NHS Lanarkshire Smoking Cessation Pharmacy Improvement Project: Pharmacy Guidance Pack Online Version Only
1 Online Version Only - PIP Visit Packs 2020-2021 Updated: January 2020 Review: January 2021
Contents Page: 1. Support Letter from George Lindsay, Chief Pharmacist, Page 3
NHS Lanarkshire 2. Pharmacy Improvement Project Contact Details Page 4
3. Smoking Cessation Service Specification August 2017 – Key Changes Page 5
4. Pharmacy Care Record System Page 8 a. PCR Hints and Tips b. PCR Screen Shot Guide c. PCR Data Recording Flow Chart 5. Cycle of Change Page 17
6. Motivational Interviewing and Behaviour Change Page 18
7. Carbon Monoxide (CO) Monitoring Page 19
8. Useful Forms and Information Page 20 a. Resources Order Form i.e. mouthpieces etc. b. Follow up request to NHS Lanarkshire c. 4 week & 12 week certificates d. Smoking in Pregnancy e. Medicines Q&A’s: What are the clinically significant drug interactions with cigarette smoking? 9. NHS Lanarkshire Varenicline PGD Information: Page 30
a. Appendix 1: NHS Lanarkshire Varenicline PGD (Community Pharmacists) b. Appendix 2: NHS Lanarkshire Varenicline PGD Risk Assessment Form c. Appendix 3: NHS Lanarkshire Varenicline PGD GP Notification Letter d. Appendix 4: NHS Lanarkshire Varenicline PGD GP Referral Letter
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1. Support Letter from George Lindsay, Chief Pharmacist
TO ALL COMMUNITY PHARMACISTS IN NHS LANARKSHIRE PLEASE SHARE WITH ALL LOCUMS AND SUPPORT STAFF AS APPROPRIATE
SMOKING CESSATION SUPPORT
As you know smoking cessation is a very important service and the community pharmacy contributes significantly to the health board and national targets for smoking cessation.
We are constantly learning and seeking to improve on the services delivered and achieve this through our Community Pharmacy Smoking Cessation Improvement programme. This initiative has the backing of myself and Community Pharmacy Lanarkshire and has very experienced and able community pharmacists such as Heather Donaldson (Boots), Nicola Cairns (Lloyds), Alex Thurlow (independents) and Victoria Radford (Community Pharmacy Lanarkshire) involved.
The purpose of this letter is to let all community pharmacies know that support from the Pharmacy Improvement Project (PIP) Team is available. This is over and above the visits from Pharmacy Champions which cover smoking cessation but a range of other issues. Should you want to contact the team on a proactive basis details are:
[email protected] 01698 201 427
Pharmacy visits to localities and community pharmacies are scheduled to build a rapport and offer support and training. You will be contacted by telephone to explain a little around the support being offered and to arrange a suitable time to visit the pharmacy. The PIP team is sensitive to the urgency of work ongoing within community pharmacies. If there is a desire for a more in-depth follow up visit this can be arranged for a mutually convenient time.
I hope you will welcome a member of the PIP team when they arrange visits and I will make sure that this e-mail reminding everyone of the context is sent to all pharmacies in the localities they intends to visit a few days beforehand.
Regards George Lindsay, Chief Pharmacist, Primary Care NHS Lanarkshire Headquarters Kirklands Hospital, Fallside Road Bothwell G71 8BB Tel 01698 858128 Fax 01698 858271
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2. Pharmacy Improvement Project Contact Details
Pharmacy Improvement Project 14 Beckford Street, Hamilton ML3 0TA Office: 01698 201427 [email protected]
Ciaran Bennett – Higher Clerical Officer [email protected] 01698 201 427
Heather Donaldson – Pharmacy Champion NHS Lanarkshire (Boots Pharmacist) [email protected] 07958 615 667
Claire McCririck– Project Manager [email protected] 01698 201 427
Contact details for NHS Lanarkshire Specialist, Mental Health and Pregnancy Services (Clients can be passed to the services below if they have had 3 or more previous quit attempts or if Pharmacist believes they would benefit from the Specialist support).
Contact Locality/Area Email address Number Bellshill Motherwell 01698 366 979 [email protected] Wishaw
Airdrie Coatbridge 01236 707 714 [email protected] North East Kilbride Hamilton Cambuslang 01698 723 233 [email protected] Rutherglen Clydesdale Pregnancy 07811 840 351 [email protected] Mental 01698 456 219 [email protected] Health
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3. Smoking Cessation Service Specification August 2017 – Key Changes
The Community Pharmacy Smoking Cessation Service forms part of the Public Health Service portion of the Pharmacy Contract.
In August 2017, Scottish Government issued a Revised National Service Specification advising of changes to the service.
Key Changes In Lanarkshire, the formulary has been updated so that Varenicline and Nicotinell patches are now JOINT FIRST LINE.
The Varenicline PGD for Lanarkshire was updated in November 2018 and can be found on the NHS Lanarkshire Community Pharmacy website here:- https://www.communitypharmacy.scot.nhs.uk/media/1611/community-pharmacy-pgd-for- varenicline-nov-2018.pdf or https://www.communitypharmacy.scot.nhs.uk/nhs-boards/nhs- lanarkshire/stop-smoking-service/
Varenicline has had the black triangle removed as a result of the findings in the EAGLES trial, and as a result the references to this drug have been updated, as have some of the associated forms. The updated Varenicline Clinical Risk assessment form and GP letter template can be found as Appendices C&D. Please make sure you are using the most up to date versions!
Most notably, if a client has a history of psychiatric illness, the default is no longer to refer to the GP. Instead, the pharmacist should refer to the PGD and if appropriate can commence treatment, monitoring the client closely.
The NES training module on Varenicline has now been revised and pharmacists are expected to undertake the updated training which is available on TURAS. Pharmacists must have completed this training and returned the signed PGD form before they can prescribe under the revised PGD.
SERVICE OUTLINE AND PRACTICE REMINDERS The service should be delivered from premises that can provide an acceptable level of confidentiality such as a consultation room The service is available to any person aged 12 or over. Consent of a parent or legal guardian is required if the person is under 13 years of age The person must be registered with a GP in Scotland The service must be available throughout standard opening hours All pharmacists and support staff who deliver the service must be trained to nationally recognised standards. This can be either the NES training available online or face to face training offered by your Health Board The service can be publicised using materials made available by Scottish Government, NHS Boards, NHS Health Scotland or relevant pharmaceutical companies
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Data about service activity and outcomes is recorded via the PCR. MDS data are electronically submitted from PCR to the National Smoking Cessation Database. Data is uploaded from the PCR to ISD once a week overnight from Wednesday to Thursday so it is really important that all your data is added to the PCR by close of play on a Wednesday.
We should PROACTIVELY seek out individuals who would benefit from the service within the pharmacy e.g. patients with cardiac or respiratory disease, pregnant women, young people and lower socio-economic groups, in other words, from the most deprived areas. What are you doing to drive this?
On the first visit to the pharmacy, the client should be asked to set a provisional quit date (not entered on PCR at this stage) and return to receive their first supply of pharmacotherapy. The return date is flexible, and can be anything from a day to over a week later from the initial contact. Assessing readiness to quit is subject to professional judgement. In exceptional circumstances, we may decide to start the quit attempt on the first visit, if the client is sufficiently prepared with their own planning to be able to commence straight away. Indeed there are some groups we would always want to start straight away e.g. pregnant women, patients who have been started on pharmacotherapy in hospital, patients referred by their GP.
PCR GUIDANCE The quit date should NOT be set on the PCR until the client returns for their Week 1 visit (including selection and prescribing of pharmacotherapy). Also, please be aware that the Quit Date refers to the date the patient STARTS the quit attempt, not the end of the 12 week programme Submitting the quit date on the PCR triggers the first payment of £30 Every client for whom a quit date is set on the PCR should have their 4-week MDS data submitted via the PCR, regardless of whether they are still attending. This will trigger the second payment of £15 Every client who is recorded as smoke-free and thus still on the service at 4 weeks should have their 12-week MDS data submitted – again regardless of whether they have continued to be successful with their quit attempt. This triggers the third service payment of £35 If the client is lost to follow up after 4 weeks, we should continue to attempt contact up to Week 6 and record this on the PCR and submit the 4 week MDS as Lost To Follow Up.• If they are lost to follow up at 12 weeks, we should then submit the 12 Week MDS as Lost To Follow Up Once a quit attempt has ended (successfully or not) and the appropriate MDS submissions have been made at the appropriate times, the quit attempt must be closed on the PCR. Leaving these open has a serious effect on the quality of the National Dataset and can prevent subsequent quit attempts from being processed properly If the client is Lost To Follow Up at 12 weeks we should also pass their details to the NHS Lanarkshire Stop Smoking Team so that they can attempt to follow up with the client. If they are able to contact the patient and the patient is not smoking this will count as a successful quit. This can be done using the form on the NHS Lanarkshire Community Pharmacy website under “Request for NHS Lanarkshire Stop Smoking Service to attempt to follow up”• CO monitoring should be offered at every appointment, and is a mandatory requirement for weeks 4 and 12
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The Reports function on the PCR should be accessed EVERY WEEK to minimise records expiring AND facilitate weekly follow ups with patients who have not attended the pharmacy in the last 7 days. If we do this every week, it will minimise the number of patients whose records are due to expire and/or awaiting 4 or 12 week follow up
To ensure we are providing our patients with the best care possible we should follow up with them every week and record the contact/contact attempts on the PCR. Use the “No interactions in the last seven days” report to help you with this Other reports we should be using weekly are:- • Expiring within the next seven days • No quit date set • Awaiting 4 or 12 week follow up
FINAL HINTS & TIPS For every client we should record weekly contact/contact attempt AND the Week 1, 4 and 12 MDS submissions When we submit the Week 4 and 12 Minimum Datasets we must also amend the Pharmaceutical Usage section on the Initial Data Capture AND update the products used. Ie at Week 4 the pharmaceutical usage should be updated to 4 weeks and the products used entered (eg NRT single product, NRT dual therapy, Varenicline) AND the same again at Week 12. If we do not do this, it generates an error record at the Health Board end and gives them a lot of extra additional work.
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4a. PCR Hints and Tips
The Smoking Cessation reports should be accessed and actioned at least once a week
Report - Expiring within the next seven days should be actioned as a priority. Every effort should be made to follow up with these clients and release and submit their 4 or 12 week MDS. If the 4 week MDS is not submitted within the required timescales, the quit attempt cannot proceed on the PCR and you will not be paid
Report - Awaiting 4 or 12 week follow up. This report highlights those patients due to have these reviews done and represent a significant milestone on their journey to stop smoking for good. A CO reading MUST be taken at these points to confirm the quit unless the follow up is not carried out face to face, in which case there is an option to select that when you are submitting the data. This is also a fantastic opportunity to celebrate success with your patients! NHS Lanarkshire has produced Achievement certificates which have been sent out to the Boots stores involved in the Test of Change and I am sure we can share these more widely as they can be a great motivational tool.
Report - Patients with no interactions in the last seven days. Actioning this report will MAKE OR BREAK YOUR SMOKING CESSATION SERVICE As part of the Service Spec, we as pharmacists have a RESPONSIBILITY TO FOLLOW UP WITH OUR PATIENTS ON A WEEKLY BASIS. This is not a nice to do. This is not an added extra. At the initial data capture the client consents to follow up and it is up to us to make sure this happens every week. IF WE ACTION THIS REPORT AT LEAST ONCE A WEEK, THE OTHER REPORTS WILL LOOK AFTER THEMSELVES!
Report - No quit date set. If a patient has had their initial consultation but not returned to the pharmacy to set a quit date, they will appear on this report. Actioning this report will allow us to encourage the client back to the pharmacy where we can support them and set a quit date.
In addition: Always enter the patients contact number on their record and never the pharmacy telephone number. If this happens, the record will not be processed. If the patient does not have a contact number, enter “Unknown.” Every effort must be made to obtain this information as follow up is a vital part of the service.
Shared care between Pharmacy & non-pharmacy services – only tick YES if the patient is being supported by the community or hospital stop smoking service e.g. has recently been discharged from hospital and set quit date whilst there.
Pharmaceutical usage and number of weeks used MUST be updated at the time of the 4 week & 12 week submission. Initial data can only be updated at this time once the quit date is set.
Every client setting a quit date MUST be followed up at 4 weeks whether they have attended or not. You have until week 6 after the quit date to submit the follow up. Three attempts should be
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made to contact the patient. If unable to contact them, enter “Lost to follow up” then complete the assessment. This will ensure payment for the pharmacy.
If the 4 week submission is missed and the client is not smoking, you will be unable to submit the 12 week data.
Should this be the case, or, if you have missed the cut off for the 12 week follow up, contact the support office when the client has completed the 12 week course and they will enter the data for you and arrange your payment. NB This is only for 12 week follow ups.
The 12 week follow up submission should be made between week 12 and 14. If unable to contact the patient, lose to follow up and let the support office know as they will then attempt contact.
Only complete the assessment when the client has been contacted at 4 weeks and is a smoker or lost to follow up or when the 12 week submission has been made.
To ensure follow ups are not being missed, best practice would be to make one or two staff members responsible for checking the reports section of PCR at a set time each week for follow ups due or contacts to be made.
If a patient has smoked in the two weeks prior to the 4 week follow up they must be entered as unsuccessful and the record closed. If assessed as still motivated to stop you will be required to make a new record with a new quit date. It is preferable that this is made the following week as the system cannot differentiate between the old record closing and the new record starting and this will cause an error to occur.
If a patient has smoked less than 5 cigarettes between the 4 week and 12 week follow up this is still counted as a successful quit at 12 weeks.
Data is uploaded from your PCR to ISD only once a week on a Wednesday night into Thursday morning so ALL data entries must be complete by close of play on Wednesday for your data and pharmacy payments to be correct.
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4b. PCR Screenshot Guide
Before starting a new assessment check the following: Does the patient consent to Follow Up? – If No, do not proceed. If yes, inform the patient that they may be contacted for follow up by NHS Scotland via text, call, e-mail or letter.
PCR will check for other quit attempts at other community pharmacies recorded in the last 12 weeks. If identified, a new quit attempt cannot be started unless undertaken at the same pharmacy as the previous attempt. Selecting the patient It may be necessary to create a record for the patient A CHI look up function is available (CHI is mandatory) The mandatory patient information for smoking cessation patients differs from the normal PCR requirements. It is necessary to record the following additional information: o Address 1 o Post Code – Please ensure this is entered correctly and in full or submission will be rejected. o Home Phone Number – NB Pharmacy telephone number must NOT be used as the record will be rejected. If the client does not have a telephone number, write UNKNOWN. Follow up is an important part of the programme and obtaining a correct contact number is necessary. o As many methods of contact as possible should be obtained e.g. e-mail, mobile number
Submission of data sets After each submission check that the Minimum dataset section Status is shown as ‘Validated’ and the Release Status as ‘Submitted’.
Reimbursement A UCF4 form should still be completed for reimbursement purposes. The patients CHI number should be included. Initial Data Capture
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See note on Page 1
Record the date on the referral or
the date of initial patient contact and tick the box for the appropriate referral source.
Select Pharmacy
Record date of first contact and select e.g. One to one sessions
Where Varenicline is selected additional questions will be presented
Select type of therapy and record number of weeks used so far (Only if patient has already started record number of weeks, otherwise 0)
IMPORTANT NOTE: These fields must be updated before each of the subsequent submissions. (Update with the number of weeks used at 4 & 12 week submission) 11 Online Version Only - PIP Visit Packs 2020-2021 Updated: January 2020 Review: January 2021
Start Quit Attempt and Confirm Quit Date
Before recording the quit attempt information any missing data will be highlighted. Use the Edit initial data capture or Edit patient links to update.
The quit date is not editable and drives the dates for the 4 week and 12 week submissions. It is recommended that at the point of initial appointment a provisional date is discussed but only recorded at the point of the first return appointment.
You should therefore click the Cancel Button when the Confirm Quit date and record contact screen is displayed after entering the initial data. When the client returns on the agreed date (around 7 days after initial visit) use the link in the Next Action section to record the quit date and first contact.
Record Quit date, this should be within the next few days Record the Contact date, this can pre-date the Quit date to allow for supply of product in preparation of quitting
Where Varenicline is provided follow-up consultations must be undertaken by the pharmacist
The data will be electronically submitted
when the Confirm quit
date button is clicked. Please continue to follow local Formulary guidance when supplying products.
**If appropriate e.g. patient is sufficiently prepared the quit date and contact can be recorded at the initial appointment. This also includes patients who have already commenced pharmacotherapy**
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Recording a Contact Record a contact each week as current practice. If this is not possible record the date and type under the Contact attempt section.
CO monitoring is a requirement at weeks 4 and 12 post quit
Please follow current Formulary guidelines and use the box to the right of the appropriate option.
Submit 4 Week Data The link to release the data will be made available in the Next Action section between 4 and 6 weeks.
IMPORTANT NOTE: If you miss the 6 weeks deadline it will not be possible to make a submission and payment will not be made.
If the patient was not successfully contacted at the 1 month follow up, or has smoked it will not be possible to progress to the 12 week submission.
Before submission it is necessary to update the Pharmaceutical usage and Pharmaceutical usage week’s fields in the initial data capture. Use this link to access the fields. 13 Online Version Only - PIP Visit Packs 2020-2021 Updated: January 2020 Review: January 2021
If smoking or lost to follow up at 4 weeks, submit the data then go to “Assessment Completion” section and enter Unsuccessful or Lost to follow up. This will close the record down.
Submit 12 Week Data The link to release the data will be made available in the Next Action section between 12 and 14 weeks.
It is not possible to submit the data if this submission window is missed and payment will not be made. If the 12 week follow up is missed please contact the support office on 01698 201427.
Complete the details following the guidance given above for the 4 week submission.
Recording the Assessment Outcome If at any point the patient is no longer attending the pharmacy and is not contactable, it should be recorded in the Assessment completion section as Client lost to follow up.
If the patient is found to have smoked in the 2 weeks prior to the 4 week submission or smoked more than five cigarettes since the last submission at week 12 an Unsuccessful result should be recorded. If at the 12 week submission they have smoked less than 5 cigarettes since week 4 it should be recorded as successful.
If the patient has quit at week 12 then the assessment should be recorded as Successful.
At least 3 separate attempts must be made to contact the patient at week 4 and 12 before recording that they have been lost to follow up.
If recording as lost to follow up at 12 weeks, contact the support office on 01698 201427 with the client details or complete the form on Community Pharmacy website and send in.
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If the 12 week follow up cannot be completed for any reason e.g. 4 week follow up not completed on time therefore 12 week cannot be submitted, then please contact the support office on 01698 201427 or complete the form on Community Pharmacy website and send in. We can then enter the correct information on the database and claim your payment for you.
Smoking Cessation Reports Additional reports have been created to support the smoking cessation service.
It is recommended that you familiarise yourself with these and in particular: Expiring within next 7 days – IF A SUBMISSION IS MISSED IT IS NOT POSSIBLE TO PROCEED AND PAYMENT WILL NOT BE MADE. No interactions in last 7 days 4 week/12 week follow ups due
When viewing the reports please be aware that the Week counter is set Mon-Sun. This means that a patient could have their first contact on a Friday and show as week 1 and then on the following Monday show as week 2.
Best Practice At least 2 staff members to be responsible for checking the reports weekly. Identify a day and time that tends to be quieter. Attempt to contact clients who have not attended and with a follow up due or about to expire. Update the records of clients attending. Close down any records outstanding i.e. Assessment completion section. Contact the support office with any 12 week follow ups that have been missed
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4c. PCR Data Recording Flow Chart
Look up client Complete Discuss but do Client returns CHI required fields not record 5-7 days later Click ‘Next Action’ & record -Quit Date quit date - List contact date - Other appropriate date
No Return – click Pathways as in Smoker/ Lost to Follow Up Click assessment green for Click confirm assessment completion weeks 5-11 quit date completion button button
Week 12 – Non Smoker Submit 4 week Week 4 Record Contact Week Generates first submit week MDS* Info 2 & 3 payment of £30 12 data
Generates third & Generates second If 2 missed visits, record final payment of £35 payment of £15 contact attempts in product & contact notes
Assessment Completion
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5. Cycle of Change
Where is the Client? What’s your job? Not interested in changing behaviour Raise doubt, correct misinformation Thinking about change Tip the balance Preparing to change Help client to plan ahead Making change Help client carry out action plan Maintenance Help client identify strategies to prevent relapse Relapse Encourage client to re-enter process
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6. Motivational Interviewing and Behaviour Change
Five Principles of Motivational Interviewing Express empathy through reflective listening. Develop discrepancy between clients' goals or values and their current behaviour. Avoid argument and direct confrontation. Adjust to client resistance rather than opposing it directly. Support self-efficacy and optimism.
Closed Question Open Question So you are here because you are concerned about Tell me, what is it that brings you here your smoking, correct? today? Do you agree that it would be a good idea for you What do you think about the possibility of to stop smoking? stopping smoking? Do you like to smoke? What are some of the things you like about smoking? How has your smoking been this week, compared What has your smoking been like during the to last: more, less, or about the same? past week? Do you think you smoke too often? In what ways are you concerned about your smoking? How long ago did you have your last cigarette? Tell me about the last time you had a smoke? When do you plan to quit smoking? So what do you think you want to do about your smoking?
Five A’s to Motivational Interviewing
ASK each client what their smoking status is, how long they’ve been smoking and how many they smoked. Find out about their previous quit attempts and they’ve thought about stopping.
ASSESS their motivation to stop using a scale from one to ten saying how interested they are in quitting and secondly how confident they feel about quitting.
ADVISE clients that stop smoking service is here to help and that they are twice as likely to quit with support and use of stop smoking products.
ASSIST clients by preparing them for what to expect. Explain any likely withdrawal symptoms they may experience and how these can be reduced with a stop product.
ARRANGE for the client to read the literature and set a quit date. Sign the client up to come back to the pharmacy on a weekly basis for support and NRT/Champix. If they’re not ready to quit make sure you encourage them to come back in for a chat if they change their mind at a later date.
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7. Carbon Monoxide (CO) Monitoring The following procedure is fairly common to all monitors:
1. Both the client and the stop smoking practitioner should use sanitiser gel on their hands before the test. Hand sanitiser must be alcohol free to avoid damaging the sensor and giving a false reading. 2. Attach a clean, disposable, mouthpiece (a fresh one for each client) to the monitor. 3. Turn the machine on 4. Ask the client to take a deep breath 5. The monitor will count down 15 seconds and beep during the last 3 seconds 6. The client needs to blow slowly into the mouthpiece aiming to empty their lungs completely 7. The parts per million (ppm) of carbon monoxide in the lungs will be displayed on the screen 8. The mouthpiece should be removed by the client (for infection control reasons) and disposed of in a refuse sack which is tied before being placed in another bag for collection (double bagging)to prevent domestic staff touching the mouth pieces 9. The CO monitor should be cleaned between tests using a non-alcoholic wipe
After the test: If test wasn’t completed adequately (i.e. client did not hold their breath for the required time or did not place their lips around the tube properly) then politely advise the client that the test needs to be repeated. Allow them a couple of minutes to get their breath back before repeating the test.
If reading was below 10 parts per million: “This reading is classed as that of a non-smoker; although the normal range for a non-smoker is between 1 and 5 ppm. However, carbon monoxide accumulates in the body and I’m sure that if we were to repeat the test later today or sooner after you’ve smoked it would be much higher. The good news is that if you do not smoke at all after your Quit Date then you can get this permanently down to the levels of somebody who doesn’t smoke.”
If reading was 10 parts per million or above: “The monitor is showing a reading of over 10 parts per million which is the level above which people are classed as a smoker and is what we would expect from you as you are still smoking. The normal range for a non-smoker is between 1 and 5 ppm and so you can see that your reading is ... times higher than what we would expect from a non-smoker. The good news is that if you do not smoke at all after your Quit Date then you can get this down to the levels of a non-smoker”
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8a. RESOURCES ORDER FORM STOP SMOKING SERVICE
NHSL Stop Smoking Service Pharmacy Improvement Project Tobacco Control Team 14 Beckford Street Hamilton ML3 0TA Tel: 01698 201427 or Fax: 01698 201 446 [email protected]
Quantity Quantity TITLE OF MATERIAL required Supplied
Steribreath Mouthpieces/Straws (box = 250)
D-Piece Mouthpiece Adaptors with filter
(box = 12)
Pico Smokerlyzer Carbon Monoxide (CO Monitor)
Wipes – alcohol free (box =100)
Stop Smoking Booklets
Pharmacy stamp/pharmacy name and address
PLEASE FAX FORM TO 01698 201 446 OR EMAIL [email protected]
Pharmacy code
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8b. Follow Up Request to NHS Lanarkshire
REQUEST FOR NHS LANARKSHIRE STOP SMOKING SERVICE TO ATTEMPT TO FOLLOW UP A PATIENT LOST TO FOLLOW UP FROM THE PHARMACY
A requirement of the Smoking Cessation Service Specification is that pharmacies are to follow patients up at 4 & 12 weeks post quit date, to confirm if the quit attempt has been successful: Pharmacies need to complete this between 4 and 6 weeks for all patients For patients continuing with the quit attempt pharmacies must complete this again between 10 and 14 weeks post quit
This information must be recorded on the PCR and Pharmacists should make 3 attempts to follow up each patient. Experience tells us that it is not always possible to contact the patient from the pharmacy and if after 3 attempts the pharmacy have not been able to contact the patient this form should be used to provide NHS Lanarkshire Stop Smoking Service with the clients details so that they can attempt to follow up.
The National Service Specification is such that NHS Lanarkshire must only provide this service for patients who the pharmacy could not follow up between 10 and 14 weeks. In order to meet the required deadlines this information should be provided to NHS Lanarkshire by week 15.
Surname Forename D.O.B. PCR Number 10-14 Follow-up due date range
Signature of Pharmacy staff ______On behalf of contractor Code ______Date ______Please send form to [email protected] or fax 01698 201 446
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8c. 4 & 12 Week Certificates
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8d. Smoking in Pregnancy
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8e. Medicines Q&A’s: What are the clinically significant drug interactions with cigarette smoking?
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9. NHS Lanarkshire Varenicline PGD Information: To access documents: Visit Community Pharmacy Scotland Website (NHS Lanarkshire Stop Smoking Service) * Double click on the links below *
a. Appendix 1: NHS Lanarkshire Varenicline PGD (Community Pharmacists) https://www.communitypharmacy.scot.nhs.uk/media/1611/community- pharmacy-pgd-for-varenicline-nov-2018.pdf
b. Appendix 2: NHS Lanarkshire Varenicline PGD Risk Assessment Form https://www.communitypharmacy.scot.nhs.uk/nhs-boards/nhs-lanarkshire/stop- smoking-service/ Search under ‘PGD and Other Resources
c. Appendix 3: NHS Lanarkshire Varenicline PGD GP Notification Letter https://www.communitypharmacy.scot.nhs.uk/nhs-boards/nhs-lanarkshire/stop- smoking-service/ Search under ‘PGD and Other Resources’
d. Appendix 4: NHS Lanarkshire Varenicline PGD GP Referral Letter https://www.communitypharmacy.scot.nhs.uk/nhs-boards/nhs-lanarkshire/stop- smoking-service/ Search under ‘PGD and Other Resources
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