redeemable at £4.00.
6.13 The advisor completes the first part of the voucher. At the pharmacy the remainder of the voucher is completed (including prescription exemption information, which will help evaluate the scheme), and voucher is retained.
The third part of the voucher is returned to the service along with the monthly summary sheet for payment. The second part is retained by the pharmacist.
6.14 At the end of each month the pharmacy returns the summary sheet plus copies of the third part of the voucher to the Stop Smoking Service.
6.15 Clients receiving NRT under this ‘scheme’ will be asked to pay a £7.20 fee (unless exempt from normal prescription charges). If paid, the Pharmacist should retain this charge and it will be recorded on the ‘NRT Supply Recommendation Form’ voucher.
Please note:
• Supply of NRT under this agreement will not replace FP10 prescriptions
• The supply of NRT through this project will supplement current prescribing through the GP route
6.16 LABELLING – All NRT products supplied must be recorded on the
Pharmacy’s patient medication record (PMR) system and have a PMR generated label affixed, including the date, patient’s name and directions for use.
7. Human Resources
7.1 All accredited staff who undertake the Service must have the full support of their employers or management where appropriate.
8. Termination
8.1 Either party may elect to terminate this Contract early by giving 14 days written notice to the other.
8.2 In the event that this agreement is terminated early in accordance with clause 7.1 the provider agrees to complete all Service obligations with existing
clients.
8.3 Notwithstanding anything in the Contract, Solihull CT may terminate this contract or any part of it immediately upon written notice to the provider if:
a. The provider commits an irremediable material breech of this Contract
and/or
b. The provider having committed a remedial material breach of this Contract,
shall neglect or otherwise fail to remedy such breach within such a
reasonable time as shall be specified after being required in writing to do
so by Solihull CT, or repeats such remedial breach within the time
allowed to remedy the original breach; and/or
c. The provider commits persistent minor breaches of this Contract
9 Confidential Information and Data Protection
9.1 The provider or accredited staff shall not disclose or allow to be disclosed to any person (except on a confidential basis when seeking professional advice) any information of a confidential nature in the course of carrying out their duties under this agreement, except as may be required by law or as directed by the Solihull CT.
9.2 The provider must store and retain personal data in accordance with the
principles and provisions of the Data Protection Act legislation and must
ensure the reliability of staff and where appropriate, the accredited staff, who
have access to such data.
10 Arbitration and Notice
10.1 This Contract is binding to both provider and purchaser. In the event of noncompliance with the terms of this agreement on the part of either party, a
meeting will be instigated within two weeks to attempt to resolve the matter.
10.2 Any notice to be served by either party on another pursuant to this agreement shall be sent in writing to the other party. Except in urgent cases, a minimum of 14 days notice will be given.