Copeland Locality Minor Ailment Scheme

20 Pages·2014·2.53 MB·English

by  Jeff Forster

Copeland Locality

Minor Ailment Scheme

Service Level Agreement

Dec 14
Copeland Locality Cumbria CCG
Minor Ailment Scheme
INDEX Page
Service Specification 3
1. Introduction 4
2. Aim 4
3. Key Objectives 4
4. Access to the service 4
5. Referral into the service 4
6. Patient Registration 5
7. Consultation Process 5
8. Referral from the Pharmacy to the GP/other appropriate
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healthcare professional
9. Supplying treatment through the Minor Ailment Scheme 6

10. When not to supply Medication through the Minor Ailment
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Scheme
11. Requirements to Provide the Service 7
12. Pharmacist and Pharmacy Staff Accreditation 8
13. Sign up and termination 8
14. Record Keeping 8
15. Scheme Evaluation 8
16. Payments 9
17. Incident Reporting and Complaints 9

Appendix

Appendix 1 – Key points for surgeries and flowchart 1 0
Appendix 2 – Model Reception staff protocol 11
Appendix 3 – Formulary Products 12
Appendix 4 – Consultation / Referral Form 16
Appendix 5 – List of Minor Ailment Scheme Conditions 17
Appendix 6 - List of Pharmacies/GP Practice involved in the MAS 18
Appendix 6a- Copeland Boundary Map for Minor Ailment Scheme 19
Appendix 7 - Agreement Form 20
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 Cumbria CCG minor ailments local
formulary.

Medicines will be supplied free for patients exempt from prescriptions
charges.

Objectives are to:

 Improve patients’ access to advice and treatment;
 Reduce unnecessary waiting times for appointments;
 Reduce GP workload for minor ailments;
 Reduce inappropriate consultations;
 Raise awareness of the role of the pharmacist in support for
self-care;
 Support primary care integration for self-care; and
 Encourage registration of hard to reach patient groups.
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1. Introduction

The Minor Ailment Scheme provides patients living in Copeland Locality with advice
and access to medicines through community pharmacies when appropriate
supporting integration and self-care.

2. Aim

To encourage patients to self-refer to their local community pharmacy, when 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) To support primary care integration for the self-care agenda.
g) Encourage registration of hard to reach patient groups
eg. Travellers and asylum seekers.

4. Access to the service

The service is available to the following:

 Patients registered with a GP practice in Copeland Locality.
 People living in Copeland Locality not registered with ANY GP practice
eg. Travellers and asylum seekers. These people can 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, or the Out of Hours service (CHOC) with a
minor ailment included as part of the scheme, may be advised on how to
access the service in the future (appendix 1 & 2)
b) Referred by pharmacy staff
Pharmacists and pharmacy staff may refer patients into the scheme when
appropriate (appendix 2)
c) Self-referral into the scheme through a participating pharmacy
Patients can self-refer into the service (appendix 2)
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6. Patient Registration

Patients can register by:

 Providing evidence of registration with a GP practice within Copeland
Locality - eg. using a repeat prescription tear-off slip or NHS card.
 The pharmacist /pharmacy staff may validate details by contacting the GP practice.

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 judgment in deciding if a supply
should be made in the absence of the patient.

7.2 The pharmacist/accredited 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 Pharmoutcomes data collection.
d) Supply of medication from the agreed formulary when appropriate.

7.3 The pharmacist/ accredited pharmacy staff should keep the consultation process as
confidential as possible.

7.4 All patients being treated under the terms of the MAS must first be registered
using the appropriate Pharmoutcomes service.
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8. Referral from the Pharmacy to the GP/other appropriate healthcare
professional

In the following situations referral should be made using the MAS Consultation/Referral
form (appendix 4)

a) Patient presenting with symptoms requiring referral.
-The pharmacist will advise the patient of the need for a GP
appointment – either urgent or routine
-The pharmacist will contact the surgery when an urgent referral is needed.
b) Patients are requesting medicines to treat a condition not covered by the scheme.
c) Formulary medicine is unsuitable for an individual patient.
d) A patient has made repeated requests for treatment for the same condition.

9. Supplying treatment through the Minor Ailment Scheme

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

 The patient is eligible for treatment within the scope of the scheme.
 The medicine required is not contraindicated, having questioned
the patient appropriately.
 The treatment provided is in accordance with the minor ailment
protocol.

NB. Only the products listed in Appendix 3 will be provided under the terms of the
scheme. Quantity supplied will be single packs as specified.

a) Over the Counter (OTC) medicines must not be supplied outside licensed indications.
b) Prescription Only Medicine (POM) will not be supplied.
c) Patients will be advised how to take/use the medicines supplied and provided with a
Patient Information Leaflet (PIL).
d) Pharmacists can use their professional discretion to supply sugar free preparations of
the same formulary items when appropriate e.g. diabetics and children.
e) When supplying the medication an entry onto the patient’s Patient Medication
Record (PMR) must be made and the product labelled as “Supplied under the NHS
Minor Ailments Scheme.”
f) Packaging should be clearly marked “NHS supply” to ensure NHS resources
are used by those they are intended for.
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10. Minor Ailments Scheme Exclusions

Circumstances where a supply should not be made:

a) If the patient has already received a supply of the same medicine within the last
two months.
b) If the patient presents on 3 or more occasions in the previous 6 months for
treatment of the same ailment. This requires referral to the GP practice.
c) If the pharmacist suspects the patient is abusing the scheme. This should be
reported immediately to the CCG by contacting Copeland Locality Cumbria
CCG Telephone :- 01229 406221
d) If the patient presents with more than 2 ailments at the same time.
Referral to GP where appropriate.
e) If the patient presents with symptoms indicating a diagnosis of a condition
which falls outside those included in the scheme.
f) If the patient or parent is unwilling to complete/use the relevant documentation.
h) If the patient requests a medicine ‘just in case’.
i) If the patient requests a medicine to take abroad.
j) If the patients request supplies to stock up their medicine cabinet.
k) 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

This service may be provided by any authorised community pharmacy within Copeland locality
subject to the following requirements:

a) The pharmacy contractor must agree with the NHS Commissioner to participate
in all aspects of the service as detailed in this document along with any
subsequent amendments as agreed with the Local Pharmaceutical Committee
(LPC).
b) The Service Level Agreement for the scheme must be signed by commissioner
and provider. 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.
c) The pharmacy should be able to provide evidence they are meeting the
requirements for all essential services in the community pharmacy contractual
framework.
d) The pharmacist in charge or pharmacy manager must ensure that any
pharmacist or locum employed by the pharmacy is briefed on the scheme, has
read the service specification and completed the mandated training requirements
before providing the service.
e) 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.
f) An accredited pharmacist must be available for at least 80% of the opening
times. Pharmacies falling below this requirement must notify Cumbria LPC so that
their accreditation to provide the service can be suspended. It is essential that
any regular locum staff should complete the training requirements so that the
service can be provided throughout all opening hours.
g) The pharmacist and pharmacy staff providing the service must conform to
GPhC standards for conduct, ethics and performance at all times.
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12. Pharmacist and Pharmacy Staff Accreditation

 Supervising pharmacists are required to complete
Responding to Minor Ailments (NHS Education for Scotland version) which is
available from CPPE.
 Accreditation should be completed within 3 months of the Minor Ailment Scheme
starting.
 It is advisable to retain the printed version of this learning as a reference source.
 CPPE Declaration of Competence needs to be completed for provision of a Minor
Ailment Service.
 All staff providing the scheme should ensure they undertake appropriate
CPD, so that they have current knowledge of guidance issued around the
treatment of minor ailments, and OTC medicines.
 Accredited Medicines Counter Assistant ( NVQ2 or equivalent ) qualified staff,
provided they adhere to a minor ailment scheme SOP and sales of medicines
protocols.

13. Sign up and termination

 All pharmacists and pharmacies must agree to the terms of service
contained within this service specification.
 Participating authorised pharmacies may withdraw from the scheme at any time.
Any withdrawal request must be made in writing to the commissioner, giving
28 days notice.
 Copeland Locality may terminate the contract with a pharmacy.
28 days notice must be given in writing, unless there is a breach of the SLA in
which case the contract would be terminated forthwith.
 If the scheme exceeds the CCGs planned budgetary forecast, the service
may be restricted or suspended pending further review.

14. Record Keeping

 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, and MUST be recorded on the appropriate Pharmoutcomes page.

15. Payments

Pharmacy contractors will be reimbursed according to the following tariff:

a) A consultation fee of £5.00 per consultation will be paid, irrespective of medicine
supply.
b) The list price of medication supplied plus VAT. Basis for pricing is indicated in
Appendix 3
c) Payment will be made monthly in response to invoices generated by Pharmoutcomes.
Numbers of consultations will be closely monitored through Pharmoutcomes.
d) 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.
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16. Scheme Evaluation

 Pharmacies participating in the scheme will be expected to contribute to evaluation
of the scheme through data collection, patient satisfaction surveys and audit. The
patient satisfaction data must be entered onto Pharmoutcomes.

 Data will be used by the Copeland Locality Cumbria CCG to evaluate
activity, outcomes and patient satisfaction.

17. Incident Reporting and Complaints

 Incidents should be recorded as part of the pharmacy’s clinical governance
procedures refer to ‘Clinical Governance requirements, Community Pharmacy
Contractual Framework’

 Pharmacies are contractually required to have to have a complaints procedure
which will enable learning and ultimately inform service improvements.
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Appendix 1

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 and supplied with a
patient information leaflet.
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 a community pharmacy within Copeland Locality
(appendix 6 /6a)
4. Practices should use posters and leaflets to advertise the service across
Copeland Locality.

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