Local Pharmacy Accredited Service

Service contract for the treatment of specific Minor Ailments

Using Patient Group Directions

in Community Pharmacies

1.Introduction

The Primary Care Trust wishes to offer a uniformly high quality service in all pharmacies across the county, providing members of the public with improved access to advice and treatment of specific minor ailments, available at least 5 days per week, at the accredited community pharmacy. Where the pharmacy is open over the weekend the service must be provided during this period.

2Background

Changes in legislation to the Medicines Act in August 2000 allowed the supply of Prescription only Medicines without a prescription under the directives of a patient group direction by specific healthcare professionals, pharmacists being one of this group.

A pilot project for a Patient Group Direction led Minor Ailments Service was commenced in the mid Cornwall area in September 2002, involving one GP practice and the 2 community pharmacies in St Austell. The Patient Group Directions cover four different conditions, bacterial conjunctivitis, impetigo, uncomplicated urinary tract infections in women and nappy rash. After completing a successful six-month pilot in St Austell the service was rolled out to practices and pharmacies in the mid Cornwall area.

Since the reconfiguration of the 3 Cornish PCTs into Cornwall and Isles of Scilly PCT in October 2006 the Minor Ailment Service has gradually expanded to cover the whole county

3Aims

To improve access and choice for people with minor ailments by promoting self care through the community pharmacy, including provision of advice and where appropriate medicines via a patient group direction without the need to visit the GP practice.
To operate a referral system from local medical practices or other primary care providers.
To improve primary care capacity by reducing medical practice workload related to minor ailments

4.Training

To provide this service all pharmacists must attend, at least once every 3 years, a training evening organised by the Primary Care Trust to update their knowledge.

The training will cover

Working within a Patient Group Direction: legal requirements and paperwork
Presentation and case studies by a Medical practitioner about each of the conditions covered, highlighting possible complications that may occur. Signs, symptoms, treatment and when to refer will be included for each minor ailment. A suggested reading list and reference sources will also be provided.
How to signpost people on to other services where appropriate.
How to become EEFO registered.

A certificate of attendance will be issued at each training session.

On completion of the evening each pharmacist must provide a copy of the attendance certificate and a completed PGD signing sheet for all minor ailments.

5.Service Outline

The service must be provided for a minimum of 5 days each week. Where the pharmacy is open over the weekend the service must be provided during this period.

The part of the pharmacy used for the provision of the service provides a sufficient level of privacy and safety. Ideally the pharmacy should have a designated consultation area, to the standard specified in the pharmacy contract.
Pharmacies will offer a user-friendly, non-judgmental, client-centred and confidential service. Pharmacies will be encouraged to become EEFO registered.
The Pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the minor ailments service have the relevant knowledge and are appropriately trained in the operation of the service.
If the pharmacist on duty is unable to provide the Minor Ailments Service then pharmacy staff must know how and where to signpost people to, to obtain treatment under the scheme. Ideally the pharmacy staff should contact the nearest pharmacy offering the service to ensure that the pharmacist on duty there will be available to help the patient.
The service is available to any person who is registered with a GP Practice in the UK and presents in the community pharmacy for treatment.
The supply of specific Prescription Only Medicines will be made in line with the Patient Group Direction: namely for
Bacterial Conjunctivitis – Chloramphenicol 0.5% eye drops or fusidic acid 1% (Fucithalmic) eye drops
Impetigo – Fusidic acid 2% cream (Fucidin Cream)
Nappy rash- Timodine Cream
Uncomplicated urinary tract infections- Trimethoprim 200mg tablets.
All medicines must be labelled in accordance with the directions stated in each Patient Group Direction and appropriate counselling and patient information leaflet must be provided at the time of the supply.
Patients will sign a consent form to agree to treatment and for the information provided to be shared with their GP. If the patient is under 16 years old then parental/guardian consent must be obtained prior to treatment.
A fee equivalent to the current prescription charge will be collected for each item supplied under a PGD if the patient presenting usually pays for their prescriptions.
The PCT will be responsible for the promotion of the service locally, including the development of publicity material, which pharmacies may use to promote the service to the public.
The service should be provided in line with national and local child and vulnerable adult protection guidelines.

6.Monitoring of service

The pharmacy will review its standard operating procedures and referral pathways for the service on an annual basis and these will be available for inspection by the PCT during the annual pharmacy contract visit.
Pharmacists have available for inspection a copy of the attendance certificate provided by the PCT at the training evening.
The pharmacy should maintain appropriate records to ensure effective ongoing service delivery and audit.

Paperwork-

For each consultation the consent form and appropriate minor ailment checklist will be completed. A copy of this will be forwarded to the patient’s GP for inclusion in their notes.
For those children under 16 years old, parental or guardian consent must be obtained prior to treatment.
Patients will be invited to complete a service questionnaire that should be returned to the Prescribing Team Office at Sedgemoor Centre, St Austell.
The age and postcode of each patient will be recorded on the audit form.
Posters and information leaflets about the service will be available at each pharmacy and local GP Practice.

The PCT will monitor the service by:

The paperwork completed and received for payment.
The leaflets and advice available at the pharmacy
The questionnaires returned by members of the public receiving the service.
The number of days a week the service is being offered by an accredited pharmacist at the pharmacy.

7.Supply

from dispensary stock, POM item.

1 x 10ml chloramphenicol 0.5% eye drops
1 x 5g Fusidic acid 1% eye drops (Fucithalmic)
1 x 15g Fusidic Acid 2% cream (Fucidin)
1 x 30g Timodine Cream
6 x Trimethoprim 200mg tablets

all medicines must be labelled with appropriate directions as specified in the PGD, state “Supplied under a PGD” and supplied with the manufacturer’s patient information leaflet.

EEFO Registration

Contact Emily Thomas, EEFO Programme Co-ordinator, The Kernow Building, Wilson Way, Pool, Redruth TR15 3QE Tel. 01209 313419, Fax 01209 314491, email , website

8.Payment

Pharmacies will be paid an administration fee of £10 per month, for each month paperwork is submitted, to cover postage and photocopying costs and £10 for each consultation made under the PGD.

Payment is made every month to community pharmacies through the submission of the completed audit form (audit A). As well as the consultation fee the pharmacy will be reimbursed at current drug tariff prices + VAT for the cost of the medicines supplied. The cost of disposable gloves and Multistix GP (25 strips per box), needed for the Urinary Tract Infection PGD, will be reimbursed provided a copy of the invoice is attached to the form.

Paperwork received more than 3 months after a supply has been made under the Minor Ailments PGDs will not be paid by the PCT.

9.Contract Penalties

Should it be brought to the attention of a member of the PCT Prescribing Team that the pharmacy has broken this contractual agreement, payments for the service will cease.

The Pharmacy will be monitored on

Offering the Minor Ailment Service for at least 5 days a week by an accredited pharmacist. Where the pharmacy is open over the weekend the service must be provided during this period.

Using the latest version of the paperwork
Correctly completing and submitting the paperwork to the PCT on time.
Have the agreed leaflets and advice available to clients at all times.

Local Pharmacy Accredited Service

Service contract for the treatment of specific Minor Ailments

Using Patient Group Directions

in Community Pharmacies

Review date31thMarch 2010

Contract drawn up by:Date

Rosalind Palmer, Prescribing Adviser

Cornwall and Isles of Scilly PCT

Signed off on behalf of Cornwall and Isles of Scilly PCT:

NamePosition:

SignatureDate

Pharmacy Contractor.

I have read and understood the attached Service Contract to provide treatment for specific minor ailments using Patient Group Directions and agree that the named Pharmacy will abide by this agreement.

Pharmacy Name and Address

Contractors Name and Signature

Date:

Please return a copy of this agreement to: The Prescribing Team, Sedgemoor Centre, Priory Road, St Austell. PL25 5AS or fax to 01726 627817

Service contract for MAS in community pharmacy issue 04/08 Review date 31/03/2010