East Kent Coastal Teaching Primary Care Trust

Service Level Agreement for The Supply of Palliative (and Urgent) Care Medication by Community Pharmacies 2011-2013Page of 15 Author Balraj Minhas Version 2.0 Responsible Committee Primary Care Development Committee Ratified by Enhanced Service Commissioning Group Date Issued Review Date Contact Point for Queries 01474 360585 Contents Page 1 Service Aims...... 2 2 Standards...... 2 2.1 Standards for Better Health...... 2 2.2 Clinical Audit...... 2 2.3 Indemnity...... 2 2.4 Training...... 3 2.5 Confidentiality...... 3 2.6 Complaints...... 3 3 Service Specification...... 4 3.1 Information Requirements for Pharmacies Offering the Palliative (and Urgent) Care Service…………………………………………………………………………………………5 3.2 Record Keeping Requirements...... 5 3.3 Quality Service Indicators...... 5 3.4 Variations...... 6 3.5 Disputes Resolution...... 6 3.6 Reasonable Endeavours...... 6 3.7 Adjudication………………………………………………………………………………….. 6 3.8 Termination...... 6 4 Performance Management...... 7 5 Palliative Care Formulary...... 7 6 Service Provision Localities/Service Provider Selection Process...... 7 7 Finance Details...... 7 8 Stock holding 7 9 Signature Sheet...... 8 Appendix 1 West Kent PCT Palliative (and Urgent) Care Medicines Service Formulary...... 9 Appendix 2 West Kent PCT Palliative (and Urgent)Care Medicines Service Pharmacy list..101 2 1 Service AimsThe aim of this service will be to: Improve and ensure the availability of palliative care medicines from community pharmacies.  Provide community pharmacists and healthcare professionals with contact details of pharmacies in their locality who have committed to stock the full range of palliative care medication as per the NHS West Kent Palliative Care (and Urgent care) Formulary. Support and provide up to date information and advice on prescription writing and dispensing in order to reduce the number of difficulties experienced by carers and relatives in obtaining supplies.2 Standards All providers will be expected to adhere to the standards as laid out in sections 2.1 to 2.72.1 Standards for Better HealthProviders must comply with Standards for Better Health (SFBH) as set out in Annex A of ‘National Standards, Local Action: Health and Social Care Standards and Planning Framework 2005/2006–2007/2008’ (July 2004) http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/do cuments/digitalasset/dh_4086666.pdf and be able to evidence compliance on an annual basis as set out by the PCT. Achieving standards required through the PCT monitoring of the Pharmaceutical Services Contract will provide evidence of compliance with SFBH. 2.2 Clinical AuditThe provider must agree to participate in any PCT-led clinical audits associated with this enhanced service.2.3 Indemnity The provider will maintain personal indemnity insurance for services carried out as part of this SLA.The provider will set up and maintain indemnity insurance against all costs, claims, demands, liabilities and damages incurred or suffered by them as a result of any act or omission of the provider, its staff or agents (unless due to the negligent, careless or reckless act or default of the PCT or employees in relation to this agreement).The provider will maintain Public Liability Insurance for the Practice premises.3 2.4 Training The provider will ensure that all staff involved in providing any aspect of care under this scheme has the necessary training and skills to do so. The provider will ensure sufficient members (including locums) of staff are trained to ensure provision of the service in the event of unforeseen absence or termination of employment. 2.5 ConfidentialityThe provider (this term includes its employees, agents and all others authorised by it) shall respect the confidentiality of all information relating to patients, carers or other users of the service. They will comply with The Confidentiality and Disclosure of Information: Caldecott, the Data Protection Act 1998 and all other relevant legislation. This requirement does not preclude appropriate sharing of information where proper legal authority for such sharing exists.2.6 ComplaintsIn the event of a complaint being made by a member of public regarding the provider (this term includes its employees, agents and all others authorised by it) then the provider will deal with the complaint under their own complaints procedure. Details of such complaints will be made available to the PCT once a formal complaint has been made by a member of the public. 4 3 Service Specification This service will be available to any patients with a valid NHS prescription, including housebound patients, during all the opening hours of the pharmacy. This does not specifically have to relate to only NHS West Kent patients.  This service is aimed at the prompt supply of palliative care, and in some cases urgent care, medicines, the demand of which may be urgent and/or unpredictable.  The pharmacy will stock the complete quota of palliative care (and urgent care) formulary drugs.  Pharmacies are required to dispense promptly and accurately all NHS prescriptions presented in accordance with the formulary. This may include telephoning suppliers to confirm delivery of extra stock.  When a pharmacy has insufficient stock to fulfil the NHS prescription, the pharmacy should supply sufficient medication to last for the period that re-stocking will take. If this is not possible then patients/carers and/or relatives requiring medication must be informed of other pharmacies participating in the Palliative Care Service, where they can obtain their medicines.  Pharmacies must ensure that stocks of these drugs are maintained at the minimum stated stock level on the formulary and that they are in date. The pharmacy must have a stock rotation process and record. The quarterly audit information must be submitted to the Pharmacy Contracts Manager, failure to do so may result in non payment for that quarter.  Any stock issued must be replaced within a 24 hour working period. In the event of a delay in replacing stock, then the pharmacy must ensure that this is documented on the quarterly audits. The West Kent Pharmacy Contracts Manager must also be informed.  The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of this service have relevant knowledge and skills and are appropriately trained in the operation of this service. This will include locum pharmacists.  The pharmacy contractor has a duty to ensure that all pharmacists and staff involved in the provision of this service are aware of and operate within local protocols.  The pharmacy contractor must ensure that Standard Operating Procedures are readily available for all staff (including locums) involved in operating under this scheme.  The pharmacy will maintain appropriate records to ensure effective ongoing service delivery and audit.  The pharmacy will provide audit data, as requested, to the Pharmacy Contracts Manager.  The pharmacy will keep patients or their representatives fully informed regarding the supply of medicines.  The pharmacy will plan in advance for increased demand of medication supplies, particularly for weekends and public holidays. This will include5 working closely with prescribers to identify requirements and ensure sufficient stocks of palliative care and urgent care drugs.  Controlled drugs should not normally be supplied without the production of appropriate identification by the patient/carer and/or relatives who are collecting the prescribed medication, in line with current CD best practice.3.1 Information Requirements for Pharmacies Offering the Palliative Care Service An up to date list of pharmacies offering the Palliative Care Service and their opening hours. Contact details for clinician service providers who may need to access the Palliative Care service as applicable. This will aid pharmacies to contact prescribers if necessary. Ensure all staff and locum pharmacists are aware of the arrangements under the scheme to avoid any unnecessary delays with the provision of the service.3.2 Record Keeping Requirements Complete and maintain accurate records, either on computer or paper and these must be available when requested by the PCT. All legal requirements for Controlled Drugs must be adhered to at all times. All pharmacies are required to keep abreast of new developments in this area post Shipman.3.3 Quality Service Indicators The palliative care pharmacies must have reviewed their standard operating procedures to ensure that these are adequate for this service. The pharmacy can demonstrate that all staff involved in the provision of this service has undertaken relevant CPD e.g. the pharmacist has completed the CPPE palliative care programme.6  The pharmacy participates in the quarterly audits requested by NHS West Kent; to ensure full payment for the scheme at the end of the year. The pharmacy co-operates with any locally agreed PCT led assessment of the service and attends any updates provided by NHS West Kent.3.4 VariationsAll variations to this agreement must be formally agreed with the PCT and the provider and confirmed in writing between the points of contact.3.5 Disputes ResolutionIn the event that the provider fails to provide the service as laid out in the specification then the PCT will refer the service faults in writing to the provider’s point of contact within ten working days of the service failure being identified. The point of contact will, within ten working days from receipt of notification, either rectify the fault or confirm agreed action in writing.In the event of a fault not being rectified reasonable endeavours come into action.3.2 Reasonable EndeavoursIn the event of a disagreement or dispute not being resolved as above, then the senior partner of the provider and a senior manager of the PCT will meet and use reasonable endeavours to resolve the dispute without resorting to adjudication.3.3 AdjudicationSuch disputes should be addressed directly to either the FHSAA(SHA), 30 Victoria Avenue, Harrogate HG1 5PR or where appropriate the local Strategic Health Authority.3.4 TerminationTermination of this agreement may be made by giving no less than 3 months notice in writing to the point of contact.7 4 Performance ManagementThe PCT will hold review meetings on an annual basis, and will cover the strategic planning of the service and performance management. As part of this review, the provider may be asked to provide information and / or attend. At least four weeks advance notice will be given of any performance meeting.5 Palliative Care FormularyThe Palliative Care Formulary has been agreed by a number of clinicians including hospice clinicians, pharmacists, and GPs. Although, this formulary mainly contains palliative care medication, selected pharmacies may be required to stock additional urgent care medication. A copy of the Palliative Care( and Urgent care) Formulary is shown in Appendix 1. This formulary will be reviewed annually and so could be subject to change.6 Service Provision Localities/ Service Provider Selection ProcessThe PCT will select pharmacies to offer the service in each locality. Pharmacies with the longest opening hours and ease of access will be preferred.7 Finance DetailsThis agreement is to cover a period of two years from 2011 until 2013.£100 per quarter will be paid to all pharmacies operating under this scheme providing all audit information and stock information requested has been provided to the PCT Pharmacy Contracts Manager on a quarterly basis and requirements as laid out in this document have been met. 8 Stock holdingAll pharmacies operating under this scheme are expected to hold at least the minimum quantities of stock as listed in the Palliative (and Urgent) Care Formulary. The initial stocking of the drugs, and any medication that goes out of date, will be met by the PCT. The re-stocking of drugs to replace dispensed drugs will be met by the Pharmacy as reimbursement for the items dispensed will come from the Prescription Pricing Division.8 The PCT will supply additional CD kits, as required, for the destruction of out of date palliative care drugs. The cost of re-stocking of out of date drugs will be met by the PCT.99 Signature Sheet This document constitutes the agreement between the provider and the PCT in regards to this enhanced service.Name of provider…………………………………………………………………. Address of provider………………………………………………………………. ………………………………………………………………………………………. ………………………………………………………………………………………. ……………………………………………………………………………………….Signature on behalf of the provider: (The signatory is also agreeing that he/she is authorised by the provider to sign on their behalf)Signature Name DateSignature on behalf of the PCT:Signature Name DatePharmacy Name:10 Appendix 1 NHS West Kent Palliative Care Medicines Service FormularyPREPARATION PACK SIZE QUANTITY Alfentanil injection 0.5mg/ml 10 1x10 Dexamethasone 2mg tabs 50 1 x 50 Dexamethasone phosphate 4mg/mL inj. 5 1 x 5 Diamorphine amps 10mg 5 1 x 5 Diamorphine amps 30mg 5 2 x 5 Glycopyrronium Bromide 200mcg/mL, 1mL inj. 10 2 x 10 Haloperidol 1.5mg tabs 28 1 x 28 Haloperidol 5mg/mL, 1mL inj. 5 1 x 5 Hyoscine butylbromide 20mg/mL, 1mL amps 10 2 x 10 Levomepromazine 25mg/mL, 1mL amps 10 2 x 10 Levomepromazine tablets 84 1 X 84 Metoclopramide 10mg tabs 28 1 x 28 Metoclopramide amps 5mg/mL, 2mL 10 2 x 10 Midazolam amps 5mg/mL, 2mL 10 2 x 10 Morphine solution 10mg/5ml 100m 2 x 100ml Oxycodone injection 20mg/2ml 5 2 x 5 Oxycodone Liquid 5mgl5ml 250ml 1 x 250ml Water for injection 10mL 10 1 x 10Urgent Care Medicines11 Appendix 2 NHS West Kent Palliative Care Medicines Service Pharmacy list Link Pharmacy 88a King Street, Maidstone, Kent, ME14 1BH 01622 752990Sainsburys Pharmacy Otford Road, Sevenoaks, Kent, TN13 5EG 01732 469198Boots UK Ltd 7-9 Calverley Road, Tunbridge Wells, Kent, TN1 2TE 01892 526486Sainsburys Pharmacy Quarry Wood Industrial Estate, Mills Rd, Aylesford, ME20 7NA 01622 701820Boots UK Ltd South Mall, Bluewater Park, Dartford, DA9 9SJ 01322 624780Lloyds Pharmacy 68-70 West Hill, Dartford, DA1 2EU 01322 311753Asda Pharmacy Thames Way, Gravesend, DA11 0DQ 01474 543410Thales Pharmacy 31 Azalea Drive, Swanley, BR8 8HS 01322 664659OUT OF HOURS SERVICE PROVIDED BY: Hodgson Pharmacy, 59 Station Road, Longfield, DA3 7QA 01474 707341 Echo Pharmacy, Oakfield Health Centre, Off Windsor Rd, DA12 5BW 01474 533754 Pender Pharmacy, 2 Milton Road, Gravesend, DA12 2RE 01474 323828 Singlewell Pharmacy, 133 Singlewell Road, DA11 7QA 01474 533674 Williams Chemist, 120 Vale Rd, Northfleet, DA11 8BS 01474 533079 Hawkhurst Pharmacy, 1 The Colonnade, Hawkhurst, TN18 4ES 01580 753222 Saxon Warrior Pharmacy, The Square, Lenham, ME17 2PG 01622 858287 Lloyds Pharmacy, 97 Heath Road, Coxheath, ME17 4EH 01622 745567 Marden Pharmacy, The Square, High St, Marden, TN12 9DP 01622 831495 Paydens Pharmacy, 12-16 Martin Square, Larkfield, ME20 6QJ 01732 843203 AE Hobbs, 72 Mount Pleasant, Tunbridge Wells, TN1 1RJ 01892 546565 Imperial Pharmacy, 4 The Pantiles, Tunbridge Wells, TN2 5TN 01892 52563012 Thompson Chemist, 1a Riding Lane, Hildenborough, TN11 9HX 01732 833433 Hadlow Pharmacy, The Square, Hadlow, TN11 0DA 01732 850259 Gosrani Pharmacy, 11 Martin Hardie Way, Tonbridge, TN10 4AE 01732 35595613

East Kent Coastal Teaching Primary Care Trust

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