NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update Community Pharmacy

PS Community Pharmacy (Feb 13)

To read in PDF format, please click here. This edition contains articles on:

  • Community Pharmacist provision of alternatives to monitored dosage systems
  • Business Continuity Planning
  • Domiciliary oxygen
  • Patient Information Leaflet
  • Commonwealth Games 2014
  • Repeated Not Dispensed items
  • Relaunch of Making the Most of My Medicines (MMy)
  • BNF Apps for Smartphones

 

Community Pharmacist provision of alternatives to monitored dosage systems

 

The Board has allocated approximately £38,000 to support a short term project encouraging community pharmacists to identify a more suitable alternative to a monitored dosage system when patients are identified as requiring assistance with compliance. The work, developed in partnership with the Area Pharmacy Contractors

Committee, builds on previous activity undertaken within the Board and seeks to utilise community pharmacist’s expertise in assessing the needs of patients in taking their prescribed therapy. Full details of the project will be circulated in the near future and will include guidance on the process along with details of the payments available.

 

All pharmacies are encouraged to participate and more information can be obtained from David Thomson on 0141 201 5311.

 

Business Continuity Planning

 

As you will be aware, contingency planning for a range of risks is a key business activity to ensure essential services continue to be provided and maintained in an emergency situation.

 

The current cold spell provides a timely opportunity to remind community pharmacy contractors that they should have an up to date Business Continuity Plan (BCP), the content of which should be relevant and reflect recent events such as adverse weather.

 

All contractors should review their plan over the next four to six weeks to ensure it remains “fit for purpose” and contains the most up to date information. There is no need for you to send a copy to the Board as previously.

 

We would recommend, however, that a copy be retained “off site” in the event that you are unable to access the pharmacy for any reason.

 

You can access a blank BCP template from the Community Pharmacy Development Team intranet site (for those pharmacies with direct access to an N3 connection).

 

 

Domiciliary oxygen

 

The exercise to transfer the provision of home oxygen away from the community pharmacy network to Dolby Vivisol will commence in NHS Greater Glasgow and Clyde in February 2013.

 

Dolby Vivisol will start from this time to visit identified patients, and move them to the national service. This will be done by geographic area and a copy of the timetable will be circulated in the near future, once this has been agreed by NHS GG&C and Dolby Vivisol. All identified patients have been given a copy of a leaflet to explain the change.

 

Community Pharmacy Scotland (CPS) and NHS Scotland have agreed on the final details of remuneration in relation to cylinder reconciliation and headsets. Community pharmacies in NHS GG&C have received a letter from CPS and BOC outlining the main issues and the agreement reached.

 

In addition, all oxygen contractors will have received a letter from the Board setting out the terms of the national and local arrangements. No final date for community pharmacies to cease providing the service has been set. We have agreed with the APCC that pharmacists should continue to dispense oxygen to ensure continuity of care during the transition to the national service.

 

Contractors are recommended to keep their BOC account open to facilitate the transition, including the return of any oxygen equipment no longer required.

 

Information for oxygen contractors on the information sent and a copy of the transition claim form can be accessed via the Community Pharmacy Development Team intranet site (for those with access to an N3 connection).

 

 

Repeated Not Dispensed items

 

As we continue to roll out CMS across the Board, some GP practices have requested for clarification regarding the feedback mechanism for items on serial scripts which are regularly not supplied to patients, often at the patient’s request. In this situation, a patient regularly asking not to have medication supplied would constitute a care issue.

 

Pharmacists should ensure that this is added to the patient’s Pharmacy Care Record as an issue and also ensure that the practice is informed as this may need the GP to carry out a medication review or review the patient’s clinical status to ensure that their condition has not deteriorated as a result of intentional non-compliance.

 

In addition, informing the GP of these situations, regardless of whether the patient is registered for CMS or not also complies with GPhC “Guidance on Consent” document produced in February 2012, applicable to CMS or AMS scripts:

 

When a competent adult refuses to give consent

  • 2.4.1 If an adult with capacity makes a voluntary, informed decision to refuse a service or treatment you must respect their decision, even when you think that their decision is wrong or may cause them harm. This does not apply when the law says otherwise, such as when compulsory treatment is authorised by mental health legislation.
  • 2.4.2 You should clearly explain the consequences of their decision but you must make sure that you do not pressure the patient to accept your advice.
  • 2.4.3 You should make a detailed record if a patient refuses to give consent. This should include the discussions that have taken place and the advice you gave.
  • 2.4.4 If you believe that the patient is at risk of serious harm due to their decision to refuse a service or treatment, you must raise this issue with appropriate healthcare or pharmacy colleagues or people involved in their care, and your employer (if applicable). Consider getting legal advice if necessary.

 

Commonwealth Games 2014

 

Glasgow is hosting the twentieth Commonwealth Games in 2014. PPSU has been asked to lead the development of the pharmacy services. There will be a registered pharmacy in the athlete village where the volunteers will be doing a range of tasks such as dispensing prescriptions for athletes and other games officials plus a minor ailments type service. We will need around 40 volunteers, a mix of pharmacists and technicians. The pharmacy will have extended opening hours with 2 shifts per day from 13th July to 6th August 2014.

 

The pharmacy service will also be responsible for stocking the treatment rooms and medical bags at the venues. All applications for volunteering must be made through the online system. Applicants must be registered with the GPhC and be able to commit to at least eight session plus three or four days of training.

 

For more information and to apply see the volunteering microsite and apply for clinical roles here.

 

BNF Apps for Smartphones

 

The NICE BNF and NICE BNFC (British National Formulary for Children) smartphone applications are now available for download by healthcare professionals who work for or who are contracted by the NHS in Scotland. The NICE BNF and NICE BNFC apps provide easy access to the latest up-to-date prescribing information from the BNF and BNFC - the most widely-used medicines information resource in the NHS and are free to healthcare professionals in Scotland via the Apple App Store and Google Play Store. Users will need to enter their NHS Education for Scotland Athens username and password to activate the app and download the content. Once downloaded and activated, the app does not rely on a network connection and will provide direct offline access to the latest version of the BNF and BNFC.

 

Eligible health and social care staff who do not yet have an NHS Scotland Athens password can register for free online via The Knowledge Network.

 

Relaunch of Making the Most of My Medicines (MMy)

 

Many community pharmacies in Greater Glasgow & Clyde have been participating in this initiative since it was established in 2002. The service relies on community pharmacists monitoring the accuracy of repeat prescriptions for two cycles after a patient has been discharged from hospital. With the programme to extend the concept to all hospital wards nearing completion, it is felt appropriate to relaunch the service in primary care and invite all pharmacies to re-register their interest in participating. Pharmacies will shortly receive an initial letter inviting them to sign up for the service. Receipt of a positive response will prompt the issue of a support pack giving fuller details of the process. A true ‘patient-led’ service with patient’s nominating their designated pharmacy, pharmacists are strongly being encouraged to sign up for this next phase of a service which continues to have a positive impact on patient care. More information can be obtained from David Thomson on 0141 201 5311

 

Patient Information Leaflets

 

We have recently been advised of a medication incident following the selection of the wrong medicine from the shelf. During the subsequent discussion with the patient, it was observed that if the information leaflet (of the wrong medicine) had been read, the error may have been spotted.

 

Could we therefore remind Pharmacists that a PIL should be provided with dispensed medication and then encourage patients to read it?