Community Pharmacy The New Contractual Framework

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Community PharmacyThe New Contractual Framework

• Lesley Woakes
• Primary Care Development Manager
• Walsall Teaching Primary Care Trust

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Implementation of the contract

• Essential Services
• Advanced Services
• Enhanced Services

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The Process for Walsall

• Design of the process
• The template
• The assessor team
• Pilot visits
• Administration support
• Review of outcomes

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The Design

• Who
• Should be involved
• Governance - accountability
• Where
• Which forums needed to be consulted?
• What
• Clinical Governance workbook supporting
  pharmacists Development of tools to support
  essential services
• Clinical Governance Community Pharmacy Newsletter
  facilitate communication
• When
• Organisation of the visits

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The Template

• Primary Care Contracting
• Self Assessment
• RAG status

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Pilot visits

• Two sites chosen
• Chair of LPC!
• Pharmacy volunteer
• Carried out in November 2005

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The assessor team

• Community Pharmacy representation
• Community Pharmacy facilitator
• Locality Pharmacists
• LPC Chair
• PCT Commissioning Manager (pilots only)
• Clinical Governance Manager

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Administration support

• Visit dates/times/team
• Supporting documentation
• Self assessment template
• Clinical Governance Workbook
• Hints and tips
• List of necessary documentation for the visit
• Timeline

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Role of Clinical Governance Workbook

• Colour coded
• GREEN where Essential Services mapped into
• Standards for Better Health
  
• BLUE information the PCT already had
• - assessed at the visit
• Clinical Governance Folder included
• The workbook
• The Assurance Framework documentation
• Hard copies sent out for each pharmacy but
  available electronically to facilitate
  communication

WHITE
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Process review

• Ongoing
• Pharmacy Implementation Group Meetings
• Informal
• Problems
• Time for the pharmacies
• for the assessors
• Self assessment
• Changes
• Only two assessors
• Self assessment

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Visit Completion

• Turnaround
• Documentation
• Action planning
• 6 month review
• Review visits
• Review of the process and identifying outcomes

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Review of outcomes

• Positive areas
• All community Pharmacys have embraced the new
  contractual framework and have implemented
  appropriate systems to support this.
• The large multiples were very flexible to the
  needs of the PCT and saw the visits as a positive
  process.
• Independent Pharmacys have adopted a number of
  different resources to support the implementation
  of the new contract.

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Review of outcomes

• Positive areas cont
• Community Pharmacists welcomed the visiting teams
  into their Pharmacys and were helpful at all
  stages of the process.
• All Pharmacists were keen to take on board
  comments and suggestions made by the visiting
  teams.

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Review of outcomes

• Areas for support/development
• Confidentiality/Data Protection - A number of
  Community Pharmacys need support in developing
  and implementing the NHS code of confidentiality
  and Data Protection.
• Recording of information The amount of
  information being recorded in Community
  Pharmacys for the Essential Services varies from
  Pharmacy to Pharmacy.
• Risk Management Appropriate systems still need
  to be implemented in a number of Community
  Pharmacys. Systems to include recording
  incidents and near misses, reporting to NPSA,
  evidence of learning from incidents, and Root
  Cause Analysis.

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Review of outcomes

• Areas for support/development
• Disability Discrimination Act Only 1 Community
  Pharmacy provided evidence of completed DDA
  patient assessment forms. Only a small number of
  Pharmacys have completed a premises assessment.
• Child Protection Although not part of the visit
  template, Child Protection has been identified
  through the CG workbook as an area which needs
  some increased guidance/support.

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Next steps

• Community Pharmacy Assurance Framework for
  2007/08
• Additions to the framework
• Areas identified as needing further work/support
  from last visits
• Control Drugs
• MURs
• Enhanced Services Smoking Cessation
• Supervised
  Methadone
• Needle
  Exchange
• Palliative
  Care

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• Thanks for listening
• Any Questions?
• Contact details
• lesley.woakes_at_walsall.nhs.uk