CPN Community Pharmacy News – August 2015 Flu vaccination service and settlement special • ‘A big win’ – flu vaccination Advanced Service announced • £2.8bn and CPCF changes explained • FAQs and flu preparation advice 5 point forward plan | Latest resources round up | Drug Tariff Watch
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CPNCommunity Pharmacy News – August 2015
Flu vaccination service and settlement special• ‘A big win’ – flu vaccination Advanced Service announced
• £2.8bn and CPCF changes explained
• FAQs and flu preparation advice
5 point forward plan | Latest resources round up | Drug Tariff Watch
2 Community Pharmacy News – August 2015
services and commissioning The healThcare landscape lpcs
Settlement 2015/16: Flu Vaccination Service launched
As part of the 2015/16 funding settlement announced last month (see page 4)
NHS England has agreed community pharmacies can offer flu vaccinations to
eligible NHS patients aged 18 and over. Here we cover some common queries.
Wales
The new AdvancedService only applies toEngland; CommunityPharmacy Walesundertakes separatenegotiations onAdvanced Services whichare provided in Wales.
Local services
In many areas localservices have beencommissioned by NHSEngland teams inprevious years. Thenational flu vaccinationAdvanced Service willreplace these services.
Funding
The national servicewill be funded fromNHS vaccinationbudgets andtherefore is inaddition to andoutside of the totalagreed communitypharmacy fundingfor 2015/16. Thetotal delivered willbe dependent onuptake of theservice, but no caphas been set forthis.
Fees and costs
Contractors will receive£7.64 per administereddose of vaccine plusreimbursement of thevaccine costs (includingVAT). An additional fee of£1.50 will also be paid pervaccination in recognitionof costs relating to theprovision of the service(e.g. training, revalidationand disposal of clinicalwaste).
Legal basis
Flu vaccinations will be administeredunder the authority of a PatientGroup Direction (PGD) and theassociated regulatory requirementsmean that they will have to beadministered by a pharmacist (ornurse or other class of person namedin Schedule 16 of the HumanMedicines Regulations 2012).Administration of a parenteral POMcannot be delegated to anotherperson after the supply has beenmade under a PGD by a pharmacist.
Training
Many pharmacists will already havereceived the training they need tooffer vaccinations for local services,but for those who do need trainingthere are a range of organisationsoffering training and pharmacists willbe free to choose the training theywish to undertake to acquire therequired skills. It is anticipated thatthe Declaration of Competenceapproach will be used to assurepharmacy contractors thatpharmacists have the necessaryknowledge and skills to provide theservice, but this and the associateddetails will be confirmed as soon aspossible.
Claiming payment
It is not yet possible to saywhether data collectionand payment claims willbe undertakenelectronically or via paper,but these details will beshared with contractors assoon as they are available.
Implementationcosts
Set up costs thatcontractors incur will notbe separately funded, butthey have been consideredin the setting of the feesfor provision of the service.
Procurement
The NHS has set outa list of possiblevaccinations in theannual flu letter andit will be up tocontractors tosource these fromtheir suppliers; therewill be no centralprocurement ofvaccinations forpharmacies.
Data reporting
Details of pharmacyreporting requirementsare still being finalisedwith NHS England, butreporting to thepatient’s GP practicewill be a requirement.PSNC is seeking tominimise burden oncontractors within thedata capturerequirements.
The key
details
psnc.org.uk 3
funding and sTaTisTics conTracT and iT dispensing and supplypsnc’s work
FAQs and Practical PointsQ. Who is eligible to receive the service?
Eligible adult patients are people aged 18 years and over, at the
time of vaccination, defined in the annual flu letter. They
include:
• people aged 65 years and over;
• pregnant women;
• carers;
• people aged 18-65 years with one or more of the following
medical conditions:
º chronic respiratory disease;
º chronic heart disease;
º chronic kidney disease;
º chronic liver disease;
º chronic neurological disease or learning disability;
º diabetes;
º splenic dysfunction; or
º a weakened immune system due to disease or treatment.
Note that care workers who are paid to provide care to people
(for example in their own homes or in care homes) are not
eligible for vaccination under the service, however they are
likely to be eligible for flu vaccination as a result of their job. In
this case the provision of flu vaccination would be a private
occupational health responsibility which should be funded by
the person’s employer.
Q. Will we need to have a needle stick injury procedure?
Pharmacy contractors should have a needle stick injury
procedure in place and all staff involved in the provision of the
service should be aware of the contents of the procedure.
Template needle stick injury procedures will be available from a
number of organisations, including the National Pharmacy
Association (NPA).
Q. Will pharmacies have to pay for disposal of clinical waste
associated with the service?
Yes. The funding agreed for the service recognises the cost of a
clinical waste disposal service which contractors will need to put
in place.
Q. When will the service commence?
PSNC, NHS Employers and NHS England anticipate that the exact
date of commencement will be at the start of September, but
implementation of the service requires regulatory changes and
the timing of such changes can be impacted on by external events
outside the control of any of the organisations. Further details on
the start date will be provided as they become available.
Q. When will the service specification be published?
The service specification is also being finalised and will be
published once it has successfully passed through NHS England’s
internal governance procedures.
What next?Further work is being undertaken by PSNC,
NHS Employers and NHS England in order to
prepare for implementation of the service.
Contractors will be updated on this as soon as
more information is available.
As is the case for any community pharmacy
service, contractors will be required to offer it
in accordance with a service specification.
PSNC, NHS Employers and NHS England are
currently finalising the service specification.
In the meantime contractors are advised to
stay up to date by signing up for PSNC's email
newsletters at psnc.org.uk/email.
You may also like to read more details about the
service at psnc.org.uk/flu. This page includes
links to FAQs and a range of other resources
How many pharmacies currentlyprovide flu vaccinations?To assess the prevalence of these services PSNC conducted a survey of LPCs early in 2015 and found that:
Almost 90%of LPCs had a local pharmacy flu vaccination
service commissioned during the 2014/15 season
21out of 25local NHS England Area
Teams commissionedpharmacy flu vaccination
services
More than5,000pharmacy contractors signedup to the services
84%of those pharmacies signed upwere active vaccination providers
Do you have more questionsabout the flu service?A range of FAQs, guidance documents and resources such aspatient communication materials have been published on thePSNC website to help support contractors as they prepare todeliver the service. Check psnc.org.uk/flu regularly toensure you don't miss the latest resources and information.
Contractors could also consider matters such as training and whether they or their team
will need any; stock requirements and procurement; what they might need to do to start
offering the service in September; how they will promote the service; and whether they
will need to update any SOPs.
Turn over to find out more about the 2015/16 funding settlement
� Commission an urgent supply service so community
pharmacists can supply routine NHS prescription medication
at weekends and out of hours if patients run out.
Benefits: Ensures patients have uninterrupted and
convenient access to medicines. Contributes to 7-day NHS
working and saves around £45 per patient.
Offer people advice at their own convenience,
using pharmacy as a first port of call
Patients often consult GPs when they can obtain
advice and help quickly and conveniently from a pharmacy.
� Use community pharmacists to advise people with
symptoms, offering treatment or referral as needed.
Benefits: Reduces demand for GP
appointments, creating capacity within
practices and a net saving of £25 per
patient per GP consultation, and offering
speedier support for patients.
Care for frail and older people
Many house-bound patients and people discharged
from hospital receive no help with their medicines
which can lead to health complications and readmission.
� Community pharmacists can provide
support to frail and older people and
their carers at their homes if necessary.
This ensures they are using medicines
properly and safely, particularly after
hospital discharge.
Benefits: Helps patients as they move between hospital and
their home.. Reduces avoidable health complications and the
costs of caring for those, saving around £2,000 per hospital
admission. Medicines advice can improve health outcomes
and prevent readmission to hospital.
Support people to manage their
long-term conditions more
effectively
People with long-term medical conditions
need support to use their medicines properly
to avoid poor outcomes, hospital admission
and sometimes even fatal complications. But
GP management of some patients is unnecessary.
� Community pharmacists should support and monitor
people with simple hypertension and asthma to help them
to manage their own health.
Benefits: Offers convenient care, support and advice that can
lead to significant improvements in disease control and
quality of life. Reduces workload for GP practices releasing
capacity for them to carry out other roles.
Help identify people with undiagnosed
respiratory disease
Nearly 3 million people in the UK
are thought to have undiagnosed Chronic
Obstructive Pulmonary Disease (COPD).
The failure to diagnose and treat the
condition at an early stage can lead to a
worsening of the disease which requires
additional expensive care or hospital treatment.
� Community pharmacists should provide risk assessments
for people potentially at risk of having or developing COPD,
followed by advice and stop smoking support or referral.
Benefits: Early diagnosis and intervention contributes to
public health efforts, and subsequent support offered by
pharmacists improves outcomes from medication, reducing
expensive treatment of exacerbations and improving patient’s
quality of life.
A sustainable NHS– the pharmacy fivepoint forward plan
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The Secretary of State for Health and the head of the NHS want radical changes in the delivery of care, needed to ensure asustainable NHS that can cope with increases in demand and financial constraints.
Community pharmacy can offer this transformational change, improving convenience for patients, creating capacity ingeneral practice and other services and releasing substantial savings for the NHS. With commitment and energy from thegovernment and the NHS we can make a big impact within just two years.
Community pharmacy is ready to help but can’t do it alone: as pharmacists, citizens and taxpayers we are calling on theDepartment of Health and NHS England to work with us to make it happen. Here is our five point action plan.
Find out more about the plan and theevidence for the services within it atpsnc.org.uk/5pointplan
psnc’s work funding and sTaTisTics conTracT and iT
In this section of Community Pharmacy News we have highlighted some keynotices for you and your team to be aware of in the coming weeks and months.
Pharmacy notice board
Funding settlement and flu service to do list:Read PSNC Briefings on the settlement and new service – visit psnc.org.uk/briefingsReview working practices to ensure that you and your teams can build the newservice into your routine work as well as continuing to offer the New MedicineService, MURs, and any local services.Sign up to PSNC’s Newsletters to ensure you don’t miss out as more information onthe flu service and CPCF changes becomes available. Sign up at psnc.org.uk/email
Are you taking on a pre-registration
trainee this year?
The ‘Pre-Registration Training Grant’ is payable to
community pharmacy contractors to support the
training of a pre-registration
pharmacy student.The grant is currently set at £18,440
per year and is authorised by the
contractor’s local NHS England team
who instructs the Pricing Authority accordingly.
PSNC has developed a template form which
pharmacy contractors may wish to use to apply
for the grant at: psnc.org.uk/prereg
Cancer support resources
Public Health England campaign
Public Health England (PHE) has launched a
national campaign to raise awareness of the
increased risk of breast cancer in older women
and the range of breast cancer symptoms. A
briefing has been created for pharmacy teams
which gives advice on how to approach the
topic with patients and gives details of where
to order free materials for the campaign.
Download the briefing at: dld.bz/dNHhU
Pharmacy newsletter
Cancer Research UK has launched a newsletter
to help support pharmacy teams. The first
issue advises on how to start conversations
about cancer. Read it now at:tinyurl.com/pharmacycancernews
The Preface of the August 2015 Drug Tariff annotates the addition to Part VIIIA ofTramadol modified-release (MR) capsules with effect from September 2015.• Tramadol 100mg MR capsules (60)• Tramadol 150mg MR capsules (60)• Tramadol 200mg MR capsules (60)• Tramadol 50mg MR capsules (60)
Therefore all prescriptions submitted with the September bundle will be reimbursedaccording to the Drug Tariff listed price.
Addition of Tramadol MR capsules to Part VIIIA
Yellow Card appThere's now an app for bothpatients and healthcareprofessionals to reportproblems with medicines.
You can download the YellowCard app from the App Store at:ow.ly/PKzB7 or Google Play at:ow.ly/PKzB8.
services and commissioning The healThcare landscape lpcsdispensing and supply
Part VIIIA Additions
Category C Additions:
SC Special Container
• Sodium dihydrogen phosphate anhydrous
340mg/Sodium bicarbonate 250mg
suppositories (10) – Lecicarbon C
• Sodium dihydrogen phosphate anhydrous
680mg/Sodium bicarbonate 500mg
suppositories (10) – Lecicarbon A
• Tramadol 100mg modified-release capsules (60)
• Tramadol 150mg modified-release capsules (60)
• Tramadol 200mg modified-release capsules (60)
• Tramadol 50mg modified-release capsules (60)
• Varenicline 1mg tablets and Varenicline
500microgram tablets SC (25) - Champix
• White soft paraffin 95% / Liquid paraffin 5%
ointment SC (50g) - Diprobase
• White soft paraffin 95% / Liquid paraffin 5%
ointment SC (500g) - Diprobase
Part VIIIA Amendments
SC Special Container
• Alendronic acid 70mg/100ml oral solution
unit dose sugar free (4) is changing to
Category A
• Alum powder (500g) is changing to Category
C J M Loveridge Ltd
• Brinzolamide 10mg/ml eye drops SC (5ml) is
changing to Category A
• Chlorphenamine 2mg/5ml oral solution (150ml)
is changing to Category C Piriton Syrup
• Paracetamol 500mg/5ml oral suspension
sugar free (150ml) is changing to Category A
• Prochlorperazine 3mg buccal tablets (50) is
changing to Category A
Part IX Deletions
It is important to take careful note of removals
from Part IX because if you dispense a deleted
product, prescriptions will be returned as
disallowed and therefore payment will not be
made for dispensing the item.
• Nélaton Catheter (‘ordinary’ cylindrical
Catheter) Single use – Cure
(Male) (HM8-HM16) 8-16ch
(Female) (HF8-HF16) 8-16ch
• Biosensor Strips – Advantage Plus
Drug Tariff WatchBelow is a quick summary of some the changes due to
take place from 1st September 2015.
JULY 2015 CPN –Correction forChanges to PartVIIIB of the DrugTariff on pg. 11
PSNC has been alerted to a
publishing error in our
article titled ‘Drug Tariff
July 2015 changes: products
moving to Part VIIIA’. There
is no equivalent licensed
product to the listings for
Amlodipine oral solution
and suspension removed
from Part VIIIB in July 2015.
Instead, there is now a
licensed ‘alternative’ listed
in Part VIIIA; this is
Amlodipine 10mg/5ml oral
solution sugar free.
Products which continue to
be prescribed as per the old
Part VIIIB listings, and
supplied as unlicensed
specials, will need to be
appropriately endorsed to
ensure correct payment.
Need to know if an item can be dispensed on
an FP10? Check on our database at:
psnc.org.uk/FP10database
When pharmacy teams receive NHS prescriptions they must check whether the items prescribed are allowed on the NHS before dispensing. If they
are not allowed, the pharmacy may not be paid for them.
Pharmacy teams may wish to check PSNC’s ‘Dispensing on an FP10 database’ (available at: psnc.org.uk/FP10database) for more information on
whether an item can be dispensed on an FP10, and we have listed some products below that we have recently received queries about.
Product Is the item Does it Is it Can it be Additional listed in the have a ‘CE’ in the dispensed information Drug Tariff? mark? blacklist? on an FP10?
Please note: If the prescription is one of the following, pharmacy staff will need to check the relevant sections of the Drug Tariff/PSNC website:
• FP10CN or FP10PN (community nurse prescriber) – Part XVIIB.