Leeds PCT Minor Ailments Scheme

Guidance Notes

Eligibility

Patients wishing to use the service must be registered with a Leeds PCT GP practice.

Confirmation of patient registration with a Leeds PCT GP practice must be established at the pharmacy by presentation of evidence produced by the patient, e.g. medical card, repeat prescription tear-off slip, pharmacy patient medication record (PMR) showing evidence of a prescription dispensed in the last 6 months.

Registration

Patients are not required to formally register with the scheme.

Consultation and Treatment

The service can only be provided for patients presenting with symptoms of the minor ailments listed minor ailment as listed. (Appendix 1)

For patients under the age of 16 the parent/guardian can accept transfer into the scheme on behalf of the patient.

Only the products listed in the formulary can be provided as part of the scheme. The medicines available within the scheme must not be supplied outside their licensed indications.

Eligible patients will only be provided with medicines to manage the minor ailment if, in the professional opinion of the pharmacist, there is a current clinical need for the medication, and the medicine required is not contraindicated.

Patients should only be supplied with medication if they present at pharmacy. Medication should not be supplied to a third party.

Patients are at liberty to decline to participate in the scheme.

The Pharmacist should carry out a professional consultation which should involve:

·  Patient assessment in relation to the presenting complaint

·  Provision of advice

·  Supply of appropriate medication (OTC pack only) from the agreed formulary

·  Record of advice and treatment

·  Completion of exemption/consultation form

·  Any medication supplied under the scheme must be labelled with full dosage instructions

Exemption/Consultation Form

Any medication supplied to patients exempt from prescription charges under the current guidelines will be provided free of charge.

Evidence of exemption must be seen in the same way as if the patient was presenting with a prescription.

The patient should be asked to read the exemption declaration form (Appendix 2) and then sign the exemption/consultation form.

Exemption/consultation forms should be retained at the pharmacy.

Details of any payments associated with the minor ailments scheme must be recorded and submitted to the PCT at monthly intervals

Key Points for Participating Pharmacies

The pharmacist must comply with all existing standards and codes of good practice, both national and local e.g. in the form of Standard Operating Procedures, as appropriate.

Participation in the Minor Ailment scheme does not abrogate pharmacists from their professional responsibilities.

The Professional lead at each community pharmacy will be responsible for completing the CPPE Minor Ailments module within three months of participating in the pilot and forward the evidence of completion to the PCT.

The pharmacist must ensure, where there is a clinical need, that appropriate medication is supplied, that the patient is advised how to take/use the medication, and is provided with a patient information leaflet as appropriate.

Patients who present with a minor ailment outside the scope of the scheme, or for whom the listed formulary product(s) is (are) not appropriate or contra-indicated, will be signposted and assisted in accessing the most appropriate treatment from an alternative healthcare professional.

Patients who, in the opinion of the pharmacist, need an urgent GP appointment will be directed to the GP either by phone or by using a pharmacy referral form. (Appendix 3)

Only the medicines listed in the formulary in the quantities stated can be issued to an eligible patient following a consultation. Further supplies of this medication following a subsequent professional consultation should only be supplied if, in the opinion of the pharmacist, it is considered appropriate.

The possibility of abuse of the scheme and/or medication must be borne in mind and reported to the GP and PCT as appropriate.

The pharmacist should endeavour to keep the consultation process as confidential as possible and as such a private consultation area would be desirable to achieve this aim.

Service Funding

The pharmacy payment structure consists of:

·  Consultation fee of £3.00 per consultation

·  Reimbursement of medication cost based on the Chemist and Druggist and Drug Tariff (January 2008 edition) plus VAT (currently 15%). Prices are subject to change to reflect price fluctuations.

Participating pharmacists will be eligible to claim a consultation fee for instances where a consultation has taken place with a patient, but a decision has been made not to supply medication under the scheme. However details of the consultation must still be recorded on the PMR and on the forms to be submitted to the PCT

Payment Schedule

Claims for payment should be sent to

Sati Ghataure, Primary Care Development Manager

2nd Floor Stockdale House

Headingley Business Park

Victoria Road

LS6 1PF

Appendix 1

Minor Ailment Formulary sheet

Ailment / Product and Unit
Oral cold sores / Aciclovir cream 5% BP 2g
Sore throat / Aspirin dispersible tablets 300mg (32)
Hay fever / Beclometasone nasal spray 50mcg/metered
Hay fever / Cetirizine tabs 10mg (7)
Hay fever / Cetirizine tabs 10mg (30)
Hay fever / Cetirizine syrup
Hay fever / Chlorphenamine tabs 4mg (30)
Hay fever / Chlorphenamine SF Oral Solution 2mg/5ml 150ml
Hay fever / Sodium Cromoglycate eye drops 2% 10ml
Mouth ulcers / Anbesol liquid 6.5ml
Thrush / Canesten Combi ®(1)
Thrush / Clotrimazole Pessary 500mg
Thrush / Clotrimazole Cream 1% 20g
Thrush / Fluconazole capsule 150mg (1)
Diarrhoea and vomiting / Loperamide capsules (6)
Diarrhoea and vomiting / Oral rehydration sachets (6)
Indigestion / Gaviscon Advance 250ml
Peptac Suspension
Gaviscon 250 ® Tablets 8/12
Allergic /dry skin conditions / Aqueous cream BP (500G)
Allergic skin conditions / Hydrocortisone cream 1% 15g
Back pain/headache/colds and flu / Co-codamol tablets 8/500 (30)
Back pain/headache/colds and flu / Ibuprofen tablets 200mg 24
48
Back pain/headache/colds and flu / Ibuprofen oral suspension sugar free 100mg/5ml 100ml
Colds and flu/backpain/headache / Paracetamol tablets 500mg (32)
Colds/flu/relief of pain children 3months to 6 years / Paracetamol SF suspension 120mg/5ml 70ml
Paracetamol SF suspension 120mg/5ml 100ml
Colds/flu relief of pain children 6 to 12 years / Paracetamol SF Suspension 250mg/5ml 100ml
Constipation / Senna 7.5mg tablets (20)
Nasal congestion / Menthol and Eucalyptus inhalation BP 1980 100ml*
Threadworms / Mebendazole tablets 100mg Ovex Pk 4
Pripsen Pk 8
Athletes foot / Miconazole 2% cream 30g
Dry cough / Pholcodine linctus BP 5mg/5ml 140ml *
Cough / Simple linctus BP 200ml*
cough / Simple linctus paediatric BP 200ml*
Nasal congestion / Pseudoephedrine linctus 140ml
Nasal congestion / Pseudoephedrine tablets 60mg (12)
Nasal congestion / Sodium Chloride nasal drops 0.9%
Warts/verrucas / Salactol ® Paint 10ml
Nappy rash / Sudocrem 125g
Nasal congestion / Xylometazoline paediatric 0.05% nasal drops 10ml *
Nasal congestion / Xylometazoline nasal spray 0.1%, 10ml *
Conjunctivitis/superficial eye infections / Chloramphenicol eye drops 0.5%
Head lice / Bug Buster Kit
Head lice / Head lice comb

Appendix 2

Exemption/Consultation Form

The patient does not have to pay because he/she:

A

/ is under 16 years of age
B / is 16, 17 or 18 and in full-time education
C / is 60 years of age or over
D / has a valid maternity exemption certificate
E / has a valid medical exemption certificate
F / has a valid prescription prepayment certificate
G / has a valid war pension exemption certificate
L / is named on a current HC2 charges certificate
X / was prescribed free-of-charge contraceptives
H / *gets income support (IS)
K / *gets income-based jobseekers allowance (JSA (IB)
M / *is entitled to or named on a valid NHS Tax Credit exemption certificate
S / *has a partner who gets Pension Credit guarantee credit (PCGC)
*Name / Date of Birth: / NI no:

*Print the name of the person (either you or your partner) who gets IS, JSA (IB), PCGC or Tax Credit

To the Patient - Please complete declaration:-
I have consulted the pharmacist under the Minor Ailments Scheme and confirm that I am exempt from prescription charges for the reason specified above.
I confirm that:
I have received advice and I have / have not (delete as appropriate) received a supply of medication from the pharmacist under the Minor Ailments Scheme
I declare that the information I have given on this form is correct and complete. I understand that if it is not, appropriate action may be taken. I confirm proper entitlement to exemption. To enable the NHS to check I have a valid exemption and to prevent and detect fraud and incorrectness, I consent to the disclosure of relevant information from this form to and by the PCT, the NHS Counter Fraud and Security Management Service, the Department for Work and Pensions and Local Authorities.
Signed Patient)…...... Date......
IMPORTANT – Your Pharmacist is providing treatment and/or advice under the Minor Ailments Scheme in line with the symptoms you have described. If your symptoms persist you should seek further advice from your doctor. Please advise the doctor which pharmacy you have attended and what advice and/or treatment you have already received from the Pharmacist. By signing this form you are giving permission for your pharmacist to:
1.  Make a written note of personal information relating to your health.
2.  Share information about your health and any medication supplied with your GP and PCT as necessary.
Evidence of Exemption Seen: YES / NO(delete as appropriate)
Signed Patient ...... ………………... Signed Pharmacist ...... …………………..

Exemption/Consultation form (continued). To be completed by the pharmacist

Patient Details (Affix bag label or enter details)

Patient name ------

Address ------

G P Practice ------

Would the patient usually have consulted with their GP for this ailment? Yes/No* (*please delete as appropriate)

Patients Presenting Symptoms (please tick)

Athletes Foot / Nappy rash
Warts / Mouth Ulcers and Teething
Verrucae / Nasal Congestion
Back Pain / Sore Throat
Colds & Flu / Stomach Upset
Skin allergies / Threadworms
Cough / Thrush
Hay Fever / Oral Cold Sores
Headache / Head Lice
Indigestion/Heartburn / Toothache
Conjunctivitis/ superficial minor eye infections

Details of product supplied or action taken (advice or referral* please tick)

Medication Supplied – affix Rx label
Advice only*
Referral*

To be completed by pharmacist – tick evidence for patient access into scheme

A / PHARMACY PMR
B / MEDICAL CARD
D / SURGERY CONFIRMED REGISTRATION
E / OTHER – please specify

Signed (Pharmacist): ……………………………………Date……….

Appendix 3

Leeds Primary Care Trust

LEEDS PCT MINOR AILMENTS SCHEME

PHARMACISTS TO GP RAPID REFERRAL FORM

Patient Name:

Patient Address:

TO THE GP

This patient has present with symptoms unsuitable for treatment under the Pharmacy First service and has been advised to make an appointment today.

Notes

Pharmacists Name, Address and Telephone Number (or Pharmacy stamp)

Date and Time:

PLEASE FAX THIS FORM TO THE GP SURGERY OR GIVE TO THE PATIENT TO TAKE TO THE SURGERY.

Appendix 4

Pharmacist Monthly Claim Form (with effect from April 2009 )

Pharmacy Name and Address:

Month:

Product and Unit / Cost Price £ / Record Number of Units Supplied, e.g. IIII I / Total Number of Units Supplied / Total Cost £
Aspirin dispersible tablets 300mg (32) / 0.35
Anbesol 6.5ml / 1.34
Aqueous cream BP 500g / 3.18
Beclometasone nasal spray (200 dose) / 5.81
Bug buster kit / 4.31
Canesten Combi ®(1) / 6.26
Cetirizine tabs 10mg (30) / 5.80
Cetirizine liquid / 2.97
Chloramphenicol eye drops 0.5% 10ml / 3.06
Chlorphenamine tabs 4mg (28) / 1.98
Chlorphenamine Oral Solution 2mg/5ml 150ml SF / 2.28
Choline Salicylate 8.7% oromucosal gel 15g SF / 1.79
Clotrimazole Pessary 500mg (1) / 4.95
Clotrimazole Cream 1% 20g / 3.92
Co-codamol Tablets 8/500 (30) / 1.19
Oral rehydration sachets (6) / 2.02
Fluconazole Capsule 150mg (1) / 2.04
Gaviscon Advance ® 250ml / 2.39
Gaviscon Advance ® Tablets pack of 12 / 1.43
Head Lice Comb / 1.25
Hydrocortisone cream 1% 15g / 2.95
Ibuprofen tablets 200mg (24)
(48) / 0.70
1.40
Ibuprofen oral suspension sugar free 100mg/5ml 100ml / 3.48
Loperamide caps 2mg (6) * / 1.80
Loratadine 10mg (30) / 2.39
Menthol and Eucalyptus inhalation 100ml* / 0.66
Mebendazole tablets 100mg (Ovex pack of 4)
(Pripsen pack of 8) / 3.41
3.42
Miconazole 2% cream 30g / 1.97
Paracetamol tablets 500mg (32) / 0.26
Paracetamol SF suspension 120mg/5ml 150ml / 0.65
Paracetamol SF Suspension 250mg/5ml 200ml / 1.13
Peptac ® Suspension 500ml / 2.16
Pholcodine linctus BP 5mg/5ml 200ml * / 0.59
Pseudoephedrine linctus 140ml / 1.70
Pseudoephedrine tablets 60mg / 1.48
Salactolol paint 10ml / 1.93
Senna 7.5mg Tablets (20) / 0.65
Simple linctus BP 200ml* / 0.64
Simple linctus paediatric BP 100ml* / 0.17
Sodium Chloride nasal drops 0.9% / 1.86
Sodium Cromoglicate eye drops 2% 10ml / 2.46
Sudocrem 125g / 1.70
Xylometazoline paediatric 0.05% nasal drops 10ml * / 1.59
Xylometazoline 0.1% Adult nasal drops 10ml * / 1.91
Xylometazoline nasal spray 0.1%, 10ml * / 1.91
TOTAL COST
VAT @ 15.0%
Number of consultations
MONTHLY TOTAL

I certify that we have carried out the consultations and supplied items as detailed above in accordance with the Leeds PCT Minor Ailments Scheme and wish to claim payment in respect of the above. I confirm that the information given above is correct to the best of my knowledge. Records of the above consultations and supplies have been retained at the pharmacy and will be made available to officers of the PCT following any reasonable

request.

Pharmacist Signature ………………………………………………

Date ………………………………..

Please return completed claim form to:

Gazala Khan

Head of Community Pharmacy Services

2nd Floor Stockdale House

Headingley Business Park

Victoria Road

LS6 1PF

·  Drugs of Limited Clinical Value – use is only justified in certain circumstances. (Prices based on Chemist and Druggist March 2009 Drug Tariff)