Published: 18/01/21

COVID 19 – Community Pharmacy: NHS Medicines Delivery Service: This circular sets out the arrangements for a new time-limited medicines delivery service to be deployed by the Community Pharmacy Network to support winter pressures, NHS remobilisation and our National Strategic Framework during the COVID-19 outbreak.

Background

Since the outbreak of the pandemic, the community pharmacy network has demonstrated its resilience and adaptability to find new and innovative ways of working to support the NHS and ensure patients continue to have access to vital medicines and pharmaceutical care across our 1,258 pharmacies.

The pandemic has seen a greater demand from patients looking for their medicines to be delivered, extended beyond shielding groups. The majority of pharmacies have managed to maintain their existing deliveries to patients and while many pharmacy owners have sought to support additional deliveries during this time, the ability to increase capacity has been limited due to costs for both infrastructure and workforce.

The latest strain of the virus brings increased risk due to the nature of increased transmissibility. It’s therefore important to reduce points of contact among the general population to help reduce infection rates in our communities. All community pharmacies are operating a patient queuing system to support physical distancing. Offering an NHS Medicines Delivery Service can help support the stay local, stay home message during this period

Detail

A time-limited medicines delivery service for those most at risk will help to alleviate the pressures on the pharmacy network and wider NHS services. This cohort would include persons considered as shielding, all patients deemed to be at high risk (as per the NHS influenza vaccination criteria but excluding those aged 55-64), those self-isolating and those whom pharmacists’ professional judgement would warrant such a service. It is envisaged that this will capture circa 1.5 million people across Scotland. Community pharmacy teams are asked to identify eligible patients and proactively offer the delivery service to them for acute and repeat medications. The service will also support those individuals or households who have been instructed to self-isolate through Test and Protect contact or a positive COVID-19 test.

The service will allow this cohort to stay at home and avoid unnecessary journeys (often on public transport) to community pharmacies, which may involve waiting outside in adverse conditions as a result of necessary COVID-secure ways of working. The service will also help community pharmacy teams to manage their workload and COVID risk from a reduced footfall.

Service development for Dispensing Doctor Practices is being considered and further information will be issued in due course.

Operations

The service will run for an initial three month period, starting 18 January 2021. It will support manageable timescales for delivery and allow for significant uptake. Deliveries should be undertaken by appropriately qualified members of the pharmacy team or a third party provider to meet existing regulatory and professional standards, retaining the essential two-way communication between the patient and the pharmacy team. Administration will be kept to a minimum, with delivery claims being made via electronic endorsement of prescription forms. Payment verification and counter-fraud checks will be determined as appropriate by NSS.

Community pharmacies are advised to use the “Other” freetype endorsement field to claim for deliveries made or attempted under the service. Two claim codes will be established – one for shorter distances (SDD) and one for longer journeys (LDD). A higher weighting will be applied to deliveries which require travel to greater distances when payments are calculated. This is applicable for any deliveries made to patient addresses over 10 miles from the pharmacy (i.e. a 20 mile return journey).

For each delivery made, the appropriate endorsement for the distance travelled should be applied once per prescription form, on the first item of each form. For example, if four items are delivered against two prescription forms, two endorsements would be made in total. .

As the network is working within existing payment system architecture, this claim mechanism cannot be used for non-electronic prescriptions (HBP, Nurse PCA (P)(2021) 1 forms etc), NHS Pharmacy First Scotland services or for instalments. Deliveries to care homes are excluded from this service.

The full service specification can be found at Appendix A

Funding and Payment

Scottish Government have agreed a fixed pool of £5m for the period January to end of March 2021. In addition, contractors who participate in this service shall receive a one off payment of £1,460 per contractor for initial set up costs and to recognise the workload associated with point 10 above which cannot be claimed electronically. Please find attached at Annex B a declaration form for those who participate in the service.

For each dispensing month, payments will be calculated based on endorsements submitted that month against a fixed funding pool.

Payments will be made one month in arrears (e.g. January ’21 delivery endorsements paid in April ’21).

Monitoring and Evaluation

The service will be reviewed prior to the planned end date (end March 2021) to assess the need for any extension.

Consultation

Community Pharmacy Scotland have been consulted on the content of this circular.

Action

NHS Boards are asked to:

• note the contents of this Circular

• copy the contents of this Circular to community pharmacy contractors on their pharmaceutical list and Health and Social Care partnerships