Important news and information for community pharmacies

“High quality care for all, now and for future generations”
Important News and Information for Community Pharmacies from
the Surrey and Sussex Area Team
January - February 2015
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Area Team News & Update
EPSr2
Information Governance
MUR PREM 2 Applications
MUR/NMS Quarterly Reports
Flu Vaccination Service
Bank Holiday Opening Hours
Informing Area Team of Change
Medicine Waste Collection
Equality Act
Shared Learning
Drug Driving Legislation
CD News
Annual Pharmacy Clinical Audit
Green Bags Project
CCG news
Area Team News & Update
Welcome to the latest edition of the Community Pharmacy Area Team
newsletter. This is emailed out directly to all contractors, company head offices,
area and regional managers and distributed through LPC’s.
There have been some changes to local contacts, please find attached an
updated useful contact sheet for you to print off and retain.
There have been many changes to the structure of the NHS in recent years and
still some confusion as to ‘who does what’.
Here is a simple guide to the NHS:
simple-nhs-guide.pdf
NHS England Organisational Alignment Capability Programme
NHS England structural re-alignment is currently taking place to save 15%
running costs. Surrey and Sussex will align with Kent from 1 st April 2015 and
become South East Sub Region.
As we start to reflect the new structures, NHS England will have a new operating
model:
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•
We now have four regional teams and these will operate on a single
level.
•
The new 12 sub regions are now integrated into these new regional
teams. We will no longer to refer to area teams.
•
A central team replaces the National Support Centre.
First Annual Review published
NHS England published its first Annual Review in September 14. This review
takes a look at some of our highlights over the last year and includes real life
case studies which show how we’ve put patients first.
Despite many challenges, 2013/14 was a year to be proud of and one where
NHS England made real progress on making some of its ambitions reality.
New Surrey and Sussex Sub Region (Area Team) Webpage
We are pleased to announce the Area Team now has a webpage aimed at
pharmacists and their teams.
Here you can easily access commonly used pharmacy forms and we will be
adding to this as the webpage develops:
http://www.england.nhs.uk/south/ss-at/comm-pharm/
Electronic Prescription Service Update
Progress is moving fast with more and more GP practices now sending electronic
prescriptions to pharmacies. Click here to view latest national statistics.
For support and advice visit: http://systems.hscic.gov.uk/eps/dispensing
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The table below illustrates the latest number of practices that have gone live or
are scheduled to go live in Surrey and Sussex:
CCG
North West Surrey
North West Surrey
North West Surrey
North West Surrey
Practice Name
New Ottershaw Surgery
Staines & Thameside Medical Group
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
North West Surrey
Brighton & Hove
Brighton & Hove
Brighton & Hove
Brighton & Hove
Brighton & Hove
Sunny Mead, Woking
Hillview Medical centre
Heathcot Medical practice
The Abbey Practice
Knowle Green MP
Sunbury Health Centre
Dr Arnold and partners
Staines Health Group
Southview Surgery
Church Street Practice
The Bridge Practice
Chobham West End Med Practice
Studholme Medical Centre
Dr G Lewis
The Crouch Oak Family Practice
Stanwell Road Surgery
The Grove Medical Centre
St John's Health Centre
The Maybury Surgery
Fordbridge Med Centre
The Hersham Surgery
St Davids Health Centre
Ashley Medical Practice
Forthouse
Mileoak
Pavilion
Ship Street
Ardingly Court
Stanford
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Proposed Go Live
Date
12/05/2015
16/04/2015
14/04/2015
08/04/2015
10/03/2015
05/03/2015
04/03/2015
03/03/2015
25/02/2015
23/02/2015
19/02/2015
18/02/2015
17/02/2015
12/02/2015
10/02/2015
05/02/2015
28/01/2015
27/01/2015
21/01/2015
08/01/2015
06/01/2015
10/12/2014
02/12/2014
03/11/2014
08/10/2014
02/10/2014
14/01/2015
24/09/2014
23/09/2014
29/05/2014
27/05/2014
“High quality care for all, now and for future generations”
Brighton & Hove
Brighton & Hove
Brighton & Hove
Brighton & Hove
Brighton & Hove
Brighton & Hove
Coastal West Sussex
Coastal West Sussex
Sackville
Portslade Health Centre
Brighton Station health centre
Park Crescent Health Centre
Haven Practice
Warmdene
Langley House Surgery
Fitzalan MC
21/05/2014
03/11/2014
29/01/2015
27/02/2015
19/11/2014
23/10/2014
24/03/2015
11/02/2015
Coastal West Sussex
willow green surgery
24/02/2015
Crawley
Southgate, crawley
10/02/2015
Crawley
Poundill medical Group
24/02/2015
Crawley
Eastbourne, Hailsham
& Seaford
Eastbourne, Hailsham
& Seaford
Eastbourne, Hailsham
& Seaford
Eastbourne, Hailsham
& Seaford
Eastbourne, Hailsham
& Seaford
Langley Corner Surgery
21/04/2015
The Cresent MP Hailsham
15/01/2015
Manor Park, Polegate
10/03/2015
Herstmonceux
26/11/2014
Bridgeside, Hailsham
19/11/2014
Harbour Medical Practice
31/03/2015
East Surrey
Lingfield Surgery
08/04/2015
Guildford & Waverley
Cranleigh Health Centre
23/02/2015
Horsham, Mid Sussex
Mid Sussex Health Centre
28/01/2015
*This table is correct at time of publication, however as more practices go live the AT, CCGs &
LPCs will keep you informed.
If a GP Practice is going live, the Area Team will contact all community
pharmacies within the vicinity 8 weeks before go live to provide support to
prepare for a smooth transition.
Now is the time for all pharmacies to prepare for using EPSR2. Ensure all
dispensing staff have smartcards, make sure you have a supply of dispensing
tokens and that EPS equipment is working and staff have been trained how to
use it.
You can apply for a smartcard by contacting the registration authority in your
area and tokens can be ordered (see attached contact sheet). Contact your
system supplier or head office for technical equipment support.
The Area Team has issued over 500 smartcards to pharmacists and dispensing
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staff across Surrey and Sussex in the last 3 months!
The link below takes you to a page with lots of information about EPSR2 and
includes a pharmacy checklist to support pharmacies getting ready for go live
http://systems.hscic.gov.uk/eps/dispensing
New Electronic Prescription Tracker
The tracker is intended for use by all staff working at prescribing and dispensing
sites to provide the status of a prescription.
An updated version of the EPS Prescription Tracker is now available.
The new version of the tracker (click here) allows users to enter a prescription ID
and find out where a prescription is in the process. It is now also possible to
search by NHS number and date range. The tracker will confirm if the
prescription has left the prescribing site, if it has reached the Spine or if it has
been delivered to a dispensing site.
How do I access the Electronic Prescription Tracker?
You can access the tracker using your PC and Smartcard. Click the following
link or paste it into your web browser:
https://portal2.national.ncrs.nhs.uk/prescriptionsadmin
Information Governance
Information governance is an important element of work in a community
pharmacy. The confidentiality and security of patient data is of paramount
importance to all of us. Any information shared between organisations must
ensure IG guidelines are adhered to.
All NHS providers, including community pharmacies need to provide information
governance assurances to the NHS on an annual basis. These assurances are
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provided through completion of an online assessment tool, the NHS Information
Governance Toolkit (IGT). For more information visit http://systems.hscic.gov.uk/infogov
Information Governance in relation to providing telephone MURs or
domiciliary MURs
We have received a number of PREM2 applications for MURs (either domiciliary
visits or by telephone) that contain patient names sent via unsafe methods such
as unsupported email or fax.
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Please note that with immediate effect the Area Team will no longer
accept PREM 2 applications sent by unsafe email (non nhs.net) or
fax. Any applications sent this way will not be authorised and will be
destroyed. This is to comply with IG requirements.
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NHS.net is the only way to safely email in PREM 2 MUR applications.
How do I get an nhs.net account?
We would like to invite all pharmacies that have not done so already, to request
nhs.net mail account by completing the form below and emailing to:
pharmacy.emailadmin@nhs.net
applicationform for
nhs.net mail acc.doc
Information Governance in relation to specials certificates of conformity
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As stated in the Drug Tariff, you are required to submit copies of certificates of
analysis or conformity for all specials NOT included in Part VIIIB of the Drug tariff
http://www.nhsbsa.nhs.uk/PrescriptionServices/3754.aspx
to the NHSCB (NHS England) of the prescriber. Please send your copies in to:
The Community Pharmacy Team (NHS England) as per attached contact sheet.
When sending in the COC/COA you must include:
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Pharmacy stamp, date and initials
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Prescriber details
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Net cost of item less any discount or rebate offered
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Please ensure any patient identifiable data is blanked out with a
permanent marker on all submissions.
MURs
A fourth target group for MURs covering patients with cardiovascular risk
factors was introduced in January 2015. The national target groups are:
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patients taking high risk medicines;
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patients recently discharged from hospital who had changes made to their
medicines while they were in hospital. Ideally patients discharged from
hospital with receive an MUR within four weeks of discharge but in certain
circumstances the MUR can take place within eight weeks of discharge;
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patients with respiratory disease; and
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patients at risk of or diagnosed with cardiovascular disease and regularly
being prescribed at least four medicines.
Currently, at least 50% of all MURs undertaken by each pharmacy in each year
should be on patients within the national target groups.
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“High quality care for all, now and for future generations”
From 1st April 2015 community pharmacies must carry out at least 70% of their
MURs within any given financial year on patients in one or more of the agreed
target groups.
All patients who receive an MUR should experience the same level of service
regardless of their condition, i.e. MURs cover all the patient’s medicines not just
those that fall within a target group. Regardless of how the MUR is delivered
i.e. face to face, over the telephone or in patient’s home, the MUR should:
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identify whether or not patients understand how their medicines should be
used and whether or not they use their medicines as prescribed
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identify how patients should correctly use their medicines and any issues
affecting correct use, for example timing
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identify if patients know why they have to use their medicines and explain
the condition for which each medicine is prescribed
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identify potential side effects
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identify if medicines no longer used by the patient
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Whilst each of the points above do not in themselves constitute an MUR,
an MUR may include discussion about one or more of these areas during
the consultation.
What is not an MUR?
An MUR is not:
brief advice about dispensed items that would otherwise be an integral part of the
essential dispensing service
any review of medication for which a pharmacy is contracted under another
service contract (such as an enhanced or locally commissioned service)
a full clinical medication review
a discussion about changes to drug treatment
a discussion about a medical condition beyond its drug treatment
a discussion on the effectiveness of treatment based on test results
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a discussion solely for the purpose of dose synchronisation of any one or more
items on a prescription
a discussion solely for the purpose of dose optimisation of any one or more items
on a prescription
a catch up on progress made from a previous MUR unless the required 12-month
period has elapsed or there has been a significant clinical change to the patient’s
circumstances.
MUR/NMS Quarterly Reports
Changes to MUR/NMS reporting with immediate effect
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The Area Team request that all pharmacy contractors now provide
ongoing information on the MURs and NMS undertaken in the previous
quarter. Each pharmacy providing MURs must complete the nationally
agreed electronic reporting template click here (a standard excel or
open office spreadsheet) by collating the necessary data from pharmacy
records for MURs and NMS conducted in that quarter.
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Completed spreadsheets must be emailed quarterly to england.ssatcommunitypharmacies1@nhs.net
Flu Vaccination Pilot Service Update
Pharmacies across Surrey and Sussex participating in the NHS pilot flu
vaccination scheme have administered 693 vaccines as of 25th January, as per
table below, to eligible adults (under 65 years of age and pregnant women). Out
of the 681 patients, 340 of those had reported receiving a vaccine from their GP
last year. In effect, the number of patients that have taken up the flu
vaccination when offered by their community pharmacy has more than
doubled!
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“High quality care for all, now and for future generations”
The pilot scheme was extended last November to all pharmacies across Surrey
and Sussex that met the sign-up criteria.
County:
Vaccines
administered:
Brighton and Hove City
67
East Sussex Downs and 48
Weald
Hastings and Rother
47
Surrey
191
West Sussex
340
Total
693
Bank Holiday Opening Hours
Easter Sunday 5th April 2015
A proposed ‘rota’ of pharmacies who have been directed to open on Easter
Sunday this year was emailed out to all contractors on 5th January, providing a
90 day notice period for any pharmacies directed to open.
If you did not receive the email, please contact us immediately.
Any pharmacies who are unable to fulfil the directed opening for the allocated
time can agree local arrangements with another contractor in their area to
undertake the directed opening session on their behalf. Any such alternative
arrangements must be informed to the Area team by Friday 6th February
2015.
Final Easter opening notices will be emailed out to all pharmacies nearer the
time.
Results of a review of commissioning arrangements for bank holidays were also
emailed along with the Easter opening directions. Changes have been agreed
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“High quality care for all, now and for future generations”
with the LPC to harmonise the out of hour directed service across Surrey and
Sussex.
Voluntary trading intentions on forthcoming bank holidays
For planning purposes, we request that all pharmacies inform the Area Team of
any proposed voluntary trading intentions as soon as possible for the bank
holidays as listed below:
Good
Easter
Friday 3rd Sunday
April
5th April
Easter
May Bank
Monday 6th Holiday
April
Mon 4th
May
Spring
Bank
Holiday
Mon 25th
May
August
Bank
Holiday
Mon 31st
August
Christmas
Day Friday
25th
December
Boxing Day
Monday
28th
December
New Year's
Day Friday
1st January
2016
Pharmacies are reminded of the benefit in informing their Area Team of their
opening intentions during bank holiday periods.
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This information is of critical importance to Area Teams in order for us to
plan pharmacy provision during holiday periods. If Area Teams are
not able to determine the opening hours of pharmacies, with a high
degree of certainty, the option may be to issue directions to one or more
pharmacies requiring them to open. This clearly is not in the best
interests of pharmacies if there are other suitable pharmacies that would
have been open; furthermore it is not considered good use of NHS
resources. Additionally this enables other organisations such as NHS111
to be informed of trading intentions for public signposting and enables
the Area Team to produce posters for all pharmacies to display.
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PSNC recommends that all pharmacies notify the Area Team of their
opening hours during bank holiday periods, using the forms available on
the NHS England website: http://www.england.nhs.uk/pharm-open-hrs/
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
Contractors are also reminded that these forms must be returned to the
Area Team by email to england.ssat-communitypharmacies1@nhs.net as
soon as possible.
Applications to close early
When making an application to close early on a particular day i.e. early
Christmas Eve closure, please ensure you align your pharmacy opening hours
with local GP practices opening hours. GP practices are not being given
permission to close early and will therefore be open during their normal
contracted hours at all times.
Signposting to other pharmacies during bank holiday periods
Under the terms of service of the NHS Community Pharmacy Contractual
Framework, signposting is an essential service. Part of this obligation is to
display details of the nearest pharmacy open whilst a pharmacy is closed; this is
of vital importance during bank holiday periods. Please ensure that all directed
opening hour notices supplied by the Area Team are clearly displayed.
Informing the Area Team of Changes affecting Fitness to Practise
All pharmacy contractors who are the subject of new adverse fitness to practise
incidents must notify the Area Team within 7 days of the occurrence for
example to notify us of a change in Superintendent pharmacist. PSNC has
produced an ‘e-form’ template, which can be completed in Microsoft Word by
clicking the link here. The Fitness to Practise forms produced by PSNC are not
mandatory. Notifications for this and any other changes should be sent to
angela.ruske2@nhs.net
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The duty to provide updated information about Fitness to Practise matters for
pharmacists on pharmaceutical lists are dealt with under Paragraph 31 of
Schedule 4 to the NHS (Pharmaceutical and Local Pharmaceutical Services)
Regulations 2013.
Clinical Waste
Patient returned medicines
Please remember that NHS England is responsible for the disposal of patient
returned medicines only. We have contracts to collect the waste from your
pharmacies with Cannon for Surrey pharmacies and SRCL for Sussex
pharmacies. For queries on these collections contact Adam Banks either on tel:
020 8335 1329 or Adam.Banks@nhs.net.
Other collections, for waste such as out of date otc medicines and confidential
paperwork, are the responsibility of the contractor and for multiples are normally
arranged by their Head Office. Needle exchange waste is the responsibility of
the service commissioner. Any queries regarding these collections need to be
dealt with internally within your organisation or with your needle exchange
commissioning organisation.
For further information on waste regulations and ‘frequently asked questions’
please see the PSNC website - http://psnc.org.uk/servicescommissioning/essential-services/disposal-of-unwanted-medicines/
Equality Act
Approximately half of the pharmacies/pharmacists that returned their PNA
questionnaire stated they were unaware of the Equality Act.
Please refer to this one-page summary factsheet for further information:
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worksheet30-equalit
y_act_2010_factsheet.pdf
Shared Learning
The Area Team receive incident reports from varied sources, invariably after a
dispensing error has been picked up by a GP, carer or hospital. To promote
shared learning, we will anonymously publish details of incidents in this
newsletter which we hope you will find useful to raise awareness amongst your
dispensing teams.
Some cases below resulted in significant harm* to the patient requiring hospital
admission:
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Pravastatin dispensed instead of pantoprazole
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Out of date insulin dispensed
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Contents of blister pack / monitored dosage system differ from label
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Alfentanil ampoules 1mg/2ml prescribed but 5mg/1ml dispensed
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Warfarin 5mg prescribed but 0.5mg dispensed
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Amitriptyline prescribed but amlodipine dispensed
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Diltiazem 60mg m/r prescribed but dihydrocodeine 60mg dispensed
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Incorrect bag label for substance misuse patient, 70ml physeptone s/f
given instead of 50ml
*Community Pharmacists and their teams dispensed 914.3 million prescription
items during 2012/13. Dispensing errors, such as the incidents above, are very
rare and on the whole do not result in any harm to patients. However, it is
important to share these incidents with other Pharmacy Teams to promote
shared learning to ensure such errors do not occur again.
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“High quality care for all, now and for future generations”
New Drug Driving Legislation
In December the Department for Transport has issued a press release calling on
pharmacies to support a new year campaign to help customers understand the
changes to drug driving legislation coming into force in March 2015.
The new offence has been introduced by the government to tackle the
irresponsible few who continue to abuse drugs and drive by giving the police new
powers to tackle the issue. It’s about making sure people who take prescription
or over the counter medicines as advised are not affected by the law.
Pharmacies are being asked to support the campaign from February 2015 by:
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Briefing pharmacy teams, using the published healthcare guidance, so
that they understand the implications of the new offence for patients.
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Displaying campaign materials online and via social media
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Displaying campaign materials in-store / pharmacies, e.g. reminder
stickers on prescription bags, shelf displays and posters
A partner pack has been developed to provide further background to the new
offence and campaign plans. To register your interest and find out more about
how your pharmacy can support the campaign contact
DfTPressReleases@dft.gsi.gov.uk. Campaign materials are available for
pharmacies to order now.
CD News
Issues with illegally written prescriptions
Now that Tramadol is schedule 3, there have been some reported issues with
EPS CD prescriptions.
Could community pharmacies please report any concerns regarding this to:
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england.surreysussex-cds@nhs.net
We can then contact the prescribers/ Chief Pharmacists etc. to get the problems
resolved.
Clarification on the start date of CD prescriptions written for instalment
dispensing
A reminder about the DATE on repeat dispensing (instalment dispensing) for
schedule 4 CD prescriptions – it needs to include the date on which it was
signed. Controlled drugs prescriptions are valid for 28 days after the appropriate
date on the prescription. The appropriate date is either the signature date or any
other date indicated on the prescription (by the prescriber) as a date before
which the drugs should not be supplied – whichever is later. The 28 day
restriction includes prescriptions for temazepam, Schedule 4 Controlled Drugs
and any owing balances.
The document below provides further clarification:
Clarification on the
start date of CD prescriptions written for instalment dispensing - Dec 10.doc
Safer Use of Controlled Drugs
The Care Quality Commission (CQC) has co-developed guidance with NHS
England with the aim to provide better guidance for health care professionals
handling controlled drugs.
The clinical subgroup of the controlled drugs national group has produced a new
newsletter and supporting information covering the “Safer Use of Controlled
Drugs - Preventing harms from the use of methadone” amongst other
subjects. The newsletter and supporting information aims to provide better
guidance for health care professionals handling controlled drugs.
The newsletter and supporting information can be found on their website here.
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“High quality care for all, now and for future generations”
Annual Pharmacy Clinical Audit
Results of Last year’s NSAID audit
The results of the 2014 community pharmacy NSAID audit have been published
jointly with the PSNC (see below). Thank you to all in Surrey and Sussex for
making this work so successful. Community pharmacies in Surrey and Sussex
reported almost 3,000 patients.
In 2014 more than 1,200 community pharmacies across England took part in an
audit of patients prescribed Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
The audit focussed on gastro-intestinal safety and included 16,366 patients. 10%
were aged over 65 (meaning they were at particular risk of gastro-intestinal
damage) and had not been prescribed any gastro-protection. Most patients
identified as ‘at risk’ of gastro-intestinal damage were then highlighted to the
prescriber for review.
Gastro-intestinal damage is a well-recognised harm due to NSAIDs but
inadequate gastro-protection is still a common prescribing error (Avery et al
2012, PRACtICe Study).The results of this audit confirm that community
pharmacists can provide a final safety net to help address this important
issue should other measures fail.
The NSAID audit is available on the PharmOutcomes electronic recording
system and was developed by the NHS Specialist Pharmacy Service (SPS)
Medicines Use and Safety Team and PSNC. The methodology provides a
successful large-scale means of raising awareness of a key safety issue and
driving improvement; it could well be used to address other medicines safety
issues on a national basis.
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“High quality care for all, now and for future generations”
This clinical audit is still available to community pharmacies via PharmOutcomes
and may be of interest to CCGs and GPs looking to work with pharmacies to
improve medicines safety. There is also a linked workshop on NSAID safety
available through CPPE.
Do get in touch if you have any queries or would like more information to:
carina.livingstone@nhs.net
The report is available as follows: Community Pharmacy NSAID safety audit
2014 – National data from PharmOutcomes. Please click here: LINK
This Year’s Annual Pharmacy Clinical Audit
All pharmacies are required to participate in two clinical audits per annum,
under the terms of service of the community pharmacy contractual framework.
One is a pharmacy-based topic of choice and the other has been nationally
determined this year.
The agreed national community pharmacy audit for this year is going to be on
emergency supply. Draft paperwork has all been agreed by PSNC, NHS
England and NHS Employers.
Guildford and Waverley CCG, as part of its urgent and emergency care work, is
addressing the issues of patients accessing repeat medication out of hours and
has agreed, with the LPC, to pilot the national audit for NHS England in the
pharmacies within the CCG area. Results will be fed back to NHS Employers
Pharmacies taking part in this pilot will then be exempt from taking part in the
audit in March 2015.
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“High quality care for all, now and for future generations”
Further information will be sent to all pharmacies when the 2015/16 national
audit has been finalised.
Green Bags Project
This project has been opened up to all pharmacies. There are now over 200
pharmacies participating in this scheme – if you are interested in taking part,
please contact carina.livingstone@nhs.net
For the latest news on the project – please read the newsletter below:
Green
Bag_Newsletter_Issue 6 Jan 2015 vs1.doc
CCG News
Surrey Downs Clinical Commissioning Group - The Surrey Prescribing
Advisory Database (‘PAD’) is an innovative resource which can be accessed by
healthcare professionals in primary and secondary care and by patients. The
PAD provides guidance and key information on medicines use within Surrey.
Click here for details - http://pad.res360.net/Search/DrugCondition/249
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