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Advanced Services
There are four Advanced services within the NHS community pharmacy contract. Community pharmacies can opt to provide any of these services as long as they meet the requirements set out in the Secretary of State Directions.
Information on the services can be found by clicking on the links below which will redirect you to the PSNC website.
Medicines Use Review (MUR) and Prescription Intervention Service
Referral for New Medicine Service Template
Secondary Care Referral for Targeted Medicine Use Review and New Medicine Service
NHS Urgent Medicine Supply Advanced Service (NUMSAS)
Appliance Use Review (AUR) Service
Stoma Appliance Customisation (SAC) Service
Provision of advanced services by pharmacy and dispensing appliance contractors.
West Yorkshire Area Team policy
This policy includes details about the provision of MURs off-site, in patients’ homes and over the telephone. This is a nationally agreed policy which Community Pharmacy West Yorkshire has had no input in to. We will be considering the implications of this policy at our next meeting.
NHS England policy on advanced services
Forms for completion (PREM2 forms) can be found on the PSNC website by here.
You should send completed forms to your West Yorkshire Area Team contact. These can be found on our website by clicking here.
NMS & MUR Submissions
The NHS Business Services Authority (NHSBSA) now administers the collection of completed MUR and NMS electronic reporting templates from pharmacy contractors on behalf of NHS England. Pharmacy contractors will no longer receive any reminder and will therefore need to remember to submit their completed quarterly MUR and NMS electronic reporting templates to the NHSBSA via the Information Services Portal.
For further information please click on the link below:
http://www.nhsbsa.nhs.uk/PrescriptionServices/5539.aspx
Referral for New Medicine Service Template
The following template can be used by prescribers to refer patients for an NMS.
Template Letter for GP NMS Referral for Patients Newly Prescribed Hypertension Medicine
Secondary Care Referral for Targeted Medicine Use Review and New Medicine Service
Guidance for the use of secondary care referral form
NHS Urgent Medicine Supply Advanced Service (NUMSAS)
NUMSAS Toolkit
The updated NUMSAS toolkit has now been published online and can be accessed here: https://www.england.nhs.uk/wp-content/uploads/2017/06/numsas-toolkit-pharmacy-staff-v2.pdf.
There have been a significant increase in incidents reported to NHS England where patients have frequently presented through the Pharmacy NUMSAS Service; attended OOH GP Care Providers or A&E Departments and successfully managed to obtain supplies at multiple sites across the Yorkshire and Humber region in a very short period of time. Furthermore there has been a report of a patient who consecutively attended five different A&E Departments in our region and managed to obtain supplies of Pethidine.
All these incidents have highlighted the potential for patient harm. Each one of us has a duty of care to identify, manage and reduce risk within our organisations. A multidisciplinary approach has been established to tackle this issue of inappropriate requests for supplies of controlled drugs/high risk medicines.
Access to the Summary Care Record is an invaluable tool and should be checked to support decisions for any requests for urgent supply of medicines.
Please read the letters below to find out more detail on the safeguards that have been out in place for General Practices and pharmacies:
NHS England Letter - NUMSAS: Inappropriate Supplies of CDs
NHS England Letter - NUMSAS Update 2019 (Pregabalin and Gabapentin)
Signing up to provide the service
Before signing up to provide NUMSAS there are a number of tasks that community pharmacy contractors should complete. PSNC Briefing 033/17: Checklist for the NHS Urgent Medicine Supply Advanced Service (NUMSAS) contains a checklist of tasks to complete before providing NUMSAS.
Contractors are able to notify NHS England of their intention to provide the NUMSAS pilot by completing the notification form on the NHS Business Services Authority (NHS BSA) website.
All contractors that meet the requirements set out in the service specification for the NUMSAS, including the requirement that the pharmacy has a shared NHSmail mailbox, are able to register; however, contractors will only be able to receive referrals from NHS 111 and provide the service when the service goes live in the contractor’s area (see ‘Roll out of the service’ section).
Requirement for a shared NHSmail mailbox
A requirement in the service specification is that if a contractor intends to provide the service, they must have a shared NHSmail mailbox for each of the pharmacy premises from where the service will be provided. Contractors should not register for the service until they have such a mailbox.
To access a shared NHSmail mailbox, users must have their own personal NHSmail address which is linked to the shared mailbox. This is to allow different staff members to access the mailbox without sharing of login details. Currently, only a small number of pharmacies have premises specific shared NHSmail mailboxes.
Information on how to obtain an NHSmail account
PharmOutcomes
Key benefits of using the PharmOutcomes service for community pharmacy contractors are:
- Structured service templates – These allow registration and follow up of all patients accessing the service. This makes the identification of repeat users easily identifiable that in turn can trigger relevant discussions about medicines management and medicines optimisation.
- Clinical record – A clinical record of all supplies and the ability to show a clear audit trail of activity and claims made.
- Automated GP notification – Saving data will automatically generate and send a notification form to the patient’s GP practice.
- NUMSAS submission tokens – The PharmOutcomes service will allow the required information, which needs to be included on the FP10DT EPS dispensing tokens, to be printed on the forms in a clear legible format.
- NUMSAS claim submission form generation – The NUMSAS claim form will be automatically system generated using recorded data and made available for printing on the 1st day of every month (please note this form must be posted to the NHS Business Services Authority, it cannot be submitted via PharmOutcomes).
Communicating with GP practices
Notifying the patient’s GP practice when a supply of a medicine or appliance is made is a requirement of the NUMSAS.
Contractors must ensure that a notification is sent to the patient’s GP practice on the same day the medicine or appliance is supplied or as soon as possible after the pharmacy opens on the following working day. This can be undertaken by secure email or secure electronic data interchange. If necessary the pharmacy should contact the GP practice for details of their secure email address. Where electronic notification is not possible, the pharmacy contractor should send the notification via post, hand delivery or “safe haven” fax (this should only happen where the pharmacy has confirmed with the GP practice the number of the fax and that it is a “safe haven”).
Where the notification to the GP practice is undertaken via hardcopy/fax the national GP Practice Notification Form should be used:
NUMSAS – GP practice notification form (Word)
NUMSAS – GP practice notification form (PDF)
NUMSAS Briefing for GP Practices
Claiming payment
To claim payment for this service, contractors must complete the NHS Urgent Medicines Supply Advanced Service Pilot claim form and submit it to the NHS BSA, along with the completed FP10DT EPS dispensing tokens (completed as part of the NUMSAS), not later than the 5th day of the month following that in which the urgent supply was made.
The process will be separate to the submission of other FP10 forms, do not send the claim form with your prescription bundle at the end of the month. The completed form should be sent to Prescription Services, Bridge House, 152 Pilgrim Street, Newcastle upon Tyne, NE1 6SN in a secure manner that enables tracking and tracing of the delivery.
PSNC Briefing 034/17: NHS Urgent Medicine Supply Advanced Service (NUMSAS) – checklist for completing an FP10DT EPS dispensing token and end of month submission process contains a checklist for completing an FP10DT EPS dispensing token after each referral and a checklist for submitting the tokens and claim form at the end of the month.
PSNC Briefing 035/17: Services Factsheet – NHS Urgent Medicine Supply Advanced Service (NUMSAS) – how much will I be paid? is a quick reference guide to see how much contractors will be paid for each referral they receive depending on the outcome of the referral.
FAQ’s
Additional information can be found on the PSNC website at http://psnc.org.uk/services-commissioning/urgent-medicine-supply-service/
Flu Vaccination Advanced Service
This service will commence from 1st September 2019 and ends on 31st March 2020.
Key Documents
- Service Specification 19/20 - it is ESSENTIAL that all pharmacists providing the service have read and understood this document as it describes the requirements for provision of the service.
- Patient Group Direction 19/20 – it is ESSENTIAL that all pharmacists administering flu vaccinations under the authority of the national Patient Group Direction (PGD):
- Read the PGD) and ensure they fully understand the content including the eligible patient groups, the inclusion and exclusion criteria and the record keeping requirements.
- Complete the Practitioner declaration on the PGD to confirm they have read and understood the content of the PGD and are willing and competent to work to it within their professional code of conduct. (A signed copy of the PGD must be kept at the pharmacy).
- Request that the relevant person for the pharmacy completes the Authorising Manager section of the PGD.
- Guidance - The 2019 Seasonal Flu Advanced Service (PSNC) – this briefing provides guidance on the 2019/2020 NHS Flu Vaccination Service and includes a helpful checklist which pharmacists can work through to ensure they are service ready.
- National Flu Immunisation Programme Plan letter 2019/20 (the annual flu letter)
Vaccines for 2019/20
The vaccines which can be used in the service are those listed in the annual flu letter for 2019/20, see here and are authorised for use by the PGD.
- For patients aged 18 to 64 years, there are two recommended vaccines:
the standard egg-grown quadrivalent influenza vaccine (QIVe) and the newly licenced cell-based quadrivalent influenza vaccine (QIVc). - For patients aged 65 and over, there are two recommended vaccines:
the adjuvanted trivalent influenza vaccine (aTIV) and the newly licenced cell-based quadrivalent influenza vaccine (QIVc).
List of products and manufacturers below:
Other Briefing Documents & Resources
Vaccine Ordering for 2019/20: Letters
Ovalbumin Content of 2019/20 Flu Vaccines
Inactivated Influenza Vaccine Information for Healthcare Practitioners
Chapter 19 of the Immunisation Against Infectious Disease, “The Green Book”, can be downloaded here: https://www.gov.uk/government/publications/influenza-the-green-book-chapter-19.
Training Requirements for the National Flu Vaccination Service
Face to face training (to cover both injection technique and basic life support training, including administration of adrenaline for anaphylaxis) is required every THREE years. See the Flu Vaccination - Training Requirements and Resources page on the PSNC site here for further information, which includes a list of possible training providers.
The Vaccination Services Declaration of Competence (DoC) must also be completed and this is required every TWO years.
In addition to completing the Vaccination Services DoC every two years, pharmacists providing the service have a professional responsibility to complete an annual update. This annual refresher training can be self-directed learning and need not be face-to-face training. This could, for example, include undertaking the assessment modules of an immunisation e-learning programme and doing/re-doing the necessary modules to refresh knowledge, reading through the ‘Information for healthcare practitioner’ documents on the PHE website, listening to any available webcasts and reading recently published articles on immunisation relevant to the area of practice. There is no stipulated way to do the annual update training but as a vaccinating pharmacist there is a professional obligation to ensure skills and knowledge are up to date.
For further information please refer to the PSNC page on training requirements for flu here. If you need any help with anything, please contact Lisa Meeks (lisa@cpwy.org) who will be happy to help.
Service Delivery Resources
Tear Off Appointment Slip / Flyer
Key facts about flu and flu vaccination - to support discussions with patients
Myth Buster - to support discussions with patients
Identifying carers for flu vaccination
Patient Leaflet - PHE Flu Vaccination (easy read version)
Patient Leaflet - Pregnancy & Flu (Kirklees)
PHE Patient Leaflet - The Flu Vaccination 2019-20 (who should have it and why)
CPWY Flu Poster - Heart Condition
Pharmacy Team Resources
Key information for HCPs - Protecting Carers From Flu
Identifying Carers - the 60 second flu chat
Checklist for Flu Vaccination Service
PSNC Factsheet: Eligible Groups for Flu Vaccination Service 2019/20
PSNC Decision Tree - Recommended Vaccines 2019/20
Flu Service Updates
Flu Vaccination Service - Ordering Flu Vaccines for 2019-20
Flu Service 19/20 Update - July 2019
Flu Service 19/20 Update - August 2019
Claiming Payment
Claims for payment for the service MUST be made electronically, using the Manage Your Service (MYS) application on the NHSBSA website (paper claims will not be accepted). Claims will be accepted by NHSBSA within six months of administration of the vaccination or by 31st August 2020, whichever date is earlier, in accordance with the usual Drug Tariff claims process. Later claims will not be processed. See PSNC page on claiming payments here if further information is required.
It is expected that the NHS Flu Service will be available on PharmOutcomes for West Yorkshire pharmacies. If you are using PharmOutcomes to record your flu vaccination delivery for the Advanced Service it is important to remember that for the national Flu Advanced Service PharmOutcomes will NOT automatically make a claim for payment. It does however generate a pre-populated pharmacy monthly return which you can print off or use when submitting your claim to the NHS BSA. Details of how to do this are in Provider User Guides on the Help tab on PharmOutcomes. The pharmacy monthly return is available to download on the first day of every month from the claim tab.
Frequently Asked Questions
The PSNC website is a great source of information and resources for pharmacy teams. This includes a useful Frequently Asked Questions (FAQs) and answers page which are updated on an ongoing basis:
Last Updated: 28th August 2019