COMMUNITY PHARMACY PALLIATIVE CARE SERVICE

April 2010- March 2011

EN3 NHS Community Pharmacy Contractual FrameworkEnhanced Service – On Demand Availability of Specialist Drugs (Availability of Palliative Care or other Specialist Medicines)

Wandsworth PCT Commissioning Strategic Goals

CSP4- Improve access to, and the responsiveness of, GP and other Primary Care services.

CSP 5- Improve the quality of services for people living with complex and/or long term conditions.

Date April 2010 Review date February 2011

TABLE OF CONTENTS Page

1. Introduction 3

2. Aims of Service 3

3. Service description 3

4. Clinical Governance 4.1 Training 4.2 Control Drugs 4.3 Handwriting Requirements for Control Drugs 4.4 Service Continuity 4.5 Operational Procedure Normal Working Hours4.6 Pharmaceutical Waste

4444555

5. Indemnity 5

6. Confidential Information and data protection 5

7. Payment Structure 6

8. Audit 6

9. Variation 6

10.Default and termination 8

Appendix 1 – Essential Service 3 9

Appendix 2 Palliative care Formulary 11

Appendix 3 Dispensing audit form 14

Appendix 4 Communications Strategy 15

Appendix 5 Invoice forms 18

Appendix 6 Monthly Item Reporting form 19

Appendix 7 Feedback form 20

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1. INTRODUCTION

The purpose of this document is to set up the operational framework for supply of medicines for palliative care by Community Pharmacists during normal working hours. A network of Wandsworth community pharmacies will stock a formulary of palliative care drugs. This service will be run within normal working hours. This will help ensure there is a supply of such medication for patients and their healthcare professional, which are in need of a palliative care service. This service links into the nation service specification EN3 - On Demand Availability of Specialist Drugs (Palliative Care)

In addition this service will link into Wandsworth PCT’s Gold Service Framework in end of life and cancer care and with the SW London and SE London Cancer Networks. This service links into the following PCT Commissioning Strategic plan goals:-

CSP4- Improve access to, and the responsiveness of, GP and other Primary Care services.

CSP 5- Improve the quality of services for people living with complex and/or long term conditions.

There is a strong emphasis communication and forging strong professional working relations between the Community Pharmacists and stakeholders involved in end of Life or Palliative care. (See Appendix 4)

There are strict protocols and drug supply legislation around controlled drugs, which will be adhered to by all relevant stakeholders.

The service level agreement is for 12 months and will be reviewed annually.

2. AIMS OF THE SERVICE

The service will allow access to palliative care medicines from a network of Community Pharmacies in the Wandsworth PCT area during normal working hours. Participating pharmacists will continually stock from an approved formulary of palliative care drugs.

3. SERVICE DESCRIPTION

Supply of these drugs shall take place under the following circumstances. During normal working hours patients or their carers will access the pharmacy

network when their usual pharmacy cannot supply Palliative care drugs during emergencies or within a normal timeframe.

All Participating pharmacists will stock all palliative care drugs listed on the formulary.

Participating community pharmacists will inform pharmacy staff and locums of the service and their responsibilities.

Participating pharmacists will provide audit feedback on the number of palliative care items dispensed drugs supplied in order to quantify demand for palliative care medicines during normal working hours.

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4 CLINICAL GOVERANCE

4.1 TRAINING Participating community pharmacists will undertake a PCT accredited training and the CPPE course in palliative care. Community Pharmacists will also ensure that locum pharmacists and second pharmacists are made aware of the service.

4.2 CONTROLLED DRUGS Community Pharmacy providers will comply with the standards laid down in the Medicines Ethics and Practice guide section 1.2 12 and the recent changes to the management of control drugs. This will include keeping records for opening and closing balances for control drugs. It will be the responsibility of the Community Pharmacy Providers to have a standard operational procedure for this service.

Participating pharmacists should report any incidents around control drugs to the PCT Accountable Officer for Control drugs

Nick Beavon Chief Pharmacist/Accountable officer for controlled drugsTel: 020 8812 7780

Community Pharmacy providers are advised to obtain further information on the section on controlled drugs on the Society’s website contains some frequently asked questions, which can be accessed at::-

www.rpsgb.org/worldofpharmacy/useofmedicines/controlleddrugs.html# and

http://www.psnc.org.uk/index.php?type=more_news&id=2056

4.3 HANDWRITING REQUIREMENTS FOR CONTROLLED DRUG SUPPLYCommunity Pharmacists are subject to very strict rules and regulations regarding the supply and dispensing of Control Drugs. Community pharmacists will not be put under pressure to supply drugs if they are presented with incorrectly written prescriptions. This responsibility will lie with the prescriber.

The information below is summarised. For more details please always refer to the Pharmacy code and ethics guide. 1. The Name and address of the patient.

2. The preparation must have the form and the strength.-E.g. MST Tablets 10mg.

3. The total quantity of the preparation, or the number of dose units in both words and figures. E.g. MST Tablets 10mg (ten mg), quantity 60, (sixty).

4. The dose. (NB –‘’as directed, prn’’, is not acceptable)

5. The prescription must be signed and dated by the prescriber and state the prescriber’s address and GMC number.

6. When the prescription is dispensed out of hours-the word urgent must be added by the prescriber. This will be relevant if the palliative care Community Pharmacists is providing a rota service.

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4.4 Service Continuity It is the responsibility of the Community Pharmacy Provider to ensure that all members of their pharmacy team including locum pharmacists, new pharmacists, pharmacy technicians and staff are made aware of this service and provided with cascade information. New Pharmacists will be expected to complete the CPPE course in palliative care and attend the next PCT accredited training session.

4.5 Operational Procedure –Normal Working Hours

1. Requests for controlled drugs cannot be made by phone calls or fax.

2. The GP or District nurse will contact the nearest pharmacy on the network list and confirm details to the Pharmacist over the phone, before sending the prescription or referring a patient.

3. All prescriptions will have the contact details of the prescriber, so a Community Pharmacist can confirm authenticity.

4. All Healthcare professionals or carers, collecting controlled drugs on behalf of their clients, should present identification when collecting controlled drugs from community pharmacy.

5. A community Pharmacist will follow normal dispensing procedures for controlled drugs.

6. The pharmacist will do a control drug balance check, once the item is dispensed.

7. The community pharmacist will log the number of palliative care drug items dispensed each month into the service activity form.

The participating pharmacists are not expected provide a delivery service. For Out of Hours supply of palliative care drugs – Please refer to the Access to Medication out of hours service. Participating community pharmacists are expected to have their own standard operating procedure.

4.6 Pharmaceutical Waste

The PCT Waste contractor will provide denaturing kits for out of date control drugs as requested by the Community Pharmacy provider.

4.7 Reciprocal Arrangements

Wandsworth PCT may recognise the training received by a registered pharmacist from another PCT within 15 months. Final approval will be based a local decision on a case by case basis by a PCT Officer. Competent Pharmacists who have been trained and accredited by other PCTs will have to follow the Wandsworth PCT Patient Group Direction and service Level agreement.

4.8 IT

All Community Pharmacy providers of the service will be expected to be compliant with Information Governance requirements, to have an NHS net Email account and an IT system with an N3 connection and MS Office. 5 INDEMNITY

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The pharmacist must ensure that their professional indemnity cover is either provided by the National Pharmaceutical Association (NPA) or other organisation who has confirmed that this activity will be included in their policy.

6 INFORMATION GOVERNANCE CONFIDENTIAL INFORMATION AND DATA PROTECTION

The named pharmacist shall not, whether during or after their appointment, disclose or allow to be disclosed to any person (except on a confidential basis to their professional advisers) any information of a confidential nature acquired by the pharmacist in the course of carrying out their duties under this Agreement, except as may be required by law or as directed by their PCT.

The pharmacist must protect personal data in accordance with the provisions and principals of the Data Protection Act legislation and must ensure the reliability of the staff that has access to such data.

All participating Community Pharmacies will be compliant with information Governance requirements.

7 PAYMENT STRUCTURE

Funding for this service takes into account appropriate as community pharmacists are being asked to take part in critical care scheme that involves risk on behalf of the Community Pharmacist, particularly around stocking a large quantity of Control drugs. Participating community pharmacists will be reimbursed by the following means.

The PCT will reimburse any out of date palliative care drugs. An annual retainer of £180 will be paid to cover the partial costs of the

formulary and to recognise that the Community Pharmacy providers are holding a very high quality of control drugs,

A Professional retainer of £200.00 for attendance of PCT accredited training for the Principal Community Pharmacy provider.

8. AUDIT

The audit for the service should provide information on the following criteria: - Demand or supply of palliative care drugs during normal working hours and

out of hours by recording the palliative care drugs dispensed during normal working hours.

Stakeholder’s view of service-feedback from GP’s, district nurses and participating community pharmacists.

The service will be reviewed on an annual basis.

9. VARIATION

The services and fee structure or any aspect of this agreement may be varied if: The parties agree in writing, or Upon request by the PCT where there is a change in the Trust’s service priorities

or where there is a change in the way in which this agreement is required to work as requested by: Changes in legislation, guidance or directions from the Department of Health,

or

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Other exceptional circumstances Proposals to vary the service may be initiated by any party. A request to vary

the service will require at least one-month’s written notice unless the parties agree otherwise.

If there are local or national changes to palliative care formularies, changes may be made to the formulary during the course of a service and participating Community Pharmacists will be informed at adjust.

If a Community Pharmacy provider is requested locally by a GP to stock a medication for palliative care which is outside the formulary, inform the PCT Community Pharmacy Lead. If the requested medication goes out of date then the costs will be met by the PCT.

10. DEFAULT AND TERMINATION

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Any party may terminate this agreement by immediate notice to the other parties if any of the other parties refuses or fails to carry out any of its obligations, if the matter complained of is:

Incapable of rectification, or Capable of rectification, but has not been rectified within 14 days of the notice being sent to the reasonable satisfaction of the non-defaulting party serving the notice.

If the pharmacist has failed to perform the services in accordance with this agreement or is otherwise in breach of this agreement, and the pharmacist has not remedied the breach where it is capable of being remedied within such a time as may have been notified to the pharmacist, the PCT may terminate this agreement in respect of the services only and provide or procure a third party to provide such services.

The PCT may terminate this agreement by immediate notice if the pharmacist ceases to provide pharmacy services from the Pharmacy or they are withdrawn or removed from the Pharmaceutical list, by whatever means.

Upon termination of this agreement each party shall return to the relevant party all the other party’s documents and materials and all copies thereof which are of a confidential nature.

The PCT may contact with Pharmacy contractors outside the PCT who may service NHS Wandsworth registered patients. Pharmacy contractors must be compliant with their contract monitoring framework in their host PCT.

The pharmacist shall co-operate fully with the PCT during any handover leading to termination of this agreement. This co-operation shall extend to full access to all documents, reports, summaries and any other information reasonable required by the PCT to achieve an effective transition without disruption to routine operational requirements.

The pharmacist shall not be entitled to assign or sub-contract its rights or obligations under this agreement to any person without prior written consent of the PCT.

Signed: ……………………………………..PCT

Signed:………………………………………Pharmacy Contractor

Date: …………………

COMMUNITY PHARMACY PALLIATIVE CARE SERVICEApril 2010- March 2011

Appendix 1 NHS Community Pharmacy Contractual Framework

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Enhanced Service 3– On Demand Availability of Specialist Drugs (Availability of Palliative Care or other Specialist Medicines)

1. Service description1.1 This service is aimed at the supply of specialist medicines, the demand for

which may be urgent and/or unpredictable, for example palliative care, tuberculosis and bacterial meningitis treatments.

1.2 The pharmacy contractor will stock a locally agreed range of specialist medicines and will make a commitment to ensure that users of this service have prompt access to these medicines at all times agreed with the PCO.

1.3 The pharmacy will provide information and advice to the user, carer and clinician. They may also refer to specialist centres, support groups or other health and social care professionals where appropriate.

2. Aims and intended service outcomes2.1 To improve access for people to these specialist medicines when they are

required by ensuring prompt access and continuity of supply.2.2 To support people, carers and clinicians by providing them with up to date

information and advice, and referral where appropriate.

3. Service outline3.1 The pharmacy holds the specified list of medicines required to deliver this

service and will dispense these in response to NHS prescriptions presented. The pharmacy may also hold specialist equipment, linked to the medicines on the list, for example syringe drivers and associated equipment.

3.2 The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service.

3.3 The pharmacy should maintain appropriate records to ensure effective ongoing service delivery and audit.

3.4 The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service are aware of and operate within local protocols.

3.5 The PCO should ensure the availability of these medicines from easily accessible pharmacies during the out of hours (OOH) period. This may include setting up an on-call rota arrangement. Consideration should be given to:

- frequency of call out in the OOH period;- the method of contacting a pharmacist who is providing the service,

for example via a local OOH provider or the local NHS Direct site;- security procedures the pharmacist may use to ascertain that a call-

out is genuine;- the way in which the prescription reaches the pharmacy;- the way in which the patient will obtain the medicine once dispensed;

and- security procedures for the use of the pharmacy premises during the

OOH period.3.6 The pharmacy provides details of on-call contacts who will meet the

commitment to have prompt access to the agreed list of medicines at all times agreed with the PCO.

3.7 The PCO will provide locally agreed induction training for participating pharmacies.

3.8 The PCO should arrange at least one contractor meeting per year to promote service development and update the knowledge of pharmacy staff.

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3.9 The PCO will agree with local stakeholders the medicines formulary and stock levels required to deliver this service. The PCO will regularly review the formulary to ensure that the formulary reflects the availability of new medicines and changes in practice or guidelines.

3.10 The PCO will agree a system which deals with the financial implications of date expiry of the medicines in the formulary.

3.11 The PCO will need to provide a framework for the recording of relevant service information for the purposes of audit and the claiming of payment.

3.12 The PCO will need to provide details of relevant referral points which pharmacy staff can use to signpost service users who require further assistance.

3.13 The PCO will disseminate information on the service to other pharmacy contractors and health care professionals in order that they can signpost patients to the service.

4. Suggested Quality Indicators4.1 The pharmacy reviews its standard operating procedures and the referral

pathways for the service on an annual basis.4.2 The pharmacy can demonstrate that pharmacists and staff involved in the

provision of the service have undertaken CPD relevant to this service.4.3 The pharmacy participates in an annual PCO organised audit of service

provision.4.4 The pharmacy co-operates with any locally agreed PCO-led assessment of

service user experience.

Background information – not part of the service specification

The NHS Security Management Service have provided guidance on lone working procedures – ‘Not alone – a guide for the better protection of lone workers in the NHS’ http://www.cfsms.nhs.uk/files/Not Alone- A Guide for the Better Protection of Lone Workers in the NHS.pdf

DH guidance on OOH medicine supply:Securing Proper Access to Medicines in the Out-of-Hours Period, DH, December 2004. http://www.out-of-hours.info/index.php?pid=6

CPPE training which may support this service:

Care of the terminally ill – communicating with patients open learning

Appendix 2 PALLIATIVE CARE DRUG FORMULARY

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Drug Dose Quantity Brand Amitriptyline Amitriptyline 10mg tablets 28    Amitriptyline 25mg tablets 28    Amitriptyline 50mg tablets 28    Amitriptyline 50mg/5ml oral solution sugar free 150  Artificial saliva Glandasone    Baclofen Baclofen 10mg tablets 84  Benzdamine Benzydamine 0.15% mouthwash sugar free 300ml DifflamBisacodyl Bisacodyl 10mg suppositories 12    Bisacodyl 5mg gastro-resistant tablets 30    Bisacodyl 5mg suppositories 5  Buprenorphine Buprenorphine 10micrograms/hour patches 4 BuTrans  Buprenorphine 20micrograms/hour patches 4 BuTrans  Buprenorphine 5micrograms/hour patches 2 BuTrans  Buprenorphine 35micrograms/hour patches 4 Transtec  Buprenorphine 52.5micrograms/hour patches 4 Transtec  Buprenorphine 70micrograms/hour patches 4 Transtec  Buprenorphine 200microgram sublingual tablets sugar free 50 Temgesic  Buprenorphine 400microgram sublingual tablets sugar free 50 Temgesicco-codamol Co-Codamol 30mg/500mg Tablets 100   Co-danthramer Co-danthramer 25mg/200mg capsules 60    Co-anthramer 25mg/200mg/5ml oral suspension sugar free 300    Co-danthamer 37.5mg/500mg capsules 60  Co-dydramol Co-dyramol tablets 100   Cyclizine Cyclizine 50mg tablets 100 Valoid

Cyclizine 50mg/ml injection 1 x 5 Valoid Dexamthasone Dexamethasone 2mg tablets 50    Dexamethasone 500microgram tablets 100  Diamorphine Diamorphine 5mg powder for solution for injection ampoules 5  Diamorphine 10mg powder for solution for injection ampoules 5

Diamorphine 30mg powder for solution for injection ampoules 5  Diamorphine 100mg powder for solution for injection ampoules 5  Diamorphine 10mg tablets 100 Diclofenac Diclofenac 50mg suppositories 10 Voltarol  Diclofenac 100mg suppositories 10  Diclofenac 75mg/3ml solution for injection ampoules 10 Voltarol I/M  Diclofenac 50mg Tablets 28  Diclofenac 100mg Tablets 28

Diclofenac sodium 75mg Sustained –release Tablets 28 Diclofenac sodium 75mg modified-release capsules 56 Diclomax SR  Diclofenac sodium 100mg modified-release capsules 28 Diclomax Retard

Drug Dose Quantity Brand Diazepam Diazepam 2mg tablets 28  Diazepam 5mg tablets 28

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  Diazepam 10mg tablets 28

  Diazepam 2mg/5ml oral solution 100ml Sandoz Diazepam Syrup

  Diazepam 10mg/2ml solution for injection ampoules 10    Diazepam 2mg/ml rectal solution 2.5ml tube- (5mg) 5    Diazepam 4mg/ml rectal solution 2.5ml tube (10mg) 5Docusate Docusate 100mg capsules 30 DioctylDomperidone Domperidone 10mg tablets 30    Domperidone 30mg suppositories 10 Motilium  Domperidone 5mg/5ml oral suspension sugar free 200ml MotiliumFentanyl Fentanyl 12 micrograms/hour patches 5    Fentanyl 25micrograms/hour patches 5    Fentanyl 50micrograms/hour patches 5    Fentanyl 75micrograms/hour patches 5    Fentanyl 100micrograms/hour patches 5  Haloperidol Haloperidol 1.5mg tablets 28    Haloperidol 10mg tablets 28    Haloperidol 20mg tablets 28    Haloperidol 500microgram capsules 30    Haloperidol 5mg tablets 28    Haloperidol 5mg/1ml solution for injection ampoules 5  Hyoscine Hyoscine butylbromide 10mg tablets  1XOP Buscopan  Hyoscine butylbromide 20mg/1ml solution for injection ampoules  1XOP Buscopanipratropium ipratropium 250mg/1ml nebules  1 x op    ipratropium 500mg/2ml nebules  1 x op  lactulose Lactulose 500mls 500ml  lansoprazole lansoprazole 30mg    Levomepromazine Levomepromazine 25mg tablets 84 Nozinan  Levomepromazine 25mg/1ml solution for injection ampoules 10 NozinanLorazepam Lorazepam 1mg tablets 28    Lorazepam 2.5mg tablets 28  Metoclopramide Metoclopramide 10mg tablets 28    Metoclopramide 10mg/2ml solution for injection ampoules 10  

  Metoclopramide 5mg/5ml oral solution sugar free 15Maxolon Paediatric Liquid

Midazolam Midazolam injection 10mg/2ml 1 x op

Hynoval

Midazolam injection 10mg/5ml 1 x op

Hynoval

Drug Dose Quantity Brand Morphine Morphine 5mg modified-release tablets 60 MST Continus  Morphine 10mg modified-release tablets 60 MST Continus  Morphine 15mg modified-release tablets 60 MST Continus  Morphine 30mg modified-release tablets 60 MST Continus

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  Morphine 60mg modified-release tablets 60 MST Continus  Morphine 100mg modified-release tablets 60 MST Continus

 Morphine 10mg tablets

56 Sevredol  Morphine 20mg tablets 56 Sevredol  Morphine 50mg tablets 56 Sevredol  Morphine 10mg modified-release capsules 60 Zomorph  Morphine 30mg modified-release capsules 60 Zomorph  Oramorph 10mg/5ml solution 100ml Oramorph

Oramorph 20mg/1lml 120ml Oramorph  Morphine sulphate 30mg suppositories 12    Morphine sulphate 15mg suppositories 12    Morphine sulphate 10mg/1ml solution for injection ampoules 5    Morphine sulphate 15mg/1ml solution for injection ampoules 5    Morphine sulphate 30mg/1ml solution for injection ampoules 5    Naproxen 250mg tablets 28    Naproxen 500mg tablets 28  Oxycodone Oxycodone 5mg capsules 56 OxyNorm  Oxycodone 10mg capsules 56 OxyNorm  Oxycodone 20mg capsules 56 OxyNorm  Oxycodone 10mg/1ml solution for injection ampoules 5 OxyNorm  Oxycodone 5mg/5ml oral solution sugar free 250ml OxyNormOxycontin Oxyconton 10mg mr Tablets 56    Oxyconton 20mg mr Tablets 56  Paroxetine 20mg Tablets    prochlorperazine Prochlorperazine 12.5mg/1ml solution for injection ampoules 10 Stemetil  Prochlorperazine 3mg buccal tablets 50 Buccastem  Prochlorperazine 5mg tablets 28    Prochlorperazine 5mg/5ml oral solution 100ml Stemetil Syrupprocyclidine Procyclidine 2.5mg/5ml oral solution sugar free 150ml Arpicolin Syrup  Procyclidine 5mg tablets 28    Procyclidine 5mg/5ml oral solution sugar free 150ml Arpicolin Syrupsalbutamol salbutamol nebules 2.5mg/2.5mls  1 x op    Salbutamol nebules 2.5mg/5mls  1 x op  tramadol Tramadol 50mg capsules 100  

Water for Injection 1ml2ml5ml10ml `

Saline for Injection2ml5ml10ml20ml

Appendix 3- FURTHER INFORMATION

RPSGB Guidance on changes in the management of Controlled Drugs

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Legal and Ethical Advisory ServiceTel 020 7572 2308 E-mail leadvice@rpsgb.org

http://www.rpsgb.org/worldofpharmacy/useofmedicines/controlleddrugs.html

Law and Ethics Fact Sheets -Controlled drugs and community pharmacy (V5 Sep 2007)

http://www.rpsgb.org/pdfs/factsheet1.pdf

Safer management of controlled drugs: changes to record keeping requirements. Interim guidance (for England only).

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_079574

http://www.ppa.org.uk/ppa/safer_management.htm#comm_pharm

National Gold Standards Framework (GSF) in Palliative care The Gold Standards Framework (GSF) is a framework to enable a gold standard of care for all people nearing the end of their lives.

http://www.goldstandardsframework.nhs.uk/

Liverpool care pathway The Liverpool Care Pathway for the Dying Patient (LCP) provides an evidence based framework for the delivery of appropriate care for dying patients and their relatives in a variety of care settings.

http://www.mcpcil.org.uk/liverpool_care_pathway

Palliative care websiteThis site provides essential, comprehensive and independent information for health professionals about the use of drugs in palliative care

http://palliativedrugs.org/

PSNC –Dispensing Control Drugs

http://www.psnc.org.uk/index.php?type=more_news&id=2056

College of Pharmacy Practice (details as of April 2010)

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http://www.cppe.manchester.ac.uk/Bookings/FullLearningPort.asp?ByTheme=true&

ReferenceAvailability

StudyHours Published Title

37029P,T  10  2006  Palliative care - update available for download 

ReferenceAvailability

StudyHours Published Title

39180P,T  10  2009  Cancer: in relation to pharmacy practice  

-P,T  6  2009  Cancer: supporting patients - new format for

a Route to revalidation 

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Appendix 4 COMMUNICATIONS STRATEGY

In order to ensure success for this service an effective communications strategy must be designed. This will ensure that the terms and conditions of the service in promoted and understood by Primary Health Care workers. The Critical success factors to this service are: -

Understanding the role of stakeholders involved in palliative care. Compliance with the Medicines Act around supply of Controlled Drugs and

handwriting requirements. Building strong professional working relationships.

o GP’s and practice staffo Secondary Care Palliative services.o Hospice healthcare Professionals.o District Nurses.

Patient issues – if there is a palliative care community pharmacist that can provide the service locally to a patient, this will improve patient care. It will be less stressful for a patient’s representative to find a pharmacist stocking the required medication, when a prescription is issued. The community pharmacist could also provide emotional support to the patient and their family, as they get to know patients

GP’s, district and Macmillan nurses- The key promotional criteria for primary care are:-

Knowing which Community Pharmacies provide this service. When these pharmacies are open.

More sensitivity and understanding about their role in the care of patients

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The PatientImproved care,

Less stress finding a pharmacy with

medication

General PracticeDistrict & Macmillan NursesKnowing who are the palliative pharmacists

PCTAudit of service

Demand patterns And good practice

The Palliative care Pharmacy

service

Communication & Relationships

Community pharmacist,

attention to training and the

needs of the patient.

Appendix 5 COMMUNITY PHARMACY PALLIATIVE CARE SERVICE INVOICE

INVOICE NAME LOCAL SCHEME 7 PALLIATIVE CARE

NAME & ADDRESS OF PHARMACY

Email address

DETAILS OF THE CLAIMANT(BANK DETAILS-OR ADDRESS WHERE

PAYMENT SHOULD BE SENT

INVOICE AMOUNT ANNUAL FORMULARY RETAINER £ 180.00

TRAINING RETAINER £100.00COST OF OUT OF DATE DRUGS (IF CLAIMING PLEASE ATTACH THE OUT OF DATE CLAIMS FORM) £…… …TOTAL CLAIMED

DATA EXTRACTION SEND IN COPIES OF INDIVIDUAL EHC PATIENT FORMS AND A COPY OF THE MONTHLY CLAIM FORM TO

Mr FADI DEXTER PRIMARY CARE SUPPORT MANAGER Wandsworth Teaching Primary Care TrustThird Floor, Wimbledon Bridge House Hartfield Road London SW19 3RUFAX 020 8812 7780

PAYMENT -PLEASE SUBMIT YOUR MONTHLY FORMS BY THE 8TH OF EACH MONTH TO ENSURE PROMPT PAYMENT TO:

Mary Clarke, Medical AdministratorPrimary Care Support Service187 Ewell Road,Surbiton, Surrey KT6 6AUTelephone:  020 8335 1327 / Fax: 020 8335 1374E-mail: mary.clarke2@nhs.net

This must be sent by the 8th of the following month.

I agree to: - Successfully complete the CPPE Course in Palliative care and attend PCT

training as is required. Stock the recommended Wandsworth PCT Palliative care Formulary. Send in Monthly palliative care figures to Wandsworth PCT. To stay up to date with Palliative care Information. To provide the palliative care service for 12 months from April 2008-March

2009. Provide feedback on the service by completing the Audit form.

Your signature……………………………………………………………………PLEASE RETAIN A COPY OF THIS INVOICE FOR YOUR RECORDS.

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Cost code 791637 6280 xX David Tamby Rajah Appendix 5 (Cont) Palliative Care Service Out of date claim forms Pharmacy………………...

DRUG STRENGTH & FORMBatch number Expiry date

QUANTITY Trade Price

TOTAL COST

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Appendix 6 Palliative Care Monthly Item Form

MONTH 2010/2011 No of Palliative Care Items Dispensed

APRIL

MAY 2010

JUNE 2010

JULY 2010

AUGUST 2010

SEPTEMBER 2010

OCTOBER 2010

NOVEMBER 2010

DECEMBER 2010

JANUARY 2011

FEBRUARY 2011

MARCH 2011

Total

Please Fax to David Tamby Rajah, Wandsworth PCT every month

Fax 020 8812 7780

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Appendix 7 FEEDBACK FORM PALLIATIVE CARE SERVICE-REFLECTIVE PRACTICE

1. Palliative formulary -in the service guide I did not dispense the following medicines/did dispense medication not in the formulary

Did not dispense Dispensed Medication outside the formulary

2. Marketing & Promotion

My local GPs, district nurses were aware of this service Yes no (Please circle)

I feel the service could be promoted well by: -

3. Training

Would you welcome more training in palliative care for 2008/9 - Yes No (please circle)

If Yes please indicate if what area(s) you would welcome training in:-

4. Your Feedback- please feedback any general comments on the service, how your role and the service could be improved.

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