NHS England nationally commissioned services

NHS Advanced Services

MURs - information, guidance, processes & resources available

Medicines Use Review (MUR) is a service which can be offered to patients by community pharmacists under the Advanced Services of the pharmacy contract; it is also referred to as a Prescription Interventon Service dependent on whether it is a planned or opportunistic consultation and it's outcomes. The aim of the Service is to achieve a concordant approach to medicine taking by:

  • identifying, discussing and resolving poor or ineffective use of their medicines;
  • identifying side effects and drug interactions that may affect patient compliance;
  • improving the clinical effectiveness and cost effectiveness of prescribed medicines and reducing medicine wastage. 

The review is one of medicine use, not a clinical review.

A self-accreditation form can be accessed here (PREM1).   The form must be completed and sent to the Wessex Area Team  together with copies of MUR Certificates for each pharmacist (including locums) intending to deliver the service. The Area Team  will be monitoring compliance with these criteria during a monitoring visit. If pharmacists wish to conduct MURs off premises, they must first fulfill all accreditation criteria and apply to their Area Team for permission using form PREM2.    Guidelines on MURs are available from the PSNC website.

Pharmacist Accreditation

Accreditation can be obtained through a number of sources:

  • The Centre for Pharmacy Postgraduate Education (CPPE); additional guidance is available by clicking here; (for Hints & Tips on Successful Accreditation )
  • Medway School of Pharmacy Skills for MURs programme.

MUR Top Tips are available for many conditions on the Chemist and Druggist website

A new MUR Training resource is available online at: www.murtraining.co.uk/

The NPA and GSK have worked together on two CD-ROM training initiatives: Communications Skills 2 and MURs - making them happen. Both of these are available free of charge to NPA members by contacting the GSK Customer Service Centre on 0800 221441.

Consultation Area

The three criteria for accreditation are:

  • The consultation area is a designated area where both the patient and pharmacist can sit down together;
  • The patient and pharmacist are able to talk at normal speaking volumes without being overheard by other visitors to the pharmacy, or by pharmacy staff undertaking their normal duties;
  • The consultation area is clearly designated as an area for confidential consultations, distinct from the general public areas of the pharmacy.

Whilst not a requirement for MURs, it is recommended that contractors invest in a consultation area which will meet the potential criteria to deliver future commissioned Enhanced Services including an appropriate sink, a networked computer for pharmacist access to patients records during consultations, a panic alarm button and create an inviting, but professional environment. An NPA document on Making Best Use of Consultation Areas is now available.

  AttachmentSizeFile Advanced Service FAQs.pdf56.56 KB 

 

NMS - information, guidance, processes & resources available

For up to date information on the New Medicine Service please go to the PSNC Website. Other resources can also be found on the attachments and websites below:

NPC- www.npc.co.uk

BTS/Sign asthma guideline - www.brit-thoracic.org.uk

Cardiovascular Risk Assessor software- www.heartuk.org.uk/HealthProfessionals/

NICE guidelines- www.nice.org.uk

Department of Health - www.dh.gov.uk

Healthy lives, healthy people -www.dh.gov.uk/en/Publichealth/Healthyliveshealthypeople/index.htm

Healthy living- www.dh.gov.uk/health/category/policy-areas/public-health/healthy-living/

Improving the lives of people with long term conditions- http://healthandcare.dh.gov.uk/improving-the-lives/

NHS Choices - www.nhs.uk

NHS information: includes guidance on all the NMS focus areas covering symptoms, causes, diagnosis, treatment, as well as guidance for patients on living with the condition

Paient.co.uk - www.patient.co.uk

Health information for patients (used by many GP practices); information available on all the NMS conditions as well as other useful tools such guidance on using inhaler devices and peak flow recording and diaries

The National Cancer Institute: information on the relation between smoking and cancerhttp://www.cancer.gov/cancertopics/tobacco/smoking/

 The Quit Smoking Community: http://quitsmokingcommunity.org/

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File NMS Toolkit - Pfizer, Talking Point 2016.png318.43 KB
File NMS__Condition-led_care_Pharmacist_Guidance_-_Diabetes_Hypoglycaemia.pdf35.51 KB

NHS Flu

LPC Flu Service Advice coming soon.....

You should today have received the first weekly email from the LPC supporting you with this years seasonal service. If you have not received the intro email (which will have been sent to the email address that the LPC has on record for your pharmacy) then please contact the Office. A copy of the email is attached below.

To help support you the LPC is soon to begin a weekly series of communications to contractors as we count down to the start of the service. Look out for helpful and informative advice on how to make the service a great success again this year.

As the flu season approaches we know many community pharmacy contractors and pharmacy teams are eager to start with a 'bang' in offering the Flu Vaccination Advanced Service from 1st September 2017 (assumed start date - to be confirmed). These weekly updates will ensure your team are ready and prepared.

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File Flu comms 2017 - 1H.pdf269.06 KB

Flu Training 2017/18 - local venues in Hampshire & Dorset

Hampshire & IOW and Dorset LPCs are working in partnership with the NPA to provide training and support for any pharmacist wishing to be eligible to deliver the NHS Advanced Flu Service that all community pharmacies are able to provide from September this year.

This training is open to all pharmacists regardless of NPA membership. Prices have been discounted from the NPA’s usual tariff rate for those quoting this invitation and referencing the LPC training initiative.

There are 5 half-day training dates available for the practical training package, which are being provided at either Chandlers Ford in Hampshire or Wimborne in Dorset. Full details are on the attached flyer & invitation letter, together with instructions on completing the enrolment form (also attached), which must then be emailed directly to the NPA Pharmacy Services Team at: npapgdservices@npa.co.uk

On receipt of this, the NPA will then arrange payment with you and send you on-line training instructions to access their on-line learning programme. This must be completed fully (with evidence) prior to attending the practical training session on the date you have chosen.

 

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File Flu Vaccs Training Flyer 2017.pdf394.05 KB
File Flu Vaccs Training Invitation Letter 2017.pdf486.49 KB
File NPA PGD Services registration-enrolment form - Dorset-Hampshire-IOW LPC 17-18.xlsx10.66 KB

FLU 2017 - Weekly update from H&IOW LPC (2)

Welcome to this week's email postcard posted to all pharmacy contractors and pharmacists. 

You should today have received the second weekly email from the LPC supporting you with this years seasonal service. If you have not received the email (which will have been sent to the email address that the LPC has on record for your pharmacy) then please contact the Office. A copy of the email is attached below.

The LPC is bringing to you a weekly series of communications to contractors to support you in preparation for this years flu season. Look out for the helpful and informative postcards each week as we count down to the start of the service in September. 

As the flu season approaches we know many community pharmacy contractors and pharmacy teams are eager to make the service a great success again. These weekly updates will ensure your team are ready and prepared.

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File Flu comms 2017 - 2.pdf298.49 KB

FLU 2017 - Weekly update from H&IOW LPC (3)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the third weekly email from the LPC supporting you with this years seasonal service. If you have not received the email (which will have been sent to the email address that the LPC has on record for your pharmacy) then please contact the Office. A copy of the emailed 'postcard' is attached below.

This weekly series of communications will support you in preparation for this years flu season. The 'postcard' provides a weekly update to ensure your team are ready and prepared for the September launch.

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File Flu comms 2017 - 3.pdf295.44 KB

FLU 2017 - Weekly update from H&IOW LPC (4)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 4th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below.

This weekly series of communications will support you in preparation for this years flu season. The 'postcard' provides a weekly update to ensure your team are ready and prepared for the September launch.

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File Flu comms 2017 - 4.pdf466.97 KB

FLU 2017 - Weekly update from H&IOW LPC (5)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 5th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below.

This weekly series of communications will support you in preparation for this years flu season. The 'postcard' provides a weekly update to ensure your team are ready and prepared for the September launch.

I have also included our top performers from last year (as reported from PharmOutcomes data only). Congratulations to all of you on achieving such great coverage. Will your pharmacy break through into this years Top 5% of providers?
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File Flu comms 2017 - 5H.pdf308.7 KB
File Wessex Top 5% flu providers 2016.pdf91.26 KB

FLU 2017 - Weekly update from H&IOW LPC (6)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 6th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below.

This series of communications builds each week to support you and your teams preparation for the start of this years flu season. The 'postcard' provides the last update prior to the launch on 1st September.

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File Flu comms 2017 - 6.pdf311.57 KB

FLU 2017 - Weekly update from H&IOW LPC (7)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 7th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below together with an update from the NHSE Regional Team and a reminder of how to reset PharmOutcomes passwords for those that need this.

This series of communications continues each week to support you and your teams successful delivery of this years flu programme

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File Flu comms 2017 - 7.pdf300.51 KB
File NHSE South (Wessex) update - Ref PH253.docx129.61 KB
File PharmOutcomes guide for new user name and password.pdf344.1 KB

FLU 2017 - Weekly update from H&IOW LPC (8)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 8th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below.

This series of communications continues each week to support you and your teams successful delivery of this years flu programme

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File Flu comms 2017 - 8.pdf298.91 KB

FLU 2017 - Weekly update from H&IOW LPC (9)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 9th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below.

This series of communications continues each week to support you and your teams successful delivery of this years flu programme

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File Flu comms 2017 - 9.pdf290.76 KB

Flu 2017 - Weekly update from H&IOW LPC (10)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 10th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below together with our radio advert currently being broadcast.

This series of communications continues each week to support you and your teams successful delivery of this years flu programme

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File Flu comms 2017 - 10H.pdf296.77 KB
File TV LPC ad.mp3236.13 KB

Flu 2017 - Weekly update from H&IOW LPC (11)

Welcome to this week's email 'postcard' posted to all pharmacy contractors for use by pharmacists and their teams. 

You should today have received the 11th weekly email from the LPC supporting you with this years seasonal service. A copy of the emailed 'postcard' is attached below together with the radio advert that has been broadcast locally over the past few weeks.

This series of communications continues each week to support you and your teams successful delivery of this years flu programme

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File Flu comms 2017 - 11H.pdf293.83 KB
File TV LPC ad.mp3236.13 KB

NUMSAS

LPC update

One of the LPC’s strategic aims is to enable greater transparency with respect to the LPC's decision making process with respect to service commissioning.  The LPC Services sub-committee now review all newly proposed or recommissioned services as part of their remit. The format of the review is in a standard format ‘Service Checklist’ which RAG (red, amber & green) rates the service against pre-agreed criteria. 

Each criteria question is RAG graded with comments made where appropriate and then once completed the overall service proposal is RAG rated with respect to the LPC’s recommendation for participation and support of the service as follows:

                              Green    - fully recommend and suggest participation by all pharmacies.

                              Amber   - recommend but aware that some reservations, pharmacies will need to assess willingness to participate individually.

                              Red        - not recommended and suggest pharmacies do not participate.

The overall RAG rating is shown on the front page together with any recommendations that the LPC would like to be considered for revision prior to commissioning. Each completed 'Service Checklist’ is then sent to the commissioner to consider specification amendments to further enhance the service for our contractors. There is a section below this, where we ask the commissioner to reply and respond to any points raised.

Following a defined period of time, the checklist (or commissioner amended checklist) is published on our website and emailed to all local pharmacy contractors so that they are clear on the LPC recommendation for that service.

So, what is the position with NUMSAS?

The current position is that considering there is still so much important information yet to be finalised, contractors are recommended to delay their sign-up to the new NUMSAS service for the time being. Wessex will not be going live until at least March 2017 and hence there is no gain in rushing to sign up for the service immediately. The LPC is negotiating a position with both the current local service commissioners; NHS England South (Wessex) & IOW CCG with regard to contracting opportunities going forward, and hence our view is that contractors should wait for more information to be available before they make a more informed choice on whether to sign-up.

With only partial information at present the Service sub-committee have currently rated NUMSAS service as red.

It is clear that the NUMSAS service is inferior to the current locally commissioned PURM schemes in both Wessex (without Isle of Wight) and the Isle of Wight. The Wessex PURM service was previously RAG rated as green and is attached.

(The Isle of Wight service was previously not RAG rated, however its terms and conditions are most favourable and it too would undoubtedly be green).

Also attached is the current NUMSAS RAG rating agreed by the sub-committee.

 

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File NUMSAS, NHS England Checklist - Service Spec update.docx35.23 KB
File PURM, NHS England (Wessex) Checklist - Service Spec.docx30.34 KB

Quality Payments

 

 

Quality Payment scheme

LPC update

As you are well aware the imposed two year Government funding package changes took effect from December 1st which removes £113m from Community Pharmacy representing a 4% reduction in revenue for this financial year and a further £95m decrease the year after; representing another 7.5%. This loss of revenue will affect all our contractors to varying amounts depending upon individual prescription items dispensed and geographical locality in respect to other pharmacies. One thing that will be consistent however is the need to review current service provision and to explore ways in which to maximise this to offset some of the direct remuneration loss from prescription payments.

A simple way to summarise the funding changes is shown pictorially below as a squeeze from both sides on Community Pharmacy.

 

The NHS Quality Payment scheme details are becoming more clear as each week goes by since their initial announcement back in October 2016.  The LPC would like to ensure that all contractors are aware of the new scheme and how best to progress achieving the maximum remuneration in the most efficient capacity.

The LPC committee formed a HLP & Quality Payments Task & Finish group to work through the detail and consider what further actions the LPC needed to take on behalf of contractors. 

There is already a lot of detail published regarding the new Quality Payment scheme. The group recommendation is that all contractors use the PSNC website as their starting point for their main reference source of information. Other sources can be used, however the information quoted soon becomes repetitious and the group felt the PSNC site was the most comprehensive. The various sections on the PSNC site are regularly updated and provide links to other information and handy tools that you can use to keep records required to qualify for payment throughout the year. Click here for a direct link to the PSNC Quality Payments webpage.

Information includes:

  • DoH service package - the scheme itself
  • Gateway criteria - the must do’s otherwise no payment at all from participation
  • Quality payment criteria - the can do’s, the more you do the more you earn
  • Review points - twice a year 
  • PharmOutcomes support - being developed, watch this space as it will contain all the links you’ll need plus keep your records and do your GP notifications.
  • CPPE support - good for directing you to learning resources (also see attachment above)
  • Payment information - how it works and what to do
  • FAQs - useful as covers questions asked so far by others
  • Webinar & slide deck - really useful to listen to and gives context to all the content above.

Additionally the group would like to qualify the following points that may not be clear in the scheme details as follows:

  • SCR local support events are currently being planned jointly by H&IOW LPC, Dorset LPC, Wessex LPN, Wessex RPS & CPPE. Details of the ‘Making the most of SCR’ meetings will be confirmed shortly, so please be sure to book onto one of these to help improve your knowledge, competence and confidence in regularly using this function. Look out for forthcoming dates and venues.
  • A Quality Payments page will be created on the LPC website that contains links to all relevant information and updates together with LPC updates on any local activity planned.
  • HLP information is available already on the LPC website (click here). The HLP guide for participating Hampshire pharmacies can be downloaded directly, although a printed copy can be posted to you if you prefer by contacting jo.addison@hampshirelpc.org.uk
  • Safeguarding criteria apply to all pharmacy professionals, so it is important to ensure that all Registered Accredited Checking Technicians are included in your planning as well as pharmacists.
  • Additionally your local Wessex Academy leads will ensure that topics are included throughout 2017 to support any concerns raised regarding Quality Payments. Planning is currently going on to cover Dementia Friends training at each groups meeting prior to April.
  • ‘PharmacyComplete' have shared a one page training record spreadsheet (attached along with their summary guide) which you may find useful to document all your training together in one place. PSNC also have individual templates on their website and PharmOutcomes are developing a virtual solution if you prefer this (not available yet)