NHS Community Pharmacy Contractual Framework

1. NHS Community Pharmacy Contractual Framework The New Medicine Service (NMS) BLPC

2. New Medicine Service • It’s all about helpingpatients to get the most from their newly prescribed medicine • Based on proof of concept research • Advanced service (time limited to March 2013) • Service will continue if it has demonstrated value to the NHS • Provision commenced 1st October 2011

3. Benefits • PSNC and NHS Employers envisage that the successful implementation of NMS will: • improve patient adherence • increase patient engagement with their condition and medicines • reduce medicines wastage • reduce hospital admissions due to adverse events from medicines • lead to increased Yellow Card reporting • receive positive assessment from patients • improve the evidence base on the effectiveness of the service • support the development of outcome and/or quality measures for community pharmacy

4. Funding • Up to £55m in both 2011/12 and 2012/13 • 2011/12 – implementation payment (£750) and target payments • 2012/13 – target payments • Target payments depend on the achievement of activity thresholds which are related to prescription volume

5. Funding – target payments 2011/12

6. NMS – outline service spec • Three stage process • Patient engagement (day 0) • Intervention (approx. day 14) • Follow up (approx. day 28) • Opportunity to provide healthy living advice at each stage Make sure you read the service spec before providing NMS!

7. NMS – Patient engagement • Follows the prescribing of a new medicine for: • Asthma or COPD • Diabetes (Type 2) • Antiplatelet / Anticoagulant therapy • Hypertension • Apply professional discretion where a formulation change occurs • Recruitment by pharmacy or via referral • Dispense script and provide advice (as part of Dispensing service) List of medicines at www.psnc.org.uk/nms

8. NMS – Patient engagement • Provide patient with information on the service • Patient leaflet text – use of this text is not mandatory • Collect written patient consent • Agree a method and time for the intervention (in 7-14 days)

9. NMS – Intervention • Intervention typically day 7 – 14 • Face to face in a consultation area or over the phone • Semi-structured interview technique to: • assess adherence • identify problems • identify the patient’s need for further information and support Make sure you are aware of the limitations of telephone consultations

10. NMS – Intervention • Pharmacist provides advice and support • agrees follow up • agrees solution(s) • refers to GP (only where absolutely necessary) • Make a record of the discussion using the standard dataset • An NMS worksheet has been published to help you make notes during the discussion You can use PharmaBase to make your records of the discussion

11. NMS – Follow up • Follow up typically between 14 and 21 days after the Intervention • Face to face in a consultation area or over the phone • Semi-structured interview technique to: • assess adherence • identify problems • identify the patient’s need for further information and support The Interview Schedule has been developed to prompt a thorough conversation with the patient

12. NMS – Follow up • Pharmacist provides advice and support • Patient adherent • Patient non-adherent • refer to GP (using nationally agreed NMS Feedback form) • provide more advice and support • Make a record of the discussion using the standard dataset • An NMS worksheet has been published to help you make notes during the discussion Only refer to the GP where absolutely necessary

13. MURs and NMS • Patients are not usually eligible for an MUR within 6 months of receiving the NMS, unless in the pharmacist’s professional opinion the patient will benefit from an MUR • A note of the reason for carrying out an MUR within 6 months should be made on the patient’s record • There is no limit on the number of NMS a patient can receive in a year

14. DNAs and completed NMS • If a patient • does not attend the intervention or follow up • cannot be contacted on the phone at the agreed time The pharmacy must attempt to contact them to rearrange the appointment • The NMS is only ‘completed’ in certain circumstances • Only competed NMS can be claimed for

15. DNAs and completed NMS

16. DNAs and completed NMS

17. Knowledge & skills for NMS • Pharmacists must complete and sign the NMS – self-assessment of readiness for community pharmacists • There is no absolute requirement for training before providing NMS… • …but pharmacists must ensure they have the requisite knowledge Make sure you record your NMS related learning in your GPhC CPD record

18. Data capture and reporting to the PCT • A standard dataset has been developed for NMS • This supports data capture in a standardised manner, to support evaluation of the service • A standard report can be requested by the PCT on a quarterly basis PharmaBase will collate your NMS data and produce the quarterly PCT report

19. PharmaBase support • The NMS module in PharmaBase supports contractors to provide the NMS service, including the following functionality: • patient registration • printing consent forms • scheduling interventions and follow ups using a pharmacy calendar (which can also be used to manage appointments for other pharmacy services) • printing a patient information leaflet and appointment reminder • creating a task list of patient reminders to be provided prior to appointments • recording the mandatory dataset for the intervention and follow up • creating NMS Feedback forms to refer patients back to their GP practice • an ‘NMS dashboard’ to allow the pharmacy team to keep track of their NMS activity during the month • creating the quarterly reports for PCTs

20. Evaluation of NMS • NMS will only be re-commissioned after March 2013 if the benefits of the service can be demonstrated • The data collected via the NMS module in PharmaBase will support the evaluation of the service • The Department of Health are currently selecting an academic team to evaluate NMS

21. What do you need to do now? • Ensure you are accredited to provide MUR’s and have a consultation room fit for purpose. • Read the service specification and the Directions • Read the PSNC/NHS Employers guidance • Read the CPPE open learning programme • Use the other CPPE and alternative learning resources as needed • Attend a local workshop on NMS (where available) The final version of the service spec was published in Oct

22. What do you need to do now? • Complete the pharmacist self-assessment form and a CPD record or two… • Develop an SOP (templates are available e.g NPA) • Train your pharmacy team on the service • With your support team, plan how the service will operate in your pharmacy • Familiarise yourself with the data recording requirements and paperwork

23. What do you need to do now? • Discuss the service with your local GP practice teams (working with your LPC where appropriate) – briefing documents are available on the PSNC website • Familiarise yourself with the PharmaBase module or software provided by your PMR system. • Notify your PCT when you are ready to start providing the NMS • Claim your £750 Implementation payment once you have completed 6 NMS (a form to do this is on the PSNC website and must be submitted by 31st March) PCT notification form can be downloaded from www.psnc.org.uk/nms

24. Information Sources • Chemist and Druggist website: http://www.chemistanddruggist.co.uk/nms • RPS website: http://www.rpharms.com/nhs-community-pharmacy-contract-england/new-medicine-service.asp • PSNC website: www.psnc.org.uk/nms • NPA website: http://www.npa.co.uk/NMS • Your LPC website or LPC contact. This hand-out has been adapted from one available on the PSNC website. A full Version can be found at: www.psnc.org.uk/nms