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New contract negotiations

New contract negotiations. Discussions underway with Department of Health NHS Confederation – representing PCTs Target agreement date – April 2004. Terms of Reference. To develop a New Framework Contract for Community Pharmacy which: -

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New contract negotiations

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  1. contract.comments@psnc.org.uk New contract negotiations • Discussions underway with • Department of Health • NHS Confederation – representing PCTs • Target agreement date – April 2004

  2. contract.comments@psnc.org.uk Terms of Reference • To develop a New Framework Contract for Community Pharmacy which: - • Provides clear minimum standards for community pharmacy, to meet the needs of Pharmacy in the Future – Implementing the NHS Plan • Provides clear and fair rewards for high quality services and promotes best value for money

  3. contract.comments@psnc.org.uk Terms of Reference • Harnesses the skills of community pharmacists and their staff, to deliver better primary and community care services to patients by developing opportunities and rewards for integrated working. • Minimises bureaucracy for both Pharmacy and PCTs

  4. contract.comments@psnc.org.uk The new contract – Department of Health • 1999 Generics pricing problems • Led to demand from government for new systems for reimbursement • 2000 Pharmacy in the Future • Promised new contract • Rewarding quality not volume • 2003 A Vision for Pharmacy in the New NHS

  5. contract.comments@psnc.org.uk New Contract - NHS Confederation representing PCTs and patients interests • Guaranteeing high quality services for patients • Consistency and accessibility of services • Making use of all clinicians within the primary care team • Ensuring the pharmacy contract supports the requirements of the new GP contract

  6. contract.comments@psnc.org.uk The new contract – PSNC • Pharmacy Plan - Recognising that the status quo is not an option • Responding to demand for transparency about income sources and proposals to remove unrecovered purchase profit • Needing to protect vital income in the face of the generics threat • Working towards a new contract which builds services around supply • Protecting supply role • Engaging fully with primary care

  7. contract.comments@psnc.org.uk The new contract – PSNC • Building a new contractual framework which allows community pharmacies to progress and prosper for many years • IT and investment in developing staff are essential • Integration into Primary Care WE ARE COMMITTED TO A NEW CONTRACT THAT PROPERLY REWARDS THE NHS PHARMACY SERVICE.

  8. contract.comments@psnc.org.uk New contract - structure • Essential services • offered by all contractors

  9. contract.comments@psnc.org.uk New contract - structure • Advanced services • accreditation requirements • training • facilities • gradual transition to providing the service – giving time to implement changes

  10. contract.comments@psnc.org.uk New contract - structure • Supplementary services • specification and value agreed nationally • commissioned locally by PCTs • PCTs and contractors will continue to be able to develop new, innovative services to fulfil local needs

  11. contract.comments@psnc.org.uk New contract - structure • The range of services provided under the contract develop over time • Some Supplementary services may become Essential or Advanced services • High quality innovative local services are gradually included in the Supplementary services list • Contract responds to the changing needs of patients and the NHS • Contract develops as the profession develops

  12. A Dynamic Framework contract.comments@psnc.org.uk AdvancedServices Supplementary Services EssentialServices Local Services

  13. contract.comments@psnc.org.uk Essential services

  14. contract.comments@psnc.org.uk Essential services - Dispensing Actions • Advice to the patient about the medicines being dispensed • Advice about possible interactions with other medicines • Recording medicines dispensed and key advice provided • Providing Compliance Aids needed by disabled patients

  15. contract.comments@psnc.org.uk Essential services – Repeat Dispensing The management of the repeat dispensing process in partnership with the patient and prescriber. Actions • Ascertaining the patient need for a repeat supply of a particular medicine. • Communicating all significant issues to the prescriber with suggestions on medication changes as appropriate, with the full involvement of the patient. • Educate patients about re-ordering of repeat medication, especially prn medication, to reduce hoarding of medicines and subsequent wastage.

  16. contract.comments@psnc.org.uk Essential services – Repeat Dispensing • Pharmacist to advise when a medication review is due.

  17. contract.comments@psnc.org.uk Essential services • Signposting patients to other healthcare professionals • Pharmacist and staff would refer patients to other health care professionals or providers when appropriate • Clinical governance • Requirements will include • SoPs • Adverse incident reporting to NPSA • Evidence of Pharmacist CPD • Service audits & patient questionnaires

  18. contract.comments@psnc.org.uk Essential services • Public health – healthy lifestyle promotion • Examples may include • Opportunistic one to one counselling on smoking cessation • Opportunistic one to one counselling of CHD patients on CHD risk factors • Promotion of ‘flu vaccination uptake in at risk groups • Educating the public on the appropriate use of antibiotics, particularly their minimal effectiveness in coughs and colds • Prompting patients with diabetes to ensure blood glucose and blood pressure monitoring is undertaken

  19. contract.comments@psnc.org.uk Essential services • Medication waste disposal • Collection of unwanted medicines via pharmacies • Service standards/accreditation would apply to disposal companies • Special arrangements will apply to Controlled Drugs (post Shipman) • Sharps disposal (possible service) • Collection of sharps via pharmacies • Sharps would only be accepted for disposal in sealed single patient sharps containers

  20. contract.comments@psnc.org.uk Advanced services

  21. contract.comments@psnc.org.uk Advanced services – Medicines Use Review Actions • Pharmacist undertakes medicines use review to meet the requirements of the Older Peoples NSF and for other patient groups • Face to face with patient • A concordance centred review, which assesses patient’s problems with current medication and its administration • Patient’s knowledge of medication regimen is assessed and developed • Report fed back to patients GP

  22. contract.comments@psnc.org.uk Advanced services – Prescription Intervention Service Actions • Pharmacist highlights problems with prescriptions, or improvements to therapy. • Interventions may include dose optimisation or synchronisation, suggestions for therapeutic substitutions based on local protocols, recommendations of changes to help with patient concordance. • Pharmacist feedback suggestions and comments to the prescriber using standardised paperwork or electronically.

  23. contract.comments@psnc.org.uk Supplementary services

  24. contract.comments@psnc.org.uk Supplementary services – Minor ailments management Actions • Service similar to the ‘Care at the Chemist’ scheme • Specified categories of patients are able to access advice and treatment of minor ailments from the pharmacist, at NHS expense • Surgery time management is improved by transfer of this group of patients to community pharmacy, in line with the objective in the new GP contract

  25. contract.comments@psnc.org.uk Supplementary services – Substance misuse services Actions • Supervision service for methadone etc • Regular contact between pharmacist and user, providing opportunities for counselling • Pharmacist can refer on to other professionals/providers when appropriate

  26. contract.comments@psnc.org.uk Supplementary services –– PSNC project - Disease specific medicines management Actions • At risk patients receive community pharmacist service • Review all patient’s medication • Discuss lifestyle issues • Agree with patient any recommendations to the GP

  27. contract.comments@psnc.org.uk Other examples of Supplementary Services • CHD screening/Healthy Living • Palliative care services • Full Clinical medication review • Out of Hours service • Prescriber support services (medical practice based) • Head Lice management service • Gluten Free food supply service • Services to schools • EHC service • Concordance services • Care home and Intermediate Care services • Home care services – domiciliary assessments • Smoking cessation • Needle exchange • Diabetes screening

  28. contract.comments@psnc.org.uk Contractor consultation Contractor ballots • Contractual framework – i.e. the services • Overall package • First Ballot • 68.5% of pharmacies voted • 95% Yes vote

  29. contract.comments@psnc.org.uk Summary • Building services around supply • Structure of contract • Essential services • Advanced services • Supplementary services • Contract develops over time • Agreement date – April 2004 if possible

  30. contract.comments@psnc.org.uk More information www.psnc.org.uk/contract

  31. contract.comments@psnc.org.uk Questions and Commentscontract.comments@psnc.org.uk

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