Service Specification

On Demand Availability of Palliative Care Medicines

  1. Aims and Objectives

To improve the care of the dying in the last few days/hours of life by:

  • pharmacies having sufficient stock of an appropriate range of palliative care medicines (PCMs) during core hours.
  • pharmacies signposting carers to another participating pharmacy with sufficient stock, in the event that they are unable to immediately supply the necessary palliative care medicines.
  1. Service Descriptions
  2. A minimum stock of PCMs (see appendix A) must be carried at each pharmacy premises accredited to do so.
  3. The pharmacy must ensure their PCM stock is audited every month: to maintain the minimum stock level of each drug,to have a shelf life sufficient to cover the period until the next audit plus one week.
  4. The pharmacy must ensure rotation of their PCM stock, wherever reasonably practicable, with their existing stock to minimise wastage.
  5. The pharmacy must ensure patients or their carers are signposted to another participating pharmacy if their own PCM stock does not fulfil the needs of a particular patient.
  6. After issuing PCMs the contractor must ensure the stock is restored to the minimum level within 24 hours.
  7. The CCG recognises the difficulty in ordering replacement stock on weekends and during holiday periods. In the event that stock cannot be replaced, patients or their carers must be signposted to another participating pharmacy.
  8. The pharmacy will take part in an annual audit of the PCMstock if requested to do so by the CCG. This may be used to ensure compliance with the specifications of this enhanced service.
  9. Supply from Pharmacies
  10. PCMs will be supplied in accordance with the Medicines Act (1968). Prescriptions will normally be issued by a general practitioner or non-medical prescriber on an FP10.
  1. Expired Medicines
  2. The pharmacy should claim payment from the CCG for PCMs obtained and held for the purposes of the ODAP service which pass their expiry date.
  3. Reimbursement for replacement of expired PCMs will calculated at the latest Drug Tariffprice.
  4. The pharmacy should submit an invoice to the CCG, a template invoice is contained inAppendix B.
  5. Record Keeping
  6. The pharmacy must keep records of their monthly audits and of any claims made to the CCG.
  7. Publicity
  8. The lists of participating pharmacies will be circulated across St Helens Primary Care Trust to GPs, MacMillan nurses, district nurses, hospices, the local authority, community pharmacies, walk-in centres, other relevant PCT staff and secondary care organisations.
  9. Payment to Participating Pharmacies
  10. Theaccredited pharmacy may claim an annual retention fee of £400.
  11. Expired medicines held under the scheme will be reimbursed at the latest Drug Tariff price. Contractors should submit an invoice to the CCG for payment based on the template in Appendix B.
  12. Please insert the St Helens CCG name and organisational code in the “invoice to” section:

NHS St Helens CCG, 01X Payables L475, Phoenix House, Topcliffe Lane, Wakefield, WF3 1WE

7.4Completed claim forms should be returned to

Heather LeCouteur

St Helens CCG Medicines Management Team

The Gamble Building

Victoria Square

St Helens

Merseyside

WA10 1DY

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Appendix A

List of palliative care medicines to be stocked

Drug name / Proprietary name / Formulation / Strength / Stock
Biotène Oralbalance / n/a / Gel / 50g / 1 x 50g
Cyclizine / Valoid / Injection / 50mg/ml (1ml ampoule) / 3 x 5
Dexamethasone sodium phosphate / n/a / Injection / 4mg/ml (1ml ampoule) / 1 x 5
Diamorphine HCl / n/a / Injection / 5mg / 2 x 5
Diamorphine HCl / n/a / Injection / 10mg / 2 x 5
Diamorphine HCl / n/a / Injection / 30mg / 2 x 5
Diamorphine / n/a / Injection / 100mg / 2 x 5
Diazepam / Stesolid / Enema / 10mg / 2 x 5
Diclofenac / n/a / Suppositories / 100mg / 1 x 10
Fentanyl / Fencino / Patch / 12micrograms/hour / 1 x 5
Fentanyl / Fencino / Patch / 25micrograms/hour / 1 x 5
Fentanyl / Fencino / Patch / 50micrograms/hour / 1 x 5
Fentanyl / Fencino / Patch / 75micrograms/hour / 1 x 5
Fentanyl / Fencino / Patch / 100micrograms/hour / 1 x 5
Gelclair / n/a / Gel / 15ml / 1 x 21
Glycopyrronium bromide / n/a / Injection / 200micrograms/ml
(1ml ampoule) / 1 x 10
Glycopyrronium bromide / n/a / Injection / 200micrograms/ml
(3ml ampoule) / 1 x 10
Haloperidol / Haldol / Injection / 5mg/ml (1ml ampoule) / 2 x 5
Heparin sodium / n/a / Injection / 10u/ml (2ml) / 10 x 2ml
Heparin sodium / n/a / injection / 10 IU/ml (5ml) / 10 x 5ml
Hyoscine butylbromide / Buscopan / Injection / 20mg/ml (1ml ampoule) / 1 x 10
Levomepromazine / Nozinan / Injection / 25mg/ml (1ml ampoule) / 1 x 10
Metoclopramide / Maxolon / Injection / 5mg/ml (2ml ampoule) / 1 x 12
Midazolam / Hypnovel / Injection / 5mg/ml (2ml ampoule) / 2 x 10
Morphine sulphate / Oramorph / Oral solution / 10mg/5ml / 1 x 100ml
Morphine sulphate / Oramorph concentrated / Oral solution / 100mg/5ml / 1 x 30ml
Nystatin / Nystan / Suspension / 100,000units/ml / 1 x 30ml
Morphine sulphate / n/a / Injection / 10mg amp / 20 x 2ml
Morphine sulphate / n/a / Injection / 30mg amp / 10 x 2ml
Ondansetron / Zofran / Injection / 2mg/ml (2ml ampoule) / 1 x 5
Oxycodone / Oxynorm / Oral solution / 5mg/5ml / 1 x 250ml
Oxycodone hydrochloride / Oxynorm / Injection / 10mg/ml (1ml ampoule) / 1 x 5
Sodium chloride / n/a / Injection / 0.9% w/v (10ml ampoule) / 2 x 10
Sodium chloride / n/a / Intravenous infusion / 0.9% w/v (100 ml) / 20x 100ml
Sodium chloride / n/a / Intravenous infusion / 0.9% w/v (500ml bag) / 2 x 500ml
Sodium chloride / n/a / Intravenous infusion / 0.9% w/v (1 litre bag) / 2 x 1L
Sodium citrate / Relaxit / Enema / 5ml / 1 x 12
Water for injection / n/a / Injection / 1ml / 1 x 10
Water for injection / n/a / Injection / 2ml / 1 x 10
Water for injection / n/a / Injection / 5ml / 1 x 10
Water for injection / n/a / Injection / 10ml / 1 x 10

NB: please note pharmacies can procure additional palliative care medication within 12 hours.

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