PCA(P)(2020)13 - NHS Pharmacy First Scotland - Service Specifications and Approved List of Products
Published: 01/07/20
Introduction
This Circular encloses Directions and a service specification for the NHS Pharmacy First Scotland service.
Background
The Scottish Government’s Programme for Government 2018/19 included the commitment:
We will build on the learning from the extended Minor Ailment Service pilot in Inverclyde and the rollout of the Pharmacy First initiative by developing and implementing a redesigned minor ailment and common conditions service available to all in the coming year.
NHS Circular PCA (P)(2020) 6, issued on 31 March 2020 enclosed Directions amending the Health Board Additional Pharmaceutical Services (Minor Ailment Service) (Scotland) Directions 2016 (“2016 Directions”). The 2016 Directions as amended and the Health Board Additional Pharmaceutical Services (Minor Ailment Service) (Inverclyde Pilot Extension) (Scotland) Directions 2017 will be revoked and replaced by the new Directions for NHS Pharmacy First Scotland attached at Annex D, which come into force as of 29 July 2020.
Detail
The Directions and Service Specification provide the legal framework for the provision and operation of NHS Pharmacy First Scotland. They should be read in conjunction with this circular and the NES training resources detailed below in paragraphs 11 and 12.
Annex A of this circular sets out Key Principles for the operation of the service while Annex B lists who is eligible to use it. Annex C provides a privacy notice template for the service which all contractors should adapt as necessary and display.
Publicity information
A leaflet on the new NHS Pharmacy First Scotland service has been developed for members of the public. Hard copies have already been distributed to every community pharmacy and GP practice.
Additional copies of the leaflet can be ordered by sending an email to: stockorders.DPPAS@apsgroup.co.uk Translated versions of the leaflet in Arabic, Bengali, Cantonese, Gaelic, Mandarin, Polish, Punjabi, Romanian, Slovak and Urdu will be available online from 29 July at www.gov.scot/publications.
A poster is also being distributed to every community pharmacy along with the leaflets. This poster will be used in the Public Health Service (PHS) campaign starting on 29 July 2020. Once this campaign has ended, the poster should be retained for future use.
As the current pharmacy Minor Ailment Service will be discontinued, any remaining stocks of Minor Ailment Service leaflets or posters should be recycled once it is replaced by NHS Pharmacy First Scotland on 29 July.
Privacy Notice
As no formal patient registration is required for NHS Pharmacy First Scotland all pharmacies are asked to use the privacy notice template which is at Annex C in order to advise patients how their data will be used. This template should be adapted as necessary for each pharmacy and must be displayed at all times in a prominent area of the pharmacy.
Training
Circular PCA(P(2020)3, issued on 9 March advised that community pharmacy contractors would receive a one-off payment in May 2020 to cover the completion of e-learning modules for the roll-out of the new NHS Pharmacy First Scotland service. The e-learning modules are now available on the NES TURAS Learn website at https://learn.nes.nhs.scot/. Pharmacy team members should register for a TURAS account to access the modules. A Quick Reference Guide is also available at the same web link.
NES held a national webinar on Thursday 25 June 2020 which has been recorded. Local virtual events will also be run by NES tutors in early July - further details will be shared shortly by NES.
Funding arrangements and payments
Circular PCA(P)(2020)2, issued on 26 February 2020, set out the funding arrangements for NHS Pharmacy First Scotland. The new payment model will be based on activity undertaken by community pharmacy contractors. The following outlines the arrangements for the current Pharmacy First and Minor Ailment Service (MAS) remuneration up to and beyond the start of the new NHS Pharmacy First Scotland service in July 2020.
Current arrangements up to 28 July 2020
The current remuneration and item reimbursement arrangements for MAS and current Pharmacy First will apply. Service remuneration based on MAS registrations banded capitation payments and local payment of Pharmacy First PGDs ceased in April 2020. These were replaced by a £2000 remuneration payment per contractor per month as an interim arrangement in light of COVID-19 disruption to NHS Pharmacy First Scotland’s planned launch. Transitional arrangements from start date 29 July to 30 September 2020
Transitional arrangements from start date 29 July to 30 September 2020
Pharmacy contractors will each continue to receive the transitionary payment put in place from the 1 April 2020 until the 30th of September 2020 to support them in embedding the new ways of working required to deliver NHS Pharmacy First Scotland. During this transitionary period, the activity recorded will be used to gauge the precise parameters of the remuneration arrangements from 1 October 2020.
Arrangements from 1 October 2020
A base payment of £1250 will be paid monthly to each contractor in addition to a share of the NHS Pharmacy First Scotland activity pool which will be distributed based on NHS Pharmacy First Scotland activity across the pharmacy network.
A report will be run on the data warehouse on the 16th of the month for the previous month to determine advice, referral and supply interventions for NHS Pharmacy First Scotland services. This ensures that claims submitted at the end of the previous month have been loaded and therefore included in the payment calculation. Claims received after the dispensing month will not be included in the remuneration payment calculation for service delivery for the month. Items supplied on the service regardless of claim date will continue to be processed and reimbursed if appropriate and applicable for the service in that month.
Weightings for the NHS Pharmacy First Scotland service elements will be applied. There will be equal weighting for advice/ supply / referral with a higher weighting of x3 for all activities relating to UTI and Impetigo. These weightings will be reviewed after six months.
Approved Products List
An Approved List of products available under the NHS Pharmacy First Scotland service has been prepared and will be published in due course as Part 17 of the Scottish Drug Tariff. This will replace the current local MAS formularies. Health Boards must inform NHS Pharmacy First Scotland providers of the Approved List of products which applies to the provision of the NHS Pharmacy First Scotland service in their area. Subject to paragraph 20, only items included on this list will be reimbursed if supplied following a consultation.
To allow for transition from MAS to NHS Pharmacy First Scotland, it has been agreed that pharmacy contractors will receive reimbursement for any products supplied from their local MAS formulary but not included in the Approved List up until 1 October 2020. A version of the Approved List can be found at Annex E.
Patient Group Directions (PGDs)
Three PGDs have been developed nationally for NHS Pharmacy First Scotland to replace existing PGDs for Fusidic acid (for treatment of impetigo), Trimethoprim and Nitrofurantoin (for the treatment of uncomplicated UTIs).
Health Boards will publish these PGDs in due course, which should be signed off by Pharmacists delivering NHS Pharmacy First Scotland for each Health Board area that they work in. Please note that the first line choice for the treatment of uncomplicated UTIs may differ between Health Board areas.
Where an Independent Prescriber Pharmacist is delivering an NHS service which would include consultations for UTIs and/or impetigo, they should not utilise the PGDs, instead using their qualification to prescribe as they ordinarily would under the agreed service specification.
IT roll-out
All Patient Medication Record (PMR) suppliers have confirmed that pharmacy IT software will support pharmacy teams to deliver NHS Pharmacy First Scotland from the launch date of 29 July 2020, providing that the required updates have been accepted by pharmacy contractors.
PMR providers have implemented a basic specification for launch, with further developments planned by some providers to improve the ease of recording consultations and to bring some terminology in line with the now agreed service specification (e.g. some areas of the PMR which will be used in NHS Pharmacy First Scotland delivery may still be labelled “eMAS” at launch). The CPS website provides an overview of how claims should be made for each PMR system at launch
Community Pharmacy Scotland has been consulted on the contents of this Circular and the Scottish Drug Tariff is being amended.
Action
Health Boards are asked to note the contents of this Circular and to bring it to the attention of community pharmacy contractors on their Pharmaceutical Lists, GPs, Health and Social Care Partnerships and Area Pharmaceutical Committees.
