< Previous | Contents | Next >

MODERNISING NHS COMMUNITY PHARMACY IN SCOTLAND

SECTION 2: INTRODUCTION OF NEW COMMUNITY PHARMACY CONTRACT

The Policy Intention

2.1 To amend existing legislation so that steps to modernise pharmaceutical care services and improve patient care, through the introduction of a New Community Pharmacy Contract, can be effected in the future.

The Need for Change

2.2 A specific action point in the Scottish Executive’s strategy document The Right Medicine was that the Executive would work with the profession to develop a new system of remuneration for community pharmacists, one that provides incentives to improve and deliver quality care health services.

2.3 Discussions with the community pharmacists’ representative body, the Scottish Pharmaceutical General Council (SPGC), on the New Contract have been ongoing during 2003 and are expected to be concluded in the first half of 2004. Subject to any required legislative provisions being in place, the intention is that the New Contract will come into operation in 2005-06 although, again subject to legislative cover, elements of the contract may be phased in during the course of 2004-05.

2.4 Although the contract discussions are ongoing, the Department and SPGC have agreed an outline framework for the New Contract. In summary it will comprise two main elements, namely:

• Core Pharmaceutical Care Services – centrally negotiated (terms of service and remuneration) and comprising:
• Chronic Medication Service
• Minor Ailments Service
• Acute Medication Service
• Public Health Service
• Additional Services – these services will, as now, be locally negotiated. A list of the current additional pharmaceutical services is at Section 1.8.

2.5 The Core Services will form the national contract and be provided by all community pharmacists in Scotland. Overall the aim of the New Contract is to improve the range and quality of care provided to patients through the development and better utilisation of community pharmacists’ skills, and those of their support staff. Whilst dispensing is a key activity, in future greater emphasis will be placed on the clinical management of an individual patient’s condition(s) or wider health care needs.

2.6 Sections 1.8 and 1.11 to 1.12 summarise the legislative framework for the provision of pharmaceutical services. Legislation will be required to ensure the implementation of all aspects of the finally negotiated New Contract provisions.

The Proposals

2.7 Whilst the detail of the New Contract core services has still to be agreed, the expectation is that it will include provision of (for example):

• pharmaceutical care for certain specified conditions
• diagnostic testing and the provision of advice in connection with self-testing
• care for people with minor ailments, without a GP prescription
• pharmaceutical advice to patients on request (unconnected to a particular supply)
• provision of public health services

2.8 Legislation will require to ensure that the terms and conditions of service for pharmacy contractors providing the new or redesigned services are capable of being set out. In keeping with the aims of the New Contract it is expected that the provisions will relate to the quality of services provided, standards of clinical practice, the training and qualifications of staff, the standard of premises and other matters related to the infrastructure of pharmaceutical services.

2.9 In terms of the quality of services and the premises from which they are provided, legislation would be expected to detail (for example):

• the people to whom services may or must be provided, e.g. to patients referred by a GP and who register with the community pharmacist
• how specific services are to be provided, e.g. in accordance with clinical protocols or standard operating procedures
• the type and format of patient records to be maintained for specific services
• the standards to which the services are to be provided
• where services may or may not be provided, e.g. patient counselling to be undertaken in designated types of area, likewise for the fitting of appliances
• the nature and standards of equipment (clinical and IM&T) used in, or in connection with, the provision of pharmaceutical services

2.10 In terms of facilitating the management, audit and clinical governance of pharmaceutical services, it is envisaged that legislation would require contractors to (for example):

• comply with the requirement for continuing professional development (CPD) through meeting duly designated clinical competencies
• provide information to Scottish Ministers or NHS Boards about the services they have provided
• institute their own clinical governance or other quality assurance activities and/or take part in those organised by others
• make arrangements for the continuing professional development of staff
• comply with good human resource management
• carry out audits of their services
• where required, report adverse incidents or near misses to Scottish Ministers, or specified 3^rd parties, in a format determined by them

2.11 As indicated above, the listed terms of service items are illustrative and should not be taken as definite or fully comprehensive at this stage.

2.12 Boards will be directed to monitor and ensure compliance by contractors with the terms and conditions of service and other regulatory requirements associated with the provision of pharmaceutical services.

Question

• Are there any specific or additional powers we need to consider in order to modernise pharmaceutical care services and further improve patient care?

< Previous | Contents | Next >