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Public Health Service Specification for the Provision of a Pharmacy Local Commissioned Service

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Public Health Service Specification for the Provision of a Pharmacy Local Commissioned Service Public Health Service Specification for the Provision of a Pharmacy Local Commissioned Service Smoking Cessation Background Smoking is the greatest single cause of preventable illness and premature death and the single biggest contributor to health inequalities. Locally, according to the Integrated Household Survey the smoking prevalence in Brighton & Hove was 25.2% in 2013 and it is estimated that there are over 50,000 smokers in Brighton & Hove. Brighton & Hove City Council has commissioned a Hospital Smoking Cessation Lead at the Royal Sussex County Hospital. This post will support inpatients, outpatients and staff who wish to quit smoking and also deliver and provide all level 2 training and update meetings for practice nurses, health care assistants, pharmacist and pharmacy assistants to provide this locally commissioned smoking cessation service. Healthy Lives, Healthy People, A Tobacco Plan for England was published in March 2011 and focuses on the action that the Government will take nationally to drive down the prevalence of smoking. The Government has set 3 national ambitions:- 1. Reduce smoking prevalence in England to 18.5% or less by the end of 2015, meaning around 210,000 fewer smokers a year. 2. Reduce smoking prevalence among young people in England to reduce rates of smoking among 15 year olds in England to 12% or less by 2015. 3. Reduce smoking during pregnancy in England to reduce rates of smoking throughout pregnancy to 11% or less by end of 2015 measured at time of birth. With the publication of the Public Health Outcomes Framework in 2013 progress can be monitored against the 3 above ambitions through national and local comprehensive tobacco control action. Smoking cessation advice is a skilled activity and should be delivered by health professionals properly trained to deliver the service in accordance to 1The Shropshire Help 2 Quit model and monitored to 2The Russell Standard. This locally commissioned service specification outlines how the service will to be provided under a contract with Brighton and Hove City Council. 1 Kevin Lewis (1995) Shropshire County and Telford and Wrekin PCTs Help 2 Quit service 2West, R. (2005) Assessing smoking cessation performance in NHS Stop Smoking Services: The Russell Standard (Clinical). Available from: http://www.ncsct.co.uk/publication_The-Russell-Standard.php 2016 -2019 Page 1 of 12 Aims of the Service The primary purpose of the smoking cessation service is to reduce the number of smokers by providing evidence-based treatment and behaviour support to smokers making quit attempts which will reduce smoking prevalence and smoking related illnesses and deaths. The smoking cessation service will be delivered in line with the most recent evidence based practice recommendations for stop smoking services issued by the National Institute for Health and Care Excellence (NICE) and Local Stop Smoking Services: Service and delivery guidance 2014 published by PHE. The smoking cessation service in pharmacies will provide one to one support and /or group sessions to people who want to give up smoking. The service will help to increase choice and improve access to Stop Smoking Services. The pharmacy smoking cessation advisors will promote national and local campaigns such as No Smoking Day, Stoptober and New Year Campaigns. The pharmacy smoking cessation advisors will help facilitate access to, and where appropriate supply, relevant stop smoking pharmacotherapy. The service will help clients to access additional treatment by offering referral to specialist services and other healthcare professionals where appropriate such as health trainers, drug and alcohol services, weight management, physical activity and mental health provision. Service Outline The service cessation service offered by the pharmacy must be provided in accordance with the smoking cessation training offered by the Smoking Cessation Service Lead Royal Sussex County Hospital (RSCH) and the NCSCT stage 1 and 2 on line assessment. The smoking cessation service offered by the pharmacy should be promoted by the whole pharmacy team. The pharmacy will purchase their own carbon monoxide monitor or have a loan machine and be responsible for the infection control and supply of mouthpieces, wipes and the calibration of the monitor according to the manufacturer’s instructions If the pharmacy ceases to provide the service, then the Smoking Cessation Service Lead (RSCH) must be informed. If the pharmacy then wishes to offer this provision again, the Smoking Cessation Service Lead (RSCH) must be informed so that eligibility to provide the service can be assessed. The pharmacy is required to take part in a Brighton & Hove City Council organised audit of the service as and when required, no more frequently than once a year. The pharmacy is required to co-operate with any Brighton & Hove City Council led assessment of service user experience, if required to do so please use the Service User Survey in Appendix 1. Brighton & Hove City Council reserves the right to withdraw or amend this service with 3 months’ notice. The Pharmacy has the right to withdraw from the service and inform the Smoking Cessation Service Lead (RSCH) by giving 1 month’s notice. 2016 -2019 Page 2 of 12 Training All pharmacists (including Locums) wishing to provide a smoking cessation service will need to have the appropriate Harmonisation Accreditation Group qualification (HAG), which includes completing the CPPE Stop Smoking CD Rom (order no: 37026), reading two publications3 and attendance at a local workshop. All pharmacy smoking cessation advisors must attend and complete the Level 2 Smoking Cessation Training (course details are in the pharmacy handbook) provided by the Smoking Cessation Service Lead (RSCH). See Appendix 4 for dates. All pharmacy staff delivering the service must successfully complete the NHS Centre for Smoking Cessation and Training online training for level 2 advisors stage 1 and 2 assessments (www.ncsct.co.uk). Records of completing this must be submitted to the Hospital Smoking Cessation Coordinator within the first year of delivering the service. All trained pharmacy smoking cessation advisors must attend 2 out of 3 update training sessions per year provided by the Smoking Cessation Service Lead (RSCH). See Appendix 4 for dates. Any Pharmacy smoking cessation advisor who has not delivered any stop smoking clinics for one year must attend a refresher 2 day intermediate training facilitated by the Smoking Cessation Service Lead (RSCH). When a trained smoking cessation adviser leaves the pharmacy, it is essential that the Smoking Cessation Service Lead (RSCH) is advised. Responsibilities of the Pharmacy The pharmacy has a duty to ensure that practice based smoking cessation advisors and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the smoking cessation service. The pharmacy provides its own carbon monoxide monitor, consumables and ensures that the monitor is calibrated according to the manufacturer’s instructions. The Gold Standard Monitoring Form (Appendix 2) must be submitted on time to the Smoking Cessation Service Lead (RSCH) so that all quarterly data can be collated and submitted to the Health & Social Care Information Centre (dates will be confirmed at the beginning of this contract). The completed template for payments (Appendix 3) must be submitted electronically and on time following a request from the Public Health Business Manager by email. Pharmacotherapy The Council will only pay for the recommended standard operating procedure for pharmacotherapy, for example 12 weeks of NRT or Champix or 8 weeks of Zyban 3 Helping smokers to stop: advice for pharmacists in England” (ISBN 1-84629-035-X) published by NICE, RPSGB and Pharmacy Health Link and “Brief Interventions and Referral for Smoking Cessation in Primary Care and other Settings (Public Health Intervention Guidance No 1)” published by NICE 2016 -2019 Page 3 of 12 The pharmacy will provide up to 12 weeks only of NRT products per client under this contract. NRT charge / exemption The client should be charged £8.20 (or the current prescription charge) per item of NRT dispensed (i.e. if a combination of 2 items is supplied this would constitute two charges). Patients who are exempt from prescription charges should complete the Payment Exemption Form (please refer to the pharmacy handbook), which should be retained in the pharmacy for 7 years for audit purposes. The payment exemption form does not need to be returned to Public Health Team at the Council. If the patient is exempt from prescription charges, and has signed an NRT payment exemption form, full payment will be received from Public Health Record keeping The pharmacy must collect accurate data from each patient as required by the Brighton & Hove City Council and complete all fields of the Gold Standard Monitoring Form (Appendix 2) and submit to the Smoking Cessation Service Lead (RSCH) following a 4 week quit outcome. The pharmacy must maintain appropriate records to ensure effective ongoing service delivery and audit. The pharmacy must submit appropriate data on time for payments as set out in this contract. Pricing Pharmacies will be paid a quarterly basis. Payments will be made based on the information submitted to the Smoking Cessation Service Lead (RSCH) and on the Brighton & Hove City Council quarterly template (Appendix 3). For all patients who access a new smoking cessation programme from 1 April
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