Lancashire Framework for Minor Ailments Scheme

22 Pages·2014·1.03 MB·English

Lancashire
Framework for
Minor Ailments
Scheme
Blackpool CCG
Service Specification
This service encourages patients to self-
refer to their local community pharmacy.
The community pharmacist will treat
minor ailments and supply medicines
according to the CCG minor ailments
local formulary. Medicines will be
Bl ac kp o o l T each i n g supplied free for patients exempt from
prescriptions charges. Objectives are to:
Ho sp i t als N HS
Improve patients’ access to advice and
Fo u n d ati o n Tr ust
treatment; Reduce unnecessary waiting
Dr Lisa R o gan - C h air o f
times for appointments; Reduce GP
M e d ic in e s Op t im i sat io n
workload for minor ailments; Reduce
su b -gr o u p o f t h e
inappropriate consultations; Raise
Lan c ash ir e Ph ar m ac y
awareness of the role of the pharmacist
N e t w o r k B o ar d
in support for self-care; Support primary
12/1/2 013 (Up d a t e d M a rch
care integration for self-care; and
2014 b y M e la n ie Pre s t o n ,
Encourage registration of
As s t . Di re ct o r M e d icin e s
unseen/unheard populations.
Op t im is a t io n fo r B la ck p o o l

CCG )
Lancashire

Pharmacy

Network

NHS Lancashire
Minor Ailment Scheme

INDEX Page

1. Introduction 2

2. Aim 2

3. Key Objectives 2

4. Access to the service 2

5. Referral into the service 2

6. Patient Registration and use of Patient Record Card 3

7. Consultation Process 3

8. Referral from the Pharmacy to the GP/other appropriate 4
healthcare professional

9. Supplying treatment through the Minor Ailment Scheme 4

10. When not to supply treatment through the Minor Ailments 5
Scheme

11. Requirements to Provide the Service 5

12. Pharmacist and Pharmacy Staff Accreditation 6

13. Sign up and termination 6

14. Record Keeping 6

15. Scheme Evaluation 7

16. Payments 7

17. Incident Reporting and Complaints 7

Appendix 1 – Key points for surgeries 8
Appendix 2 – Model Reception staff protocol 9
Appendix 3 – Formulary 10
Appendix 4 – Referral Form 11
Appendix 5 - Resources for Self Care 12

February 2014 1
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
1. Introduction

The Minor Ailment Scheme provides patients living in NHS Blackpool CCG with
advice and access to medicines through community pharmacies where appropriate
supporting integration and self-care.

2. Aim

To encourage patients to self-refer to their local community pharmacy where
appropriate. The community pharmacist will provide advice on specified minor
conditions and supply medicines according to the local formulary in appendix 3 free
of charge for patients exempt from prescriptions charges. (This includes patients with
a prepayment certificate).

3. Key Objectives

The scheme aims to deliver the following objectives:

a) Improve patients’ access to advice and treatment.
b) Reduce unnecessary waiting times for appointment
c) Reduce GP workload for minor ailments.
d) Reduce inappropriate consultations
e) Raise awareness the role of the Pharmacist in support for self-care.
f) Supports primary care integration for the self-care agenda.
g) Encourage registration of unseen/unheard populations eg. Traveller’s and asylum
seekers.

4. Access to the service

The service is available to the following:
a) Patients registered with a GP practice in Blackpool CCG
b) People living in Blackpool not registered with a GP practice. These people will
be provided with advice and/or treatment, then signposted to a local GP
practice for NHS registration.

5. Referral into the service

Patients can be introduced to the scheme in the following three ways:

a) Referral by a GP Practice or other healthcare professional
Patients presenting at a GP surgery, out of hours, or walk-in centre with a minor
ailment included as part of the scheme, may be advised on how to access the
service in the future.

b) Referred by pharmacy staff
Pharmacists and pharmacy staff may refer patients into the scheme where
appropriate.

c) Self-referral into the scheme through a participating pharmacy
Patients can self-refer into the service.

February 2014 2
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
6. Patient Registration and use of the Patient Record

Patients can register by:

a) Providing evidence of registration with a GP practice within
Blackpool CCG eg. Using a repeat prescription tear-off slip or
NHS card. The pharmacist may validate details by contacting the
GP practice.

b) If a patient or pharmacist cannot confirm registration with a GP
practice within Blackpool CCG the patient can access the scheme
at that time. The patient should be advised of alternative methods
of accessing care subsequently until registration with a GP
practice is confirmed.

c) The patient should be encouraged to use the pharmacy that
normally dispenses their prescriptions. However, presentation with
a minor ailment consultation at another participating pharmacy in
Blackpool CCG is acceptable.

7. Consultation Process

7.1 The patient should attend the pharmacy in person to receive a consultation
and if appropriate a supply of medication, in the same way they would be
required to attend a GP appointment for a prescription. There may be
exceptions to this and pharmacists are asked to exercise their professional
judgement in deciding if a supply should be made in the absence of the
patient.

7.2 The pharmacist or suitably trained member of pharmacy staff should carry out
a professional consultation with reference to the minor ailment scheme
formulary (appendix 3). This will involve:

a) Patient assessment.
b) Provision of advice.
c) Completion of Pharm-outcomes data collection.
d) Supply of medication from the agreed formulary where appropriate.

7.3 The pharmacist should keep the consultation process as confidential as
possible.

7.4 The pharmacist should ensure the patient has completed and signed the
declaration of exemption of prescription charges. This will be printed from
Pharm-outcomes following completion of the online consultation form. This
should occur each time the patient accesses the scheme and records
retained securely in the pharmacy for audit purposes. The time scale for this
is five years.

February 2014 3
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
8. Referral from the Pharmacy to the GP/other appropriate healthcare
professional

In the following situations referral should be made using the form in appendix 6:

a) Patient presenting with symptoms requiring referral. The pharmacist
will advise the patient of the urgency to be seen by a GP.
b) Patient is requesting medicines to treat a condition not covered by the
scheme.
c) Formulary medicine is unsuitable for an individual patient.

9. Supplying treatment through the Minor Ailment Scheme

Patients will be provided with medicines to manage their condition if:

a) The patient is eligible for treatment within the scope of the scheme.
b) The medicine required is not contra-indicated.
c) The treatment provided is in accordance with the minor ailment
protocol.

NB. Only the products listed, in the quantities outlined in Appendix 3 will be provided
as part of the scheme.

9.1 OTC medicines must not be supplied outside licensed indications.

9.2 POM medicines will not be supplied.

9.3 Patients will be advised how to take/use the medicines supplied and provided
with a Patient Information Leaflet (PIL).

9.4 Pharmacists can use their professional discretion to supply sugar free
preparations of the same formulary items where appropriate e.g. diabetics
and children.

9.5 When supplying the medication an entry onto the patient’s PMR must be
made and the product labelled as “Supplied under the NHS Minor Ailments
Scheme.”

9.6 Packaging should be clearly marked “NHS supply” to discourage inadvertent
behaviour and ensure NHS resources are used by those they are intended
for.

10. When not to supply treatment through the Minor Ailments Scheme

10.1 Circumstances where a supply should not be made by the minor ailment
scheme are:

a) If, in the pharmacists professional opinion, the patient has either already
received a supply of the same treatment, or presents with the same ailment,
too frequently and requires referral to the GP.

February 2014 4
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
b) If the pharmacist suspects the patient is abusing the scheme. This should be
reported immediately to the CCG by contacting Medicines Optimisation or
Primary Care Leads on 01253 651200.

c) If the patient presents with more than 2 ailments at the same time. Referral to
GP where appropriate.

d) If the patient presents with symptoms not indicative of ailments included in the
scheme.

e) If the patient or parent is unwilling to complete/use the relevant
documentation.

f) If the patient requests a supply for purpose of replacement.

g) If the patient requests a medicine ‘just in case’.

h) If the patient requests a medicine to take abroad.

i) If the patients request supplies to stock up their medicine cabinet.

j) If the patient request medicines in lieu of a repeat prescription e.g.
paracetamol for chronic pain. Long term conditions must continue to be
managed by the primary care teams.

11. Requirements to Provide the Service

11.1 This service may be provided by any authorised community pharmacy
within Blackpool CCG, subject to the following requirements:

a) The pharmacy contractor must agree with the NHS Commissioner to
participate in all parts of the service as detailed in this document along
with any subsequent amendments as agreed with the LPC.
b) This agreement will be in writing and signed by both parties using the
appropriate NHS contractual arrangements.
c) A standard operating procedure (SOP) must be produced for provision of
the service, which clearly defines roles and responsibilities of relevant
staff within the authorised pharmacy.
d) Medicines Counter Assistant qualified staff may be delegated to
undertake the minor ailment consultation provided they adhere to a minor
ailment scheme SOP and sales of medicines protocols. However, overall
responsibility and accountability will remain with the Responsible
Pharmacist.
e) The pharmacy should be able to provide evidence they are meeting the
requirements for all essential services in the community pharmacy
contractual framework.
f) The pharmacist in charge or pharmacy manager must ensure that any
pharmacist or locum employed by the pharmacy is briefed on the scheme
and has read the service specification before providing the service.
g) The pharmacist and pharmacy staff providing the service must conform to
GPhC standards for conduct, ethics and performance at all times.

February 2014 5
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
12. Pharmacist and Pharmacy Staff Accreditation

12.1 No formal accreditation is required to deliver the service as only over
the counter medicines can be supplied as treatment under the scheme.

12.2 All staff providing the scheme should ensure they maintain continuing
education and CPD, to keep up to date with guidance issued around the
treatment of minor ailments, and OTC medicines.

13. Sign up and termination

13.1 All pharmacists and pharmacies must agree to the terms of service
contained within this service specification.

13.2 Participating authorised pharmacies may withdraw from the scheme at
any time. This must be made in writing. A notice of 28 days is required.

13.3 The NHS Commissioner may terminate the contract with a pharmacy.
This must be made in writing. A notice of 28 days is required.

13.4 If pharmacies withdraw from the scheme the pharmacist may continue
to provide the service from other authorised pharmacy premises located
within Blackpool CCG.

13.5 If the scheme proves to be unsuccessful or unnecessary, the contract
may be terminated to ensure NHS resources are prioritised according to
desired outcomes.

13.6 If the scheme is successful but exceeds the CCGs planned budgetary
forecast, the service may be restricted or suspended pending further review.

14. Record Keeping

14.1 A record of any medication supplied through the minor ailment
scheme should be documented in the Patients Medication Record (PMR) on
the pharmacy IT system.

15. Payments

15.1 Pharmacy contractors will be reimbursed according to the following
payment structure:

a) A consultation fee of £3.00 per consultation will be paid. Numbers of
consultations will be closely monitored through Pharm-Outcomes.
b) The list price plus VAT, of medication supplied as indicated in appendix 3
(prices will be updated via Pharm-Outcomes).
c) From 1 April 2014, payments will be made from the CCG following submission
of required dataset via Pharm-Outcomes.

15.2 Where an item is supplied outside of the protocol or MAS formulary,
payment will not be paid for the supply and reimbursement for the
consultation will not be made.

February 2014 6
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
Payments will be made monthly based on the information submitted through Pharm-
outcomes.

16. Scheme Evaluation

16.1 Pharmacies participating in the scheme will be expected to contribute
to evaluation of the scheme through data collection, patient satisfaction
surveys and audit.

16.2 Data will be used by the CCG to evaluate effectiveness with respect to
delivering the desired outcomes including patient satisfaction.

17. Incident Reporting and Complaints

17.1 Incidents should be recorded as part of the pharmacy’s clinical
governance procedures (refer to Essential Service 8 – Clinical Governance,
Community Pharmacy Contractual Framework).

17.2 Pharmacies are expected to have an internal complaints procedure to
which will enable learning and ultimately service improvements.

February 2014 7
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
Lancashire
Appendix 1
Pharmacy

Network
KEY POINTS FOR GP SURGERIES

1. Patients presenting to GPs with minor ailments that could be safely managed
through the Minor Ailments Service should be directed to the service
accordingly.

2. Patients should be referred into the minor ailments service only where they
meet the inclusion criteria. Particular attention should be paid to product
license especially in relation to young children.

3. Patients should be advised to attend their usual community pharmacy.

4. Practices should liaise with relevant pharmacists to allow the rapid referral
procedure and repeat requests procedure to operate effectively (Appendix 6).

5. Practices should use posters to advertise the service across Blackpool CCG.

6. GP surgeries can request a copy of the pharmacy consultation form. This can
be recorded in the patient’s notes if required.

February 2014 8
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG
Appendix 2
Lancashire
MODEL RECEPTION STAFF PROTOCOL
Pharmacy

Network

A. For patients making an appointment at GP Practice:

1. If the patient is suffering from one of the ailments included in the scheme
(Appendix 3), the scheme should be explained to the patient. The patient
should be offered the choice of whether they would like to access the service
from the community pharmacy where no appointment is required. If the
patient accepts they should be offered the following advice:

a) Patients should be provided with a ‘Minor Ailments Scheme’ information
leaflet, if presenting in person.
b) Patients should be directed to a pharmacy for consultation and/or
treatment.
c) If patients are exempt from prescription charges they will receive
medicines at the pharmacy for free under the scheme.
d) If patients normally pay an NHS prescription charge they can choose to
purchase the medication.

2. If a patient prefers not to visit the pharmacy an appointment should be made
with the Doctor in the usual manner.

3. If the patient is not suffering from one of the ailments included in the scheme
an appointment should be made with the doctor in the usual manner.

B. For Patients Self Referring at the Pharmacy

Some patients may choose to visit their community pharmacy direct and join the
scheme. Consultation and supply under the scheme can be made in the following
circumstances:

a) The pharmacist is satisfied that the patient is either registered with a
Blackpool CCG surgery (with supporting evidence).
b) For individuals not registered with a GP practice (such as travellers and
asylum seekers), a consultation and subsequent supply can be made
providing the pharmacist encourages and signposts such individuals to a
nearby GP practice for registration.
c) For treatments excluded under the scheme, patients may be sold a
product or referred back to the practice where appropriate.

C. Rapid Referral from the Pharmacy

a) In the event of an urgent referral, the pharmacist will refer the patient back to
the surgery using the referral form in Appendix 6. This will be given to the
patient and a copy faxed to the GP practice, together with the advice to seek
an appointment at the surgery.
b) A referral back to the practice may be made if, in the pharmacists’
professional opinion, the patient has attempted to access treatment through
the scheme for the same ailment more frequently than is considered
appropriate. The GP Referral Form (Appendix 6) should be used for this
purpose.

February 2014 9
Dr Lisa Rogan – Chair of Medicines Optimisation Sub-group of LPN
Linda Bracewell – Lancashire Local Pharmacy Network Chair
Updated March 2014 for NHS Blackpool CCG