Service Specifications for Point of Dispensing Intervention Service

1. This agreement is between

NHS England (Yorkshire and Humber) (the commissioner)

Unit 3 Alpha Court Monks Cross YORK YO32 9WN

And the Provider: (“the pharmacy”) Trading as: Address:

Contractor ODS code: F

2. Purpose

Community Pharmacists will contribute to the reduction of prescribed unwanted medicines, which currently are wasted. This service will be undertaken at the point of dispensing. This will help to prevent patient’s stockpiling of prescribed medicines and reduce inefficiencies in prescribing on FP10s. The service will inform GP repeat prescribing processes thus contributing to improved patient outcomes through harm reduction, reduced hospital admissions, and increased medicine concordance. It is expected that the service will encourage Pharmacists to carry out Medicine Use Reviews (MUR) with patients who they have identified as having issues with their prescribed medicines or processes around ordering repeat medicines.

The object of this scheme is to reduce the burden of waste medicines within the East Riding of Yorkshire, which has far reaching implications both financially and in terms of harm and health outcomes for patients in the East Riding of Yorkshire:  To reduce the number of unwanted medicines dispensed and therefore wasted, by not dispensing items not required by the patient.  To notify the prescriber when an item prescribed has not been dispensed.  To promote, support and encourage good repeat / prescribing practices with patients and GP practices.  To highlight under usage of medicines to the prescriber.  To inform the prescriber whether the continued supply or non-supply of items would be considered clinically significant.  To highlight prescribing inefficiencies to the prescriber.  To reduce unnecessary prescribing costs.

Page 1 of 12 3. Period

This agreement is for the period 1st October 2017 to 31st March 2020.

4. Termination

One months’ notice of termination must be given if the pharmacy wishes to terminate the agreement before the given end date.

One months’ notice of termination must be given NHS England (Yorkshire and Humber) wishes to terminate the agreement before the given end date.

NHS England (Yorkshire and Humber) may suspend or terminate this agreement forthwith if there are reasonable grounds for concern including, but not limited to, malpractice, negligence or fraud on the part of the pharmacy.

5. Obligations

The pharmacy will provide the service in accordance with the specification (Schedule 1).

Community Pharmacy Humber on behalf of NHS England (Yorkshire and Humber) will manage the service in accordance with the specification (Schedule 1).

6. Payments

NHS England (Yorkshire and Humber) will pay the following:

A professional fee of £4 will be paid for each point of dispensing intervention made. In addition to the professional fee a payment equivalent to 10% of the net ingredient cost of the product not dispensed will be made.

The pharmacy will enter the service delivery information onto the PharmOutcomes system and invoices will be generated automatically.

Payments will be made by BACS within 28 days of the submitted invoice.

7. Standards

The service will be provided in accordance with the standards detailed in the specification (Schedule 1).

8. Confidentiality

Both parties shall adhere to the requirements of the Data Protection Act 1988 and the Freedom of Information Act 2000.

Any approaches by the media for comments or interviews must be referred to NHS England (Yorkshire and Humber).

Page 2 of 12 9. Indemnity

The pharmacy shall maintain adequate insurance for public liability and professional indemnity against any claims which may arise out of the terms and conditions of this agreement.

Any litigation resulting from an accident or negligence on behalf of the pharmacy is the responsibility of the pharmacy who will meet the costs and any claims for compensation, at no cost to NHS England (Yorkshire and Humber).

Page 3 of 12 Schedule 1

Service Specification – Community Pharmacy Point of Dispensing Intervention Service.

This service will be provided to patients registered with East Riding of Yorkshire CCG. (See Appendix 1.)

1. Service description

1.1 The pharmacy will carry out checks at the point of prescription hand out to identify items that have been prescribed but are not required by the patient.

1.2 Where items are found that are not required by the patient the pharmacy will, at the discretion of the pharmacist, make an intervention to not dispense the item.

1.3 When the pharmacist makes an intervention as described in 1.2, they will notify the patient’s GP that they have made that intervention and the reason why the item was not required.

1.4 When the pharmacist makes an intervention as described in 1.2, they will, at their discretion, deliver a Medicines Use Review to support the patient’s safe use of the prescribed medicines.

2. Aims and intended service outcomes

2.1 To reduce the number of unwanted medicines dispensed and therefore wasted, by not dispensing items not required by the patient.

2.2 To notify the prescriber when an item prescribed has not been dispensed.

2.3 To promote, support and encourage good repeat / prescribing practices with patients and GP practices.

2.4 To highlight under usage of medicines to the prescriber.

2.5 To inform the prescriber whether the continued supply or non-supply of items would

be considered clinically significant.

2.6 To highlight prescribing inefficiencies to the prescriber.

2.7 To reduce unnecessary prescribing costs.

3. Service outline

3.1 The pharmacy will at the point of handing out a completed prescription to a patient (or their representative where the patient has consented to the representative acting in this capacity) discuss with the patient the contents of the completed prescription and whether each item as dispensed is required by the patient.

3.2 Where, as a result of the discussion described above, an item that has been ordered on the prescription is identified as not being required by the patient, the pharmacy will, at the discretion of the pharmacist, make an intervention to not dispense the item.

3.3 When the pharmacist makes an intervention as described in 1.2, they will make a record of the intervention on PharmOutcomes that captures the following information: (a) The name and address of the patient (b) The name and practice of the prescriber (c) The date of the intervention (d) The name, strength (if required), form and quantity of the item that the intervention has been made on (e) The reason, as reported by the patient, that item was prescribed but is no longer required. (f) Any action that the pharmacist has taken to prevent that item from being unnecessarily prescribed in the future

3.4 When the pharmacist makes an intervention as described in 3.2, they will notify the patient’s GP that they have made that intervention and the reason why the item was not required. (This will be normally be done automatically by the PharmOutcomes system, but may sometime require the pharmacy to post the notification).

3.5 When the pharmacist makes an intervention, as described in 3.2, that in their discretion may be clinically significant to the patients continuing treatment, they will deliver a Medicines Use Review to support the patients safe use of the prescribed medicines.

3.6 Where a pharmacy makes an intervention described in 3.2 on a prescribed item, they should check the patient history on PharmOutcomes to see if the patient has received a similar intervention in the previous period of treatment for the same item. If there has been a previous intervention the pharmacy should record this in the PharmOutcomes record and if appropriate, deliver a Medicines Use Review to the patient.

3.7 Where a pharmacy makes an intervention as described in 3.2, on an item that is prescribed on a paper prescription form, they shall score through the item so as to make it illegible.

3.8 Where a pharmacy makes an intervention as described in 3.2, on an item that is

prescribed through the Electronic Prescription Service, they endorse the item as Not Dispensed (ND) on the Electronic Prescription Service claim.

3.9 The pharmacy staff will ensure that the service is explained to the patient at the outset. This explanation will include the reasoning for the service. They must re- assure any patient anxious about having an item not dispensed this time and that it may not mean it has been automatically removed from the repeat prescription.

4. Training and Premises Requirements

4.1 All participating pharmacies will provide a professional consultation area for patients who request it. Pharmacists should ensure full patient confidentiality, and compliance with data protection requirements. Service is only open to pharmacies that are able to provide an intervention MUR.

4.2 The pharmacy contractor must have a standard operating procedure (SOP) for this service. All support staff must ensure they are familiar with all aspects of the scheme before commencing the service.

5. Service availability

The pharmacy contractor should seek to ensure that the service is available throughout the pharmacy’s opening hours. To encourage ease of access to the service it should be offered across a range of times including where possible Saturdays and Sundays.

6. Quality Standards

6.1 Community Pharmacy contractor providers of this service will comply with the General Pharmaceutical Council standards of conduct, ethics and performance at all times.

6.2 The pharmacy reviews its standard operating procedures and the referral pathways for the service on an annual basis.

6.3 The pharmacy can demonstrate that pharmacists involved in the provision of the service have undertaken continuing professional development (CPD) relevant to this service.

6.4 The pharmacy participates in any NHS England (Yorkshire and Humber) led audit of service provision.

6.5 The pharmacy co-operates with any NHS England (Yorkshire and Humber) led assessment of service user experience.

7. Claiming payment

Community Pharmacy Humber will provide access to a PharmOutcomes platform for the recording of relevant service information for the purposes of audit and the claiming of payment.

Appendix 1 – List of GP Practices in East Riding of Yorkshire CCG

ADDRESS PHONE NUMBER BEVERLEY GROUP PRACTICE 01482 888690 30 LOCKWOOD ROAD BEVERLEY HU17 9GQ 01482 862474 THE SURGERY SAMMAN ROAD BEVERLEY HU17 0BS THE HALLGATE SURGERY 01482 845832 123 HALLGATE COTTINGHAM HU16 4DA GREENGATES MEDICAL GROUP 01482 881298 117-119 WALKERGATE BEVERLEY HU17 9BP

THE SURGERY 01482 881517 25 GREENWOOD AVENUE BEVERLEY HU17 0HB 01482 881824 MINSTERGATE SURGERY LINCOLN WAY BEVERLEY HU17 8RH THE BEVERLEY HEALTH CENTRE 01482 862733 MANOR ROAD BEVERLEY HU17 7BZ ANLABY SURGERY 01482 658918 HALTEMPRICE LEISURE CENTRE SPRINGFIELD WAY ANLABY HU10 6QH THE MITCHELL PRACTICE 01482 634004 15 SCHOOL LANE NORTH FERRIBY HU14 3DB THE OLD FIRE STATION SURGERY 01482 862236 ALBERT TERRACE BEVERLEY HU17 8JW

BRANCH SURGERY 01482 882281 SWINEMOOR SURGERY SAMMAN ROAD BEVERLEY HU17 0BS Tel: 01482 882281

WILLERBY & SWANLAND SURGERY 01482 652652 45 MAIN STREET WILLERBY HULL HU10 6BP

BRANCH SURGERY 01482 633570 SWANLAND SURGERY THE OLD PUMP HOUSE WEST END SWANLAND HU14 3PE COTTINGHAM MEDICAL CENTRE 01482 622740 17-19 SOUTH STREET COTTINGHAM HU16 4AJ NORTH BEVERLEY MEDICAL CENTRE 01482 882546 PIGHILL LANE, OFF WOODHALL WAY BEVERLEY HU17 7JY THE MEDICAL CENTRE 01377 243055 CRANWELL ROAD DRIFFIELD YO25 6UH

BRANCH SURGERY 01377 243055 48 SOUTHFIELD ROAD WETWANG YO25 9XX THE CHESTNUTS SURGERY 01482 847250/ 01482 45 THWAITE STREET 846888 COTTINGHAM HU16 4QX THE PARK SURGERY 01377 272747 6 EASTGATE NORTH DRIFFIELD YO25 6EB

BRANCH SURGERY 01377 256066 22a HIGH STREET NAFFERTON YO25 4JR

PRACTICE 1 01262 670683 THE MEDICAL CENTRE STATION AVENUE BRIDLINGTON YO16 4LZ MANOR HOUSE SURGERY 01262 602661/ 676543 PROVIDENCE PLACE BRIDLINGTON YO15 2QW BRANCH SURGERY 01262 850172 THE SURGERY CHAPEL STREET FLAMBOROUGH YO15 1LQ

PRACTICE 3 01262 670686 THE MEDICAL CENTRE STATION AVENUE DD: 01262 401686 BRIDLINGTON YO16 4LZ PRACTICE 2 01262 670690 THE MEDICAL CENTRE STATION AVENUE DD: 401829 BRIDLINGTON YO16 4LZ FIELD HOUSE SURGERY 01262 673362 18 VICTORIA ROAD BRIDLINGTON YO15 2AT

BRANCH SURGERY 01262 850172 THE SURGERY CHAPEL STREET FLAMBOROUGH YO15 1LQ WOLDS VIEW PRIMARY CARE CENTRE 01262 423464 ENTRANCE A BRIDLINGTON DISTRICT HOSPITAL BESSINGBY ROAD BRIDLINGTON EAST YORKSHIRE YO16 4QP

THE SNAITH & RAWCLIFFE MEDICAL GROUP 01405 863190 THE MARSHES BUTT LANE SNAITH GOOLE DN14 9DY

BRANCH SURGERY THE SURGERY STATION ROAD RAWCLIFFE GOOLE DN14 8QR GILBERDYKE HEALTH CENTRE 01430 440225 THE HEALTH CENTRE THORNTON DAM LANE GILBERDYKE HU15 2UL THE MEDICAL CENTRE 01430 430318 PINFOLD STREET HOWDEN DN14 7DD MONTAGUE MEDICAL PRACTICE 01405 762830 FIFTH AVENUE GOOLE DN14 6JD MARKET WEIGHTON GROUP PRACTICE 01430 875353 10 MEDFORTH STREET MARKET WEIGHTON YO43 3FF BARTHOLOMEW MEDICAL GROUP 01405 767711 GOOLE HEALTH CENTRE WOODLAND AVENUE GOOLE DN14 6RU

BRANCH SURGERY 01405 762778 ALFREDS PLACE SWINEFLEET ROAD GOOLE DN14 5RN THE HESSLE GRANGE MEDICAL PRACTICE 01482 645295 11 HULL ROAD (Hessle & Anlaby) HESSLE HU13 9LZ

BRANCH SURGERIES FIRST LANE ANLABY HU10 6UE

01482 631420 50 CHURCH STREET (Nth Ferriby) NORTH FERRIBY HU14 3AA PARK VIEW SURGERY 01482 648552 87 BEVERLEY ROAD HESSLE HU13 9AJ PEELER HOUSE SURGERY 01482 646581 1 FERRIBY ROAD HESSLE HU13 ORG THE RIDINGS MEDICAL GROUP 01482 667108 4 CENTURION WAY BROUGH HU15 1AY

BRANCH SURGERIES 01430 424764 SOUTH CAVE MEDICAL PRACTICE 67 FERRY ROAD SOUTH CAVE HU15 2JG 01482 848261

THE VILLAGE HALL OLD VILLAGE ROAD LITTLE WEIGHTON 01430 860221 HU20 3US

RUSH VIEW HOLME-ON-SPALDING MOOR 01757 288315 YORK YO43 4BJ

THE SURGERY HIGHFIELD ROAD BUBWITH YO8 6LY EASTGATE MEDICAL GROUP 01964 530350 37 EASTGATE HORNSEA HU18 1LP 01964 527066 BRANCH SURGERY 2 CROSS STREET ALDBROUGH HU11 4RW HEDON GROUP PRACTICE 01482 899111 MARKET HILL HOUSE 4 MARKET HILL HEDON HU12 8JD

BRANCH SURGERY 01964 622706 CHAPEL LANE KEYINGHAM HU12 9RA CHURCH VIEW SURGERY 01482 899348 MARKET HILL Ext: 152 HEDON HU12 8JE 01964 622214 BRANCH SURGERY PROSPECT HOUSE CHAPEL LANE KEYINGHAM HU12 9RA LEVEN & BEEFORD MEDICAL PRACTICE 01964 542155 29 HIGH STILE LEVEN HU17 5NL

BRANCH SURGERY 01262 488234 THE SURGERY RECTORY LANE BEEFORD YO25 8BA SOUTH HOLDERNESS MEDICAL PRACTICE 08444 773562 ST NICHOLAS SURGERY QUEEN STREET 01964 613221 WITHERNSEA HU19 2PZ

BRANCH SURGERIES HODGSON LANE SURGERY 01964 671999 HODGSON LANE ROOS HU12 OLF 0844 4773572 THE SURGERY ST PATRICK’S GREEN PATRINGTON HU12 OPF