Provision of Enhanced Palliative Care and Emergency Stock Service 2014/15

Ref:FTL70
9 April 2014
The Pharmacy Manager
Glastonbury Pharmacy
Feversham Lane
Glastonbury
Somerset
BA6 9LP / Bristol, North Somerset, Somerset and South Gloucestershire Area Team
South Plaza
Marlborough Street
Bristol
BS1 3NX

1

Dear Colleague

Provision of Enhanced Palliative Care and Emergency Stock Service 2014/15

I am pleased to inform you that the Somerset Palliative Careand Emergency Stock service has been extended for a further 12 months. As your pharmacy has previously offered this service, I would like to invite you to take part again for this year. If so, please complete the invoice attached and submit it to the Area Team at the address below. Payment will be made by the PPD.

If your pharmacy no longer wishes to provide the Palliative Care Service please could you let us know, so that we can, if necessary, invite another pharmacy to provide this service?

In the meantime, if you have any queries regarding continued provision of the service, please do get in touch.

Yours sincerely

Gaynor Woodland

Primary Care Commissioning Support (Pharmacy)

NHS England – BNSSSG Area Team

Wynford House

Lufton Way

Yeovil

BA22 8HR

Enc: Invoice template for April 2014 to March 2015

PALLIATIVE CARE &EMERGENCY MEDICINES STOCK LIST

Medicine / Stock level
Alfentanil solution for injection 500mcg/ml / 5 x 2mls
Cyclizine solution for injection
50mg/ml / 10 x 1ml
Dexamethasone solution for injection 4mg/ml / 10 x 1ml
Dexamethasone tablets 2mg / 100
Diamorphine powder for solution for injection 10mg / 10
Diamorphine powder for solution for injection 30mg / 10
Diazepam solution for injection 5mg/ml (10 x 2mls) / 5 x 2mls
Diazepam rectal tubes 10mg / 5
Diclofenac suppositories 100mg / 10
Domperidone suppositories 30mg / 10
Fentanyl patches 75mcg / 5
Fentanyl patches 100mcg / 5
Glycopyrronium bromide solution for injection 200mcg/ml / 10 x 1ml
Haloperidol solution for injection 5mg/ml / 5 x 1ml
Hyoscine butylbromide solution for injection 20mg/ml / 10 x 1ml
Hyoscine hydrobromide solution for injection 400mcg/ml / 10 x 1ml
Levomepromazine solution for injection 25mg/ml / 10 x 1ml
Levomepromazine tablets 25mg / 84
Metoclopramide solution for injection 5mg/ml / 10 x 2mls
Midazolam solution for injection 5mg/ml / 10 x 2mls
Morphine sulphate solution for injection 10mg/ml / 20 x 1ml
Morphine sulphate solution for injection 30mg/ml / 10 x 1ml
Morphine sulphate solution (Oramorph®) 10mg/5ml / 3 x 100mls
Morphine sulphate concentrated solution (Oramorph Concentrated®) 100mg/5ml / 1 x 30mls
Oxycodone solution for injection 10mg/ml / 10 x 1ml
Sodium Chloride solution for injection 0.9% / 10 x 10mls
Water for injection / 40 x 10mls
Clexane 4000 units(pre-filled syringes) (40mg/0.4ml) / 1 x 10pfs
Clexane 6000 units(pre-filled syringes) (60mg/0.6ml) / 1 x 10pfs
Clexane 8000 units(pre-filled syringes) (80mg/0.8ml) / 1 x 10pfs
Clexane 10000 units(pre-filled syringes) (100mg/1.0ml) / 1 x 10pfs
Clexane Forte 12000 units (pre-filled syringes) (120mg/0.8ml) / 1 x 10pfs
Clexane 150000 units(pre-filled syringes) (150mg/1ml) / 1 x 10pfs
Relenza dose inhalation powder 5mg / 1 pack of 5
Tamiflu Capsules 30mg / 10
Tamiflu Capsules 45mg / 10
Tamiflu Capsules 75mg / 20
Tamiflu Powder for Oral Suspension / 1 x 65mls

INVOICE FOR THE PROVISION OF PALLIATIVE CARE & EMERGENCY MEDICINESTOCK SERVICE

Pharmacy Name:......

Trading Address:......

......

By submitting this invoice I hereby agree that:

the above named pharmacy has the approved stock of palliative care and emergency medicines as listed below in stock and available for dispensing;

the pharmacy will maintain the approved stock of palliative care and emergency medicines and replace items used on prescription in the normal manner;

the list of approved stock of palliative care and emergency medicines may be varied at the discretion of the Somerset Clinical Commissioning Group and the NHS England Area Team.

Medicine / Stock level
Alfentanil solution for injection 500mcg/ml / 5 x 2mls
Cyclizine solution for injection
50mg/ml / 10 x 1ml
Dexamethasone solution for injection 4mg/ml / 10 x 1ml
Dexamethasone tablets 2mg / 100
Diamorphine powder for solution for injection 10mg / 10
Diamorphine powder for solution for injection 30mg / 10
Diazepam solution for injection 5mg/ml (10 x 2mls) / 5 x 2mls
Diazepam rectal tubes 10mg / 5
Diclofenac suppositories 100mg / 10
Domperidone suppositories 30mg / 10
Fentanyl patches 75mcg / 5
Fentanyl patches 100mcg / 5
Glycopyrronium bromide solution for injection 200mcg/ml / 10 x 1ml
Haloperidol solution for injection 5mg/ml / 5 x 1ml
Hyoscine butylbromide solution for injection 20mg/ml / 10 x 1ml
Hyoscine hydrobromide solution for injection 400mcg/ml / 10 x 1ml
Levomepromazine solution for injection 25mg/ml / 10 x 1ml
Levomepromazine tablets 25mg / 84
Metoclopramide solution for injection 5mg/ml / 10 x 2mls
Midazolam solution for injection 5mg/ml / 10 x 2mls
Morphine sulphate solution for injection 10mg/ml / 20 x 1ml
Morphine sulphate solution for injection 30mg/ml / 10 x 1ml
Morphine sulphate solution (Oramorph®) 10mg/5ml / 3 x 100mls
Morphine sulphate concentrated solution (Oramorph Concentrated®) 100mg/5ml / 1 x 30mls
Oxycodone solution for injection 10mg/ml / 10 x 1ml
Sodium Chloride solution for injection 0.9% / 10 x 10mls
Water for injection / 40 x 10mls
Medicine / Stock level
Clexane 4000 units(pre-filled syringes) (40mg/0.4ml) / 1 x 10pfs
Clexane 6000 units(pre-filled syringes) (60mg/0.6ml) / 1 x 10pfs
Clexane 8000 units(pre-filled syringes) (80mg/0.8ml) / 1 x 10pfs
Clexane 10000 units(pre-filled syringes) (100mg/1.0ml) / 1 x 10pfs
Clexane Forte 12000 units (pre-filled syringes) (120mg/0.8ml) / 1 x 10pfs
Clexane 150000 units(pre-filled syringes) (150mg/1ml) / 1 x 10pfs
Relenza dose inhalation powder 5mg / 1 pack of 5
Tamiflu Capsules 30mg / 10
Tamiflu Capsules 45mg / 10
Tamiflu Capsules 75mg / 20
Tamiflu Powder for Oral Suspension / 1 x 65mls

Please pay the amount of £200.00 for the provision of this service to:

...... (Name of pharmacy)

SIGNED......

Print Name......

Position......

Date / / 2014