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Public Health Service

The Public Health Service (PHS) is one of the four core community pharmacy services and currently consists of 4 elements:

  1. Ensuring that there is a health-promoting environment in the pharmacy - including promoting national campaigns using a combination of window posters, promotional materials and staff training (e.g. raising awareness of bowel cancer screening, flu vaccination uptake, hydration, etc.)

  2. Offering a sexual health service (EHC)

  3. Offering a smoking cessation service

  4. Offering access to prophylactic paracetamol for childhood vaccinations where appropriate

The Public Health Service aims to:

  • Promote and support a proactive approach to self-care and keeping well

  • Make use of windows/frontage and/or display space in pharmacies to promote health

  • Provide access to appropriate health education information, materials, and support

  • Contribute to the preventative health agenda

  • Offer opportunistic interventions to promote health

Smoking Cessation Service Delivery during COVID-19

Circular PCA(P)(2020)09 aids community pharmacy teams in supporting people through their smoking quit attempt by outlining some temporary flexibility in how the national service can be delivered and support that may be available from local specialist smoking cessation teams.

About the Service

The Introduction of the national pharmacy smoking cessation service in 2009 has seen community pharmacy deliver around 70% of all NHS stop smoking attempts in Scotland. The pharmacy network has made a crucial contribution towards public health targets to reduce smoking rates to below 5% by 2034, as set out in current tobacco control policy.

The service is delivered against a specification which has developed over the years to include the processes to be followed in carrying out the service and a PGD for prescribing Varenicline which is adapted and adopted for local use by each Health Board. The service specification is a great place to start if you have questions about what can and cannot be done in community pharmacy.

The latest update to the service specification and Varenicline PGD was published in August 2017. This remains mostly unchanged from the 2014 version, but makes clear that those who do not wish to use a product during their quit attempt can be supported as well as emphasising that where a client has had several quit attempts a discussion should be initiated as to which NHS cessation service was the most appropriate for their needs.

To ensure that pharmacy teams’ contribution toward supporting quits is recognised and to claim service fees, it is crucial that those involved in service delivery are familiar with and comfortable using the smoking cessation module on the PCR. The full guide can be found here.

Remuneration

Quit attempt event MDS submission Remuneration basis
Submission of the MDS information with confirmed quit date (normally first return appointment)

£30		 To be electronically submitted once the quit-date is confirmed with client. This will form the basis of the timelines for the 4-week and 12-week post-quit date follow-ups. At the end of each calendar month a count will be made, by Practitioner Services Division (PSD), on the central smoking cessation database of patients for MDS submissions for new quit attempts that meet the validation requirements.
Four week post-quit date 

£15

This should be performed for every patient who enters the service

 To be electronically submitted immediately after
the 4-week post- quit date and not later than 6 weeks from the confirmed quit-date.		 At the end of each calendar month a count will be made, by Practitioner Services Division (PSD), on the central smoking cessation database of patients for MDS submissions for the 4-week stage that meet the validation ­­­­requirements.
Twelve week post-quit date

£35		 To be electronically submitted between 12 and 14 weeks from the confirmed quit-date.,(If the patients quit attempt is known to have failed during the period the PCR may be submitted between 10 and 14 weeks.) At the end of each calendar month a count will be made, by Practitioner Services Division (PSD), on the central smoking cessation database of patients for MDS submissions for the 12-week stage that meet the validation requirements.

Education

NHS Education for Scotland has produced a number of learning resources to aid contractors in delivering the service. The service specification states that the NES multi choice questions must be completed to a satisfactory standard.

The latest eLearning package to support the smoking cessation service can be found on Public Health Scotland’s Virtual Learning Environment. Any team member can access this once they have set up a learning account.

Key Facts

We have created a PHS Smoking Cessation Key Facts Sheet to give you further information on the service.

CPS Webcast

We have recorded a webcast on the PCR and Smoking Cessation Support Tool. The webcast runs through two scenarios in terms of patients accessing the service and talks you through how the support tool works. It will also demonstrate how to use the reports function to give you an idea of how the PCR has been adapted to deliver the new service.

View the Smoking Cessation Support Tool webcast now.

The webcast lasts for 20 minutes but you can skip to the following sections by following the links below:

PCR Smoking Cessation Template Forms/Letters

  • This template form can be used to collect the data required to enter into the PCR
  • Varenicline Clinical Risk Assessment Form
  • Supply of Product Letter to GP Template 1
  • Supply of Product Letter to GP Template 2

PCR Administration Guide

4 Week Smoking Status Data Should Be Submitted For All Patients

The office has received feedback from Health Boards that the number of 4 week data set submissions from the PCR is very low compared with the number of quit dates set. Members are reminded that all patients who access the service should have data submitted for their quit date and their smoking status at 4 weeks post quit. The 4 week data is required for Health Boards to monitor quit rates. There is a £15 fee for submitting data at week 4.

Please see our PCR guide for helpful information.

Varenicline Support

Further support on Varenicline (Champix) supply can be found on the Pfizer website. Pfizer representatives can also provide you with product information on Champix. To book a phone or web-based appointment you can use the following link https://www.pfizerline.com/uk/ask-pfizer. Pfizer also have other support materials available on their website.

*CPS does not have any say over the content of these webpages. We add the link to provide further support for practitioners who feel they may benefit from the content and materials provided in their professional judgement.

PHS Poster Supplier Change

The contract for the management of Scottish Government posters in pharmacies has moved from Republic of Media (who subcontracted the work to Tactical Media) to APS Group. As a result the posters will now be mailed to each pharmacy location rather than being delivered and installed by APS Group.

This arrangement has been in operation since the start of March 2021.

If your poster holder requires to be replaced, please contact stockorders.DPPAS@theapsgroup.com and a replacement will be sent to you.

PHS Poster Campaigns 2023

Bowel Screening

To find out more call the Helpline on 0800 0121 833 or visit www.bowelscreening.scot.nhs.uk

Treat Yourself Better

The campaign is in response to inappropriate antibiotic prescribing and GP appointments be used for conditions which could be treated in the pharmacy.

www.treatyourselfbetter.co.uk

latest PGD for Levonorgestrel can be found under each Health Board’s page on www.communitypharmacy.scot.nhs.uk.

Service Aim

  • To provide extended access through the NHS to advice and Emergency Hormonal Contraceprtion (EHC) as part of the Public Health Service (PHS) element of the community pharmacy contract.

Service Outline

  • The PHS Sexual Health service consists of the Emergency Hormonal Contraception (EHC) service

  • The service is provided and funded as a national NHS service by NHS Scotland through the PHS element of the community pharmacy contract and comply with policies and standards set by the NHS for the provision of such services

  • A pharmacist who chooses not to supply EHC on the grounds of religious, moral or ethical reasons must treat the matter sensitively and advise the client on an alternative local source of supply (such as another pharmacy, GP or sexual health service). (see RPSGB Medicines, Ethics and Practice Guide)

  • If a client is showing symptoms that indicate another sexually transmitted infection then they must be advised and encouraged to attend the local specialist sexual health service, GUM clinic or their GP practice for further investigation.

  • The pharmacist must ensure, where appropriate, that the client is counselled on other sexual health matters and related topics. Written information should also be available on these topics

  • The pharmacist must use their professional judgement to consider, and where appropriate, act on any child protection issues brought to their attention. This should be in line with the local child protection procedures and any national or local guidance on under 16s sexual activity.

Service Standards

  • There is an accompanying service specification and set of standards for EHC provision

  • To allow use of Levonorgestrel (POM) under the PHS, a National PGD has been developed

  • The pharmacist providing the service should ensure that a standard operating procedure is in place which covers all aspects of service provision.

Training

  • The pharmacist providing the service must practise within their own competency

  • Distance learning resource packages are available from National Education Scotland (NES) Pharmacy for pharmacists who wish to develop their knowledge and skills in sexual health services

  • The pharmacist providing the service must be aware of and operate within the national service specifications.

Record Keeping

It is a requirement of the service that appropriate records, including patient medication records, are kept and maintained by the pharmacist, to enable verification of service provision and training requirements, and to provide information for internal and external audit and evaluation purposes.

Remuneration

Payments for supplying EHC are as follows:

  • Payment of £30 per EHC Intervention

  • Reimbursement for Levonorgestrel or Ulipristal prescribed using CPUS Prescription form
  • Contractors should remember to prescribe either Levonorgestrel 1500mcg, Levonelle 1500 or Ulipristal Acetate 30mg to ensure payment for medicine supply.

Contractors should consult their Public Health Service Payment report sent by PSD to ensure they are receiving this payment.

Background Information

RPSGB Medicines, Ethics and Practice (current edition)

Local child protection protocols and policies

NES Child Protection distance learning pack

NES Sexual and reproductive health e-learning – access via NES Portal

GPHC guidance on consent, sexual boundaries, confidentiality and provision of pharmacy services affected by religious moral beliefs.

National Health Service (Scotland) ACT 1978

Health Board Additional Pharmaceutical Services (Public Health Service) (Scotland) Directions 2014.

The Scottish Ministers, in exercise of the powers conferred by sections 2(5), 27A, 27B, 28A and 105(7) of the National Health Service (Scotland) Act 19781, and all other powers enabling them to do so, give the following directions

The contract for the management of Scottish Government posters in pharmacies has moved from Republic of Media (who subcontracted the work to Tactical Media) to APS Group. As a result the posters will now be mailed to each pharmacy location rather than being delivered and installed by APS Group.

This arrangement has been in operation since the start of March 2021.

If your poster holder requires to be replaced, please contact stockorders.DPPAS@theapsgroup.com and a replacement will be sent to you.

PHS Poster Campaigns 2023-24

  • Detect Cancer Early Campaign (18th September 2023 - 22nd October 2023)
  • Dentistry (31st October 2023 – 11th December 2023)
  • Right Care Right Place (12th December 2023 – 8th January 2024)
  • Smoking Cessation (9th January 2024 – 5th February 2024)
  • Sexual Assault Response Co-ordination Service (6th February 2024 – 4th March 2024)
  • Menopause (5th March 2024 – 31st March 2024)