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  • Community Pharmacy Emergency Supply during a Pandemic Service

    ECHO Training 7th April 2020

    Gillian Plant - HSCB Pharmacy Co-ordinator

    Sinead McElroy - HSCB Pharmacy Adviser

  • Aims of the service

    • Ensure that at this time of unprecedented demand, patients can access an urgent supply of their regular prescription medicines where they are unable to obtain a prescription

    • Ensure equity of access to medicines irrespective of the patient’s ability to pay

  • Community Pharmacy Emergency Supply during a Pandemic Service

    • Service commenced on Monday 6th April 2020

    • Service removes the requirement for a patient to pay the costs of medicine(s) received via emergency supply

    • Pharmacies will be reimbursed for medicines supplied; it will not be necessary to request a prescription from the GP practice

    • Service operates through-out all of the pharmacy’s opening hours

    • Legal basis: Regulation 226 of Human Medicines Regulations (HMR) 2012

  • Regulation 226 of HMR 2012 • Enables the “emergency sale” of prescription only medicines by a

    person lawfully conducting a retail pharmacy business if the following conditions A and B are met:

    • Condition A is that the supply is made whilst a disease is, or in

    anticipation of a disease being imminently, – (a) Pandemic; and – (b) A serious risk, or potentially a serious risk, to human health.

    • Condition B is that the pharmacist by or under whose supervision the prescription only medicine is to be sold or supplied is satisfied – (a) That treatment with the prescription only medicine has on a previous occasion been

    prescribed by a relevant prescriber for the person to be treated with it; and – (b) As to the dose which in the circumstances it would be appropriate for that person to

    take.

    http://www.legislation.gov.uk/uksi/2012/1916/regulation/226/made

    http://www.legislation.gov.uk/uksi/2012/1916/regulation/226/made

  • Contract for service • A contract has been distributed to all pharmacies (with initial letter

    from HSCB)

    • It is not necessary to return a signed contract to HSCB in order to provide this service

    • Contract must be signed by the contractor / Responsible Pharmacist and retained in your pharmacy

    • This will act as an Assumed Contract to enable your pharmacy to provide this service

    Although an Assumed Contract is being issued, contractors are not obliged to offer this service. Should you choose not to provide this service, please contact your HSCB local office asap

  • Remuneration

    • Initial funding of £1 million has been made available to set up and deliver this service during April 2020

    • A tiered payment model based on prescription volume will be used to allocate this funding

    • Pharmacists will be reimbursed for medicines supplied using the new NCR (no carbon required) pharmacy vouchers (PV)

    • The NCR PV1 is a duplicate form: – top copy will be submitted to BSO for payment

    – bottom copy will sent to the GP practice to provide details of the medicines dispensed

  • Distribution of PVs & Service Specification / Guidance Document • By Friday 3rd April 2020, contractors should have received

    an initial allocation of 200 x NCR PV1s

    • A copy of the Service Specification / Guidance for Pharmacists for this service should have accompanied the delivery of NCR PV1s

    • Pharmacies will receive a second allocation of 200 x NCR PV1s should be delivered to pharmacies at end of April

    • Guidance on how to direct order future supplies will accompany second allocation

  • Patient Eligibility

    • Patient must be registered with a GP practice in Northern Ireland

    • Patient must have previously received a supply of the requested medicine(s) via a prescription

    • Patients not registered with a GP practice are not eligible for an emergency supply via this service

  • Patient not eligible for service / supply cannot be validated:

    • Patient is not eligible: patients who are not eligible to access the service should be referred to a GP or OOH

    • Pharmacist determined the supply was not appropriate: pharmacists should use their professional judgement to determine if there is a reason why a supply is not appropriate

    • Previous supply cannot be confirmed: pharmacist cannot make a supply; the patient should be referred to their GP or OOH

  • Service Provision • Eligibility: confirm that patient is eligible to use the service

    • Patient consent: if patient / patient’s carer requests this service then consent will be assumed

    • Patient / Carer / Representative identification: Where the person requesting the supply is not known to pharmacy staff, steps should be taken to confirm the validity of the request

    • Privacy notice: ensure the patient is aware of the way in which their personal information will be processed

    • Establishing need: obtain information on the medicines and the dose a patient requires

    • Access to patient’s PMR: where the pharmacy does not have access to the patient’s PMR, reasonable attempts must be made to ensure that the patient has previously received these medicines via a prescription

  • Supply of medicines • Quantity: 30 days treatment, or in the case of insulin, ointments,

    creams or inhalers the smallest pack size available. A full cycle of an oral contraceptive could be supplied

    • Excluded medicines: pharmacists cannot make emergency supplies of Schedule 2, Schedule 3 or Schedule 4 part 1 Controlled Drugs (CD) with the exception of phenobarbital or phenobarbital sodium for epilepsy

    • Medicines liable to abuse or misuse

    • Medicines not supplied: In some cases the pharmacist may determine that it is not appropriate to supply some or all of the medicines a patient requests

    • Successive supplies via emergency supply: there is no restriction to patients receiving further supplies of their repeat medicines via this service

  • Completion of NCR Pharmacy Voucher • NCR (non-carbon required) duplicate copy

    pharmacy vouchers

    • If unknown to pharmacy, it may be advisable to get the patient / person requesting the emergency supply to sign and record their contact details on the front of the PV

    • Complete and sign the PV at the time of the consultation

    • Record the GP practice in the top left-hand corner of the PV

    • Code the item(s) from Code Book

    • Endorse 'Emergency Supply‘ • BSO Submission: The top copy of the PV

    • GP Communication: The bottom copy

    should be delivered, as soon as practicably possible, to the GP practice

  • Record Keeping • Patient Medication Record (PMR): by labelling

    the medicines a record will be made in the patient’s PMR

    • POM register entry not required

  • Action for contractors • Retain in the pharmacy, a copy of the contract, signed by the contractor /

    Registered Pharmacist, as proof of contract. • Ensure that all pharmacists involved in the provision of this service have

    relevant knowledge of the Emergency Supply provisions of regulation 226 of the Human Medicines Regulations (HMR) 2012.

    • Ensure that all pharmacists are competent in the operation of the

    Community Pharmacy Emergency Supply during a Pandemic Service. • Ensure that only the new NCR duplicate copy PV1s are used in the delivery

    of this service. • Ensure that a Standard Operating Procedure (SOP) is in place to support

    delivery of the service. NPA have produced an SOP template, available on BSO website.

  • Contacts All information relating to this service available at BSO website:

    http://www.hscbusiness.hscni. net/services/3124.htm

    CPNI have produced a training video for pharmacy staff which can be viewed at:

    https://www.youtube.com/wa tch?v=2eLe_HjRW0c

    http://www.hscbusiness.hscni.net/services/3124.htm http://www.hscbusiness.hscni.net/services/3124.htm http://www.hscbusiness.hscni.net/services/3124.htm http://www.hscbusiness.hscni.net/services/3124.htm https://www.youtube.com/watch?v=2eLe_HjRW0c https://www.youtube.com/watch?v=2eLe_HjRW0c https://www.youtube.com/watch?v=2eLe_HjRW0c

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