Enhanced Service for Availability of Specialist Medicines (including Palliative Care and Intravenous Antibiotics)
Service Level AgreementContents:
- Finance Details
- Signature Sheet
- Background
- Service Aims
- Objectives
- Termination
- Service Specification
- Agreed List of Specialist Medicines
- Training
- Record Keeping and Adverse Incidents
- Contingency Planning
- Access
- Service User Satisfaction
- Ongoing Measurement & Evaluation
1. Financial Details
This agreement is to cover the period from 1/4/2014 to 31/3/2015.
In 2014/2015 each pharmacy contracted to provide this service will receive:
- Reimbursement at cost for medicines included in the agreed list which have become time expired provided normal stock rotation procedures have been followed within the pharmacy.
PAYMENT WILL ONLY BE MADE UPON RECEIPT OF PHARMACY SIGNATURE SHEET
2. Signature SheetThis document constitutes the agreement between the pharmacy andNHS England in regards to this local enhanced service.
Name and address of Pharmacy Contractor:
………………………………………………………………………………………………………….
……………………………………………………………………Postcode….………………………
Signature on behalf of the Pharmacy:
Signature / Name / DateSignature on behalf ofNHS ENGLAND:
Signature / Name / Date3. Background- not part of the service specification
The purpose of this enhanced service is to clarify the common standards for the provision of palliative care and other specialist medicines. Its aim is to improve access to palliative care medicines, particularly in the out of hours periods to facilitate care of patients.
The NHS Security Management Service have provided guidance on lone working procedures – ‘Not alone – a guide for the better protection of lone workers in the NHS’
Alone- A Guide for the Better Protection of Lone Workers in the NHS.pdf
DH guidance on OOH medicine supply:
Securing Proper Access to Medicines in the Out-of-Hours Period, DH, December 2004.
4. Service AimsThis service is aimed at the supply of specialist medicines, the demand for which may be unpredictable, for example palliative care or where intravenous antibiotics have been prescribed for administration in the community.
The pharmacy contractor will stock a locally agreed range of specialist medicines and will make a commitment to ensure that users of this service have prompt access to these medicines at all times within their contracted hours.
The pharmacy will provide information and advice to the user, carer and clinician. They may also refer to specialist centres, support groups or other health and social care professionals where appropriate.
5. Objectives- To improve access for people to these specialist medicines when they are required by ensuring prompt access and continuity of supply.
- To support people, carers and clinicians by providing them with up to date information and advice, and referral where appropriate
6. Termination
The pharmacy may giveNHS England 3 months’ notice in writing should they be unable to continue to deliver the service.
NHS England may give the pharmacy 3 months’ notice of termination of the service, and this may be reduced to one month in the event that audits demonstrate that a clinically safe service is not being delivered to patients. The practice would be expected to work withNHS England to improve its service and, if necessary, to undertake further training to ensure a safe service to patients.
7. Service Specification7.1The pharmacy holds the specified list of medicines required to deliver this service (as outlined in section 8) and will dispense these in response to NHS prescriptions presented. In circumstances where they are unable to supply promptly the item(s) will direct the patient or carer to the nearest Enhanced Provider checking first that they have the supply in stock.
7.2The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service.
7.3The pharmacy should maintain appropriate records to ensure effective ongoing service delivery and audit.
7.4The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service are aware of and operate within local protocols. This extends to locums who may work in the pharmacy in occasions.
7.5The NHS England Area Team will agree with local stakeholders the medicines formulary and stock levels required to deliver this service. The NHS England Area Team will regularly review the formulary to ensure that the formulary reflects the availability of new medicines and changes in practice or guidelines.
7.6The NHS England Area Team will agree a system which deals with the financial implications of date expiry of the medicines in the formulary.
7.7The NHS England Area Team will provide a framework for the recording of relevant service information for the purposes of audit and the claiming of payment.
7.8The NHS England Area Teamwill provide details of relevant referral points which pharmacy staff can use to signpost service users who require further assistance.
7.9The NHS England Area Team will disseminate information on the service to other pharmacy contractors and health care professionals in order that they can signpost patients to the service
8. Agreed List of Specialist MedicinesThe table below lists the specialist medicines and quantities that will be held by all pharmacies participating in the enhanced service:
Drug / StockAlfentanil 500mcg/ml (1ml amp) / 10
Benzylpenicillin 600mg injection / 2
Cefotaxime 500mg injection / 4
Ceftriaxone 1g injection / 8
Clarithromycin 500mg injection / 2
Cyclizine 50mg/ml injection / 10
Dexamethasone 3.8mg/1ml injection / 10
Diamorphine 10mg injection / 10
Diamorphine 30mg injection / 10
Enoxaparin 100mg pre-filled syringe / 10
Gentamicin 40mg/ml (2ml amp) / 4
Haloperidol 5mg/ml injection / 10
*Hyoscine butylbromide 20mg/ml injection / 20
*Hyoscine hydrobromide 400mcg/ml injection / 10
Levomepromazine 25mg/ml injection / 10
Metoclopramide 10mg/2ml injection / 10
Midazolam 10mg/2ml injection / 10
Morphine Sulfate 10mg/1ml injection / 10
Oxycodone 10mg/ml (1ml amps) / 10
Oxycodone 10mg/ml (2ml amps) / 10
Phytomenadione 2mg/0.2ml injection
(Konakion MM Paed) / 5
Sodium Chloride 0.9% (1L) / 2
Teicoplanin 400mg injection / 2
Water for Injection (10ml) / 10
*Please take care when supplying Hyoscine on a prescription. Ensure that the correct strength and salt have been stated.
9. TrainingCPPE training which may support this service:
Palliative Care Open Learning
10. Record Keeping and Adverse IncidentsReporting of incidents should be in line with the pharmacy policy, with serious untoward incidents such as those relating to an emergency admission or death of a patient (where this is attributable to either the treatment or to the relevant underlying medical condition) being notified within 24 hours of becoming aware, to the NHS England Area Team by telephone on 01935 385276 or by email to .
The pharmacy should keep relevant records of supplies on their computerised patient medication records as appropriate.
Complaints should be documented and acted upon in accordance with NHS Complaints Procedure with notification of formal complaints to the NHS England Complaints Manager as part of the annual complaints report.
11. Contingency PlanningProviders are encouraged to include the availability of specialist drugs service in their contingency plans.
12. AccessProviders should demonstrate that they are providing a responsive and accessible service to patients.
13. Service User SatisfactionProviders should demonstrate that they have sought the views of service users on the service at least annually (for example by surveying users).
14. Ongoing Measurement & Evaluation14.1The pharmacy reviews its standard operating procedures and the referral pathways for the service on an annual basis.
14.2The pharmacy participates in an annual NHS England Area Team-organised audit of service provision.
14.3The pharmacy co-operates with any locally agreedNHS England Area Team-led assessment of service user experience.
Specialist Medicines Enhanced Service 2014-15
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