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As well as the core and national services which community pharmacies in Scotland provide to their communities, there is a range of local services which have been developed in response to the needs of people living in the 14 different Health Boards.
Although this is a relatively small country in terms of population, there are stark contrasts between demographics, geography and social issues which require more tailored solutions. The compact nature of Health Boards also allows for controlled tests of change, with some of our most successful national services like Pharmacy First having their origins as local innovations. NHS Boards negotiate locally with Community Pharmacy Health Board Committees on remuneration for the following pharmaceutical services (not an exhaustive list):
Advice to Residential Homes
Support for people with substance misuse issues
Needle Exchange Services
Compliance support solutions
Disposal of Patients’ Unwanted Medicines
Out of Hours rotas
Collection and delivery services
Details of each Board’s local services can be found on the NHS Community Pharmacy Website under the relevant Board’s tab.
Advice to Residential Homes
Some NHS Health Boards contract with community pharmacies that supply medicines to care homes to deliver advice on the handling of medicines and on medication policies. Sometimes this will include the training of care home staff. The service will look different in each area, and contractors wishing to provide this advice to care homes that they service should speak with their Health Board Pharmacy colleagues in the first instance.
Support for people with substance misuse issues
This service is provided as part of the holistic support that the NHS and social services offer for people with substance misuse issues, which may include the misuse of opioids, prescription medications, alcohol and more. The detail of which medications are used in treatment and what support is delivered varies by Health Board. The core of these services are the dispensing and/or supervision of substitution therapies, with recent developments in some areas including a move to providing a ”package of care”, with structured interventions aimed at improving overall health outcomes delivered by pharmacy staff. Contractors interested in providing these services should speak with their Health Board Pharmacy colleagues in the first instance.
Injecting equipment provision (Needle exchange)
Services that enable the provision of injecting equipment aim to protect individual and public health by reducing the incidence of blood-borne infection and drug-related deaths amongst service users by:
providing sterile injecting equipment and related paraphernalia as agreed locally
reducing the rate of sharing and other high-risk injecting behaviours
promoting safer injecting practices
providing and reinforcing harm reduction messages including safe sex advice and advice on overdose prevention.
They also aim to protect the health of local communities by preventing the spread of blood-borne infections by providing safe disposal facilities for used injecting equipment and to help patients who use the service to access other health, voluntary, and social care services where appropriate.
Contractors interested in providing these services should speak with their Health Board Pharmacy colleagues in the first instance, though the spread of these services is generally informed by a needs assessment, and not all contractors will be able to participate.
Disposal of Unwanted Medicines
NHS Boards are required by the Scottish Government to provide a service whereby patients are able to return unwanted medicines to their community pharmacy. Once collected, the Health Board is responsible for ensuring its collection and disposal by incineration.
Changes in waste legislation have occurred over the last few years and contractors may contact their Health Board for advice on the safe disposal of unwanted medicines.
Vaccine Supply
Vaccine supply arrangements in Scotland
Since 2016, the Scottish Government has run a central procurement system for the seasonal influenza vaccination programme. Tenders are issued for the procurement and distribution of the vaccines and doctors are advised on when and how to obtain supplies. We know that there continues to be some confusion over the new arrangements and we would suggest that any queries from GP practices should be referred to the flu vaccine coordinator at the NHS board.
The 2018 General Medical Services (GMS) contract has specified that all vaccination programmes will be moved out of general practice by the end of 2021, with each Health and Social Care partnership responsible for the transformation of services. The opportunity for community pharmacy to be involved in the provision of NHS flu vaccinations is currently being investigated.
Unplanned Pharmacy Closures
If a community pharmacy has an unplanned pharmacy closure, the NHS Board needs to be notified. We are in the process of setting up full contact details for this on our website, so the information is all in the one place and easy to find. Please click on the link below for details and make sure your pharmacy teams are aware of this requirement and where to access the information if required.
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Anne Shaw | Primary Care Manager Pharmacy & Optometry | Tel: 01563 578651 or 07805 248 789
Carolyn Dickson | Assistant Primary Care Manager - Pharmacy & Optometry | Tel: 01563 578651 or 07557 114 209
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Email: communitypharmacy.team@borders.nhs.uk | Tel: 01896 825 540
Other Information
It is recognised that due to exceptional circumstances out with your control you may have to close your pharmacy for a portion of the day.
It is essential that if the pharmacy is unexpectedly closed for more than 30 minutes you inform NHS Borders of this closure, and the reason for this closure.
Whilst we would not anticipate that this happens regularly, in the instance that you are in one of the following situations, please download the guide for more details: here
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Primary Care Development Team: Email: dumf-uhb.PCD@nhs.net Tel: 01387 244 284
Pharmacy Dept D&G Royal Infirmary: Tel: 01387 241 557 - If you are unable to source urgently required medication
Other Information
Further details of what to do in the event of an unplanned closure or if you are unable to source urgently required medication are available in the letters below:
Temporary Suspension of Pharmaceutical Services Communication
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Email: fife-uhb.primarycareadmin@nhs.net Tel: 01592 226 930
Other Information
It is recognised that due to exceptional circumstances out with your control, you may have to close your pharmacy for a portion of the day.
It is essential that if your pharmacy is unexpectedly closed for more than 30 minutes you inform NHS Fife Primary Care Department of the closure and the reason for this closure, along with making every effort to alert patients and surrounding GP surgeries
Whilst we would not anticipate that this happens regularly, please follow the guidance within the Unplanned Closure document below.
Unplanned Closures in Community Pharmacy
Please also see guidance from Addiction services on missed doses of OST and action to be taken
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Email: carol.droubay@nhs.scot | FV-UHB.communitypharmacysupport@nhs.scot
Other Information
On the rare occasion where an emergency results in the closure of a pharmacy, the pharmacist on duty or a senior member of the pharmacy team must inform the health Board on 01786 457231 AND by e-mail. In instances where a pharmacy is required to close, the pharmacy manager or support staff available in situ should download and complete the following checklist. The following actions should be undertaken and checked off. The checklist should be emailed on completion to: FV-UHB.communitypharmacysupport@nhs.net | carol.droubay@nhs.net
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Primary Care Contracts Team: Email: gram.pcctpharmacy@nhs.scot | Tel: 01224 556 730
Other Information:
Please state the reason for the closure, how long the pharmacy is expected to be closed and any procedures the pharmacy has put in place (e.g. utilising BCP, sign on the window to direct patients).
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Community Pharmacy Development (CPD): Tel: 0141 201 6046 Email: ggc.cpdevteam@nhs.scot
Please Note: Notify of inability to open the pharmacy and potential length of time for closure (if known).
Other Information:
Contact local addiction teams/drug services and shared care practices to advise of closure details
If possible, negotiate access to the pharmacy to retrieve prescriptions and CD records
Relocate staff and relevant records to the nearest alternative pharmacy if possible
Arrange to notify patients of alternative dispensing arrangements including where to obtain replacement prescriptions if required
If new prescriptions are required ensure accurate PMR / CD recording information is available where possible, to assist prescribers
Update Business continuity plans to incorporate lessons learnt
The Addictions pharmacy team can be contacted on 0141 303 8931 for advice and support
Make contact with the CPD Team when the pharmacy re-opens to provide services so that the Closure Log can be updated and relevant persons contacted
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Tel: 01463 706830 - Please leave a voice mail if the office is closed.
Other Information
Notify local GP practices and all daily dispensing patients
Inform the daily dispensing patients’ GP
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Email: pharmacycareservices@lanarkshire.scot.nhs.uk
In the past few weeks the number of unplanned closures or restriction in hours from community pharmacies has decreased and this is, of course, very welcome.
It is still important that we plan for this situation and, together with Community Pharmacy Lanarkshire, we have agreed on the following plan which we are now implementing.
It is also worth noting that we are expecting further national guidance and if and when that comes this plan will be revisited. It will also be reviewed in light of experience.
The key points are:
The context is that pharmacies will only seek to close or restrict hours as a last resort.
Pharmacies should have a Business Continuity Plan in place which they identify actions they need to take to ensure continuity of care for patients who have a particular reliance on their pharmacy and may be affected by an unexpected closure. Obvious examples will include patient receiving ORT for addiction, “special” unlicenced medicines which may be difficult to obtain, and patients requiring dosetted medication. These are only examples and each pharmacy will have its own. That BCP should describe the actions which will be taken to secure care for such patients and clearly the mitigations required for a few hours of closure are more straightforward than a full day or more.
Our experience is that most unplanned closures can be managed where the closure/restriction in hours is
Closure of 4 hours or less
Closure for no more than 2 days in a row
There is realistic access to services from other pharmacies.
Closure does not compromise limited access to late night service provision where the OOH service and public have an expectation of service.
The pharmacy has applied their BCP indicating how patients reliant on the pharmacy will be cared for
Suitable signs will be put in the pharmacy to let patients know when the pharmacy will reopen.
4. We have therefore agreed that when criteria 3a-3f are in place we will automatically authorise a “last resort” closure/restriction in hours without the need to seek additional authorisation from the Health Board
5. In addition, a key aspect for successfully managing the situation is timeous and accurate communication of when the pharmacy will close and will reopen and we are establishing a new system to enable comprehensive and real time communication which will work 7 days per week.
6. The way a pharmacy must communicate their temporary closure will be to send a single email to pcs@lanarkshire.scot.nhs.uk with the words SHORT TERM AND TEMPORARY RESTRICTION IN HOURS OF A COMMUNITY PHARMACY in the title. The email should then give:
Pharmacy Name
Pharmacy Address
Pharmacy Phone Number
Time when the pharmacy closed
Time when the pharmacy will reopen.
Short explanation.
The name of the person making the decision
NB: This email will then be auto-forwarded, in real-time, to a broad range of partners including:
Community Pharmacies in NHS Lanarkshire
General Medical Practices as appropriate
Locality Prescribing Advisers and General Practice Clinical Pharmacists
NHS 24 and NHS Lanarkshire OOH service
Hospital pharmacies
Addiction service
Community Nursing and Palliative Care Services
Locality social care services.
8. To enable the auto-forwarding function to work in the most reliable way it is suggested that you cut and paste the title into your email and also use this only for the purpose of communicating short-term closures because any other communications would also be auto-forwarded.
9. It naturally follows that if a closure or restricted hours is anticipated for longer than the criteria above then prior authorisation should be obtained from the Health Board and initial contact should be via pcs@lanarkshire.scot.nhs.uk who will discuss with Christine Gilmour or Richard Shearer as appropriate. Christine/Richard can also be accessed by phone via the pharmacy office at 01698 752978.
10. This system will also be added to the NHS Lanarkshire section of https://www.communitypharmacy.scot.nhs.uk/nhs-boards/nhs-lanarkshire/ and the relevant site at Community Pharmacy Scotland. https://www.cps.scot/unplanned-pharmacy-closures
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Email: HUB.LUCS@nhslothian.scot.nhs.uk Tel: 0131 537 8427 (Email detailing the closure)
Email: nhs24providerupdates@nhs24.scot.nhs.uk Tel: 0131 537 8427 (Email detailing the closure)
Email: communitypharmacy.contract@nhslothian.scot.nhs.uk (Email community pharmacy template for an unexpected temporary closure to Primary Care Contracts Organisation)
Other Information
It is recognised that due to exceptional circumstances out with your control you may have to close your pharmacy for a portion of the day.
It is essential that if the pharmacy is unexpectedly closed for more than 30 minutes you inform PCCO of this closure, and the reason for this closure.
Whilst we would not anticipate that this happens regularly, in the instance that you are in one of the following situations, please download the documents below for full guidance:
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TBC
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Contact: Mary McFarlane | Principle Pharmacist NHS Shetland | Tel: 01595 743 370
Other Information:
Unplanned Temporary Change of Hours or Closure (Less than 1-month notice)
Applicants should notify the Principal Pharmacist of any unplanned change of hours or closure as soon as possible, in the circumstances of emergency this can first be a phone call (where possible) but the pharmacy contractor must also complete and submit a completed Pro-forma to detail the nature of the issue, the means for providing alternative care in the meantime, the planned recovery timescale, the plans for maintaining service provision and the name and number for a key contact managing the issue. This information will then be passed to the Primary Care Pharmacy Team for information, and to identify any support that could be provided. As the intention of this protocol is in response to emergency circumstances, the Primary Care Pharmacy Team will acknowledge as soon as possible and provide such support as is practicable.
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The following document supports delivering of services during winter 2022/23 through anticipated short staffing and/or increased patient demand. Closures may be planned or unplanned.
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Email: stephen.smith@nhs.scot
Other Information:
Please complete the Notice of unplanned temporary suspension of Pharmaceutical Services form and send to the email address above.