Background to service. 2.1 The investment made by the NHS in medicines is for the explicit purpose of delivering health gain to the population. For this investment to bring the best possible outcomes for the people who are prescribed these medicines, pharmaceutical care of the correct quality has to be delivered reliably, safely, effectively and efficiently. The 2011 regulations to the National Health Service (Pharmaceutical Services) (Scotland) Act, places a duty on Boards to secure adequate pharmaceutical care services for the patients within their boundaries. Where medicines are prescribed by secondary care services to outpatients, it may be appropriate for the specified pharmaceutical care to be provided by community pharmacy or homecare. The placement of community pharmacies and their integration within the local healthcare system may mean that they are the preferred route of service provision.
2.2 Pharmaceutical Care Services, provided by community pharmacy, for patients receiving medicines supervised by secondary care has a number of advantages over traditional homecare services: Service provision is more likely to be fully integrated with other local services delivered within the local healthcare system. Access by vulnerable populations is facilitated, including those with less stable lifestyles and the homeless. Effective communication is promoted between community pharmacy, general practice and the secondary care service. Such provision supports and accelerates familiarity with use of these newer medicines within the community setting. Ensuring that patients’ medicines are provided within the context of other medicines prescribed in primary care and the pharmaceutical care needs of the patient. Supports the validity and reliability of the community pharmacy held pharmaceutical care record. Enables assessment of patients’ needs for compliance support and delivery of enhanced support where required as part of the patient’s clinical management plan.
2.3 The national arrangements to provide pharmaceutical services, that all local NHS pharmacy contractors are obliged to provide, includes provision for the supply of medicines in response to a prescription from secondary care. However, these arrangements allow a pharmacy contractor to source medicines to fulfill a prescription from wherever they see fit, subject to the requirements to deliver a product of suitable quality. For almost all of the medicines to be delivered under this agreement there is a primary ca...
Background to service. Since 2014 several new oral direct-acting antiviral (DAA) medications have been licensed for the treatment of Hepatitis C. The use of a DAA medications in Hepatitis C treatment has been proven to achieve sustained virological response (SVR) rates of greater than 95% in most patient groups, with improved tolerability and reduced durations of treatment. These treatment courses usually last 8 or 12 weeks, depending on the patient’s genotype, viral load and liver function. Treatment of chronic hepatitis C viral (HCV) infection has two patient-orientated goals: Clear the infection and achieve sustained eradication of HCV. This is known as achieving a sustained virological response (SVR) and is defined as the persistent absence of HCV RNA in serum at least twelve weeks after completing antiviral treatment. Prevent progression of liver damage to cirrhosis, Hepatocellular carcinoma (HCC) and decompensated liver disease requiring liver transplantation. Pharmacy contractors are ideally placed to deliver Hepatitis C treatments, with enhanced compliance support, support with the successful delivery of patient centred care for Hepatitis C patients within NHS Grampian. Community pharmacy involvement contributes to strong local patient compliance with regimens and related success in terms of positive treatment outcomes.
Background to service. The NHS Grampian Community Pharmacy Palliative Care Network was set up in 1999 after a formal needs assessment recognised the need for the prompt supply of palliative care drugs by community pharmacists, especially during out-of-hours periods.
Background to service. The National Institute of Clinical Excellence (NICE) defines Medicines Support as “Any support that enables a person to manage their medicines. This varies for different people depending on their specific needs”. Community pharmacists are one group of professionals within the wider multi-disciplinary team who can have an input into supporting patients managing their medicines by the supply of Medication Administration Record (MAR) charts alongside dispensed medication. Within their Guidance Document 67, “Managing Medicines for adults receiving social care in the community” NICE makes several references to community pharmacy and how can input into this topic. The three Health and Social Care Partnerships (HSCP’s) within NHS Grampian (Aberdeen City, Aberdeenshire & Moray) have their own information on how medicines support is delivered within their areas. These documents are linked in the reference section and should be read in conjunction with this SLA to ensure a comprehensive understanding of the wider service available to patients.
Background to service. 3.1 The investment made by the NHS in ONS is for the explicit purpose of delivering health gain to the population. For this investment to bring the best possible outcomes for the people who are prescribed ONS, pharmaceutical care of the correct quality has to be delivered reliably, safely, effectively and efficiently. The National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009 as amended (“the Regulations”), places a duty on Boards to secure adequate pharmaceutical care services for the patients within their boundaries. Where ONS are requested by a Registered Dietitian (registered with the HCPC), it may be appropriate for the specified pharmaceutical care to be provided via community pharmacy. The placement of community pharmacies and their integration within the local healthcare system may mean that they are the preferred route of service provision.
Background to service. 2.1 The investment made by the NHS in medicines is for the explicit purpose of delivering health gain to the population. For this investment to bring the best possible outcomes for the people who are prescribed these medicines, pharmaceutical care of the correct quality has to be delivered reliably, safely, effectively and efficiently. The 2011 Regulations to the National Health Service (Pharmaceutical Services) (Scotland) Act Regulations 2009, places a duty on Boards to secure adequate pharmaceutical care services for the patients within their boundaries. Where medicines are prescribed by secondary care services, it may be appropriate for the specified pharmaceutical care to be provided by community pharmacy or homecare. The placement of community pharmacies and their integration within the local healthcare system may mean that they are the preferred route of service provision.
2.2 Pharmaceutical Care Services, provided by community pharmacy, for patients receiving medicines initiated by secondary care has a number of advantages over traditional homecare services: • Service provision is more likely to be fully integrated with other local services delivered within the local healthcare system. • Access by vulnerable populations is facilitated, including those with less stable lifestyles and the homeless. • Effective communication is promoted between community pharmacy, general practice and the secondary care service. • Ensuring that patients’ medicines are provided within the context of other medicines prescribed in primary care and the pharmaceutical care needs of the patient. • Supports the validity and reliability of the community pharmacy held pharmaceutical care record. • Enables assessment of patients’ needs for compliance support and delivery of enhanced support where required as part of the patients’ clinical management plan.
Background to service. 3.1 This service was developed following similar provision put in place at the beginning of the COVID 19 pandemic, which allowed COPD patients who are at high risk from respiratory infections, to obtain appropriate rescue medicine(s) for an exacerbation without the need to obtain a prescription from their GP. This service is separate to the provision during COVID.
Background to service. NHS Grampian clinical treatment services for substance misuse provide integrated, evidence based clinical service to patients in both specialist and primary care settings. The aim of this service is to reduce the harm associated with illicit drug use and support patients towards stabilisation and recovery. Ultimately this will enable them to fulfil their potential in society. With increasing integration as part of the Health and Social care Integration programme, there is a move to provide tailored clinical and social support to patients. This SLA aims to define the role of community pharmacy in this collaboration. Effective communication between the partners involved in each patient’s care plays an important part in the effective delivery of this service.
Background to service. 2.1 The National Council for Hospices, the Specialist Palliative Care Services and the Scottish Partnership Agency for Cancer and Palliative Care and the Scottish Partnership Agency for Cancer and Palliative care have adopted the following definitions: • General Palliative Care: care delivery with a palliative approach is a core skill that every health care professional, in whatever setting, should possess if dealing with patients with incurable progressive disease. • Specialist Palliative Care: care delivered by a multi-professional team. The team works collaboratively with those providing a palliative approach and deals with more complex problems to ensure that patient and family needs are met.
2.2 In 1999 the Scottish Executive Department of Health issued guidance under NHS XXX(1999)78 : Community Pharmacy: Model Schemes for Pharmaceutical Care and NHS (Primary Care) Act 1997 with the purpose being two fold: • To ensure continuity of supply of agreed palliative care medicines and devices for drug delivery • To create a network of palliative care community pharmacies to provide advice and information to patients, carers, GPs, nurses and other community pharmacies. Since then this has become incumbent on Boards to continue to deliver a palliative care service appropriate to their population
Background to service. The provision of compliance aids has been a long-standing service provided by NHS Grampian community pharmacy contractors which was originally part of Model Schemes which were introduced by the Scottish Government in 2002. NICE guidance document NG67 “Managing medicines for adults receiving social care in the community” highlights the potential use of a monitored dosing system for suitably assessed patients as one part of a much wider role of overall management of medicines and patient care. Contractors undertaking this service are advised to review NG67 alongside the content of this SLA. While it is important to acknowledge that the supply of compliance aids play a role in supporting patients care at home it should not be a universally accepted that when a patient requires support with medication that they are provided with a compliance aid. No patient should be commenced on a compliance aid without prior assessment from a suitably qualified healthcare professional AND a conversation with the general practitioner (GP).
