Pharmacy Support to Stop Advisor Scheme
Service Level Agreement
Date: ______to ______
This Service Agreement represents a contract between North Somerset Primary Care Trust and the Pharmacy Contractor named below.
Name: ______Pharmacy: ______
Address: ______
1. Background
The Pharmacy Support to Stop Scheme was launched in April 2004 as a pilot project. Its aim is to provide pharmacy based, one to one stop smoking support to motivated smokers referred onto the scheme through a number of routes. The pilot will be monitored and evaluated and extended if successful.
The requirements of the scheme are outlined in this service agreement and involve:
· A series of support/counseling sessions for clients, lasting approximately 6 weeks, provided by a trained, pharmacy based advisor.
· Monitoring and follow up of clients four weeks after the quit date.
· Appropriate completion and prompt return of client monitoring forms.
· Inclusion in the voucher scheme for the supply of nicotine replacement therapy.
The payment associated with the provision of this service reflects, therefore, the additional requirements of stop smoking support, record keeping and follow up, that goes beyond normal clinical practice and which is detailed in section 2 below.
2. Key Tasks in Detail
The tasks stated within this Service Agreement are to be carried out by each pharmacy taking part in the scheme as follows:
Training
a) Pharmacists/pharmacy assistants becoming support to stop advisors will attend 15 hours of training, facilitated by specialists from North Somerset PCT. The training will cover smoking cessation skills and techniques. The PCT specialist advisors will also arrange a site visit to go through the initial process and the paperwork of the scheme. They will provide ongoing support and training for the pharmacy based advisor and quality assessment of the scheme.
b) Following training we would expect the support to stop advisor to have at least 2 hours per week dedicated time for support to stop work. Attendance at other training events is expected to maintain service standards and
c) Training on effective brief interventions with smokers, effective referral into the service, and the mechanism of the pharmacy support to stop scheme should be cascaded to all the pharmacy staff. As many staff as practicable should attend the 2 hour training provided by North Somerset PCT.
Referral
d) Smokers can be referred onto the scheme by pharmacy staff and the scheme may be promoted within the pharmacy. Referral may also come from other health professionals or from the specialist service at North Somerset PCT. North Somerset PCT will regulate referrals to maintain the scheme within the allocated budget.
Initial Assessment
e) On receipt of a referral, the registered pharmacy based advisor will confirm the client’s suitability for the programme by assessing motivation and determining whether the client will benefit from intensive support. This may be done face to face, over the telephone or using a questionnaire. Clients not yet ready to quit should be provided with brief advice and leaflets and advised to rejoin the scheme when ready to set a quit date. Clients not wanting support to quit cannot receive NRT from the pharmacy scheme but can still buy their NRT. The initial assessment should be brief as there is no payment for this. If necessary, a list of clients wanting to enter the STS programme should be kept and the pharmacy should let the PCT know. (01275 546744)
First Appointment
f) This should take place in a private consultation area and last about 30 minutes. The rest of
the support programme should be agreed with the client. A baseline carbon monoxide test should be carried out and a quit date set. The monitoring form should be filled in and agreement made about the use of pharmacotherapy. If NRT is being used then this should be given to the client as described below.
Subsequent appointments
g) These should be offered at weekly intervals up to 4 weeks after the quit date and follow the
format described in the training. Carbon monoxide tests should be carried out at each visit and the interventions recorded on the monitoring form. If NRT is being used then this should be given to the client as described below.
h) The four week follow up consultation to determine smoking status should be completed in person so that carbon monoxide validation of smoking status can be carried out. This follow up should be completed/attempted between 4 – 6 weeks after the quit date. At least three attempts should be made in person, by letter or by telephone.
Monitoring Forms
i) At the 4 week follow up, correctly completed monitoring forms should be photocopied and one
copy sent to administration, Stop Smoking Service, North Somerset Primary Care Trust, Waverley House, Old Church Road, Clevedon, BS21 6NN. The other copy can be kept by the pharmacy for their own records, as support for clients usually continues for longer than 4 weeks.
Completing the follow up and returning clients individual record sheets (IRS) promptly 4 weeks after the quit date ensures correct payments are made to the pharmacy.
Payments cannot be made for IRS’s which are returned after the quarter has closed.
Supply of pharmacotherapies for stopping smoking
j) The pharmacy based advisor should discuss with the client the range of pharmcotherapies available. It is the pharmacist’s responsibility to ensure that the appropriate pharmacotherapy is recommended for use by the client.
k) The advisor and pharmacist should sign the voucher for the supply and the client should sign to say they have received the product.
k) Each supply form allows supply of NRT for up to 4 weeks. For each supply form, the pharmacist
should collect the prescription fee or require the client to tick and sign that they are eligible
to free prescriptions. All clients should then sign the form. This form will then act as the pharmacy’s
invoice to claim the cost of pharmacotherapy.
l) Pharmacotherapy can be supplied for up to 12 weeks (on three supply forms), in quantities outlined on the forms. ie One weeks supply only for the first two weeks, followed by two weeks supply
up to 12 weeks. Clients should not receive more than 2 weeks supply at one time.
m) Pharmacotherapies should not be given until the client has set a quit date in the following week.
3. Fees and Payment
a) A fee of £30 will be paid for every client setting a quit date and who is supported through to the four
week follow up stage if the following criteria have been met:
· Where possible the four week follow-up should be completed face to face and the clients’ carbon monoxide level recorded, along with the quit attempt outcome.
· If a client defaults from the scheme at any stage after setting a quit date, the advisor must still follow up the client at four weeks, making 2 attempts by telephone, and if unable to contact a letter must be sent, of which there is a copy in the Advisors manual. These attempts must be recorded on the Individual Record Sheet.
· The four week follow up must be completed or attempted at least 3 times within 4 – 6 weeks of the quit date.
· The monitoring form must be submitted prior to the deadlines outlined in section 2h of this agreement.
· All essential information on the monitoring form must be completed.
Payments will be made via the finance department of North Somerset PCT on a quarterly basis.
b) The cost of any Pharmacothrapy supplied under the Pharmacy Support to Stop Scheme will be
reimbursed (drug tariff cost plus VAT) on a monthly basis, following the receipt of a supply form which matches a monitoring form. This payment will be made by the PPA under the heading of ‘local service 1’.
4. Service Volume/Referrals
a) You will be registered onto the scheme, following successful completion of the training and assessment by your advisor(s) and you will be issued with a toolkit including Advisors
Manual and a carbon monoxide monitor.
b) The number of clients each pharmacy can report maybe restricted due to constraints on
funding.
c) If you wish to leave the scheme, one month’s notice is required to arrange return of the toolkit
And notify health professionals responsible for referral of clients
16/11/2010 1 of 3 Created on 5/5/2004 9:17:00 AM SLA for Pharmacy Support to Stop Scheme.doc Amended on 13/09/2005