Services Database QUIT E-Voucher Scheme

Service ID

418761

Description

The QUIT E- Voucher Scheme Pathway
Tobacco Treatment Advisors (TobTAs) based in the NHS Trusts are National Smoking Cessation Training Centre certified. They will undertake a specialist assessment of the patient and with the patient agree the patient’s tobacco addiction treatment plan. This will include motivational support, as well as, where clinically indicated, pharmacotherapy.
In line with the QUIT Programme ethos that smoking is a long term condition and not a life style choice, patients will be offered treatment within secondary care on an opt out basis. Discussion will be around the need for treatment rather than whether patients are ‘ready to quit’. Further information about this can be found in the QUIT e-learning module one ‘What is QUIT and why are we doing it’ on the SYB QUIT website (www.sybics-quit.co.uk – aiming for website to be live in April/May 21).
There are a number of scenarios (see page 9) where the TobTAs will need to provide the patient with a change of product or additional supplies of medication when the patient is in the community rather than in the hospital.
This will be done via a request to the community pharmacy to supply NRT and / or varenicline (the later under a patient group direction) via a PharmOutcomes electronic voucher (using the e-referral modules in PharmOutcomes).
Trust’s Tobacco Treatment Advisors are also providing support to Trust staff who wish to quit smoking. Some Trusts are considering using the e-voucher scheme as a means of supplying the staff receiving support from the Tobacco Treatment Advisors with the pharmacotherapy. The same process should be followed for staff members as for patients. Only staff members who are registered with SYB CCGs GPs are eligible for this service.
The Tobacco Treatment Advisor will:

  • Agree with the patient the community pharmacy that they wish to collect their medication from (from a list of participating pharmacies).
  • Complete the e-referral request within PharmOutcomes, which includes details of drug (including product type for NRT), dose and duration of supply.
  • Submit the e-referral request via PharmOutcomes to the patient’s choice of pharmacy, who will receive it in real time.
  • Record in the patient’s Pharmacy Medication Record (PMR), as well as in PharmOutcomes, the drugs requested.
  • Ensure that the patient has arrangements in place for their ongoing behavioural support – either from the Trust TobTAs or transfer of care to the local community stop smoking service / integrated well-being service.
  • Inform the patient that it will be the Pharmacist’s decision whether or not to supply the NRT or varenicline.

Note:

  • Where patients are having a second or subsequent e-referral request, the TobTA will encourage patients to use the same pharmacy as where previous supplies have been collected from.
  • The usual maximum duration of supply requested will be two weeks or standard drug pack size. In exceptional cases (eg if the patient is going on holiday) a slightly longer duration of supply may be requested.
  • The patient will not be given a copy of the voucher or a code number.
  • Individuals who were under the care of the local community stop smoking service (SSS) prior to hospital admission will have this support paused temporarily while an inpatient and until after the first follow up call post discharge by the Trust TobTA. Thus it is acceptable for community pharmacists to supply medication for these individuals as requested by Trust TobTAs prior to the community SSSs picking up the care again.

The receiving pharmacy will:

  • Receive the requests to supply NRT and / or assess the patients for varenicline supply under the patient group direction, via PharmOutcomes.
  • Requests may be made for one or two NRT products on the NRT e-referral.
  • A separate e-referral will be used for requests for varenicline.

Note: As patients are unable to smoke in hospital, patients started on varenicline while in hospital may also be prescribed NRT, to run alongside the varenicline, for a time limited period. To reduce the risk of patients who have been discharged within two weeks of commencing varenicline starting to smoke again on discharge, community pharmacists may occasionally be asked to supply a patient with both NRT and varenicline. This will be included in the patient group direction.
Please check for each patient whether e-referrals have been issued for both NRT and varenicline.

  • The pharmacy has the option of rejecting the referral in PharmOutcomes. This option can be used for a ‘no show patient’ or if the pharmacist assessed the patient to be unsuitable for the requested medication. A message will automatically go back to the referring service.
  • Check that the patient or their representatives are collecting the medication within four weeks of the e-referral being issued.
  • As many patients will be unwell or vulnerable to Covid 19, all consultations / assessments may be undertaken with the patient by phone or online video consultations (including for the initial varenicline PGD assessment) rather than them needing to attend the pharmacy in person.

Location of service

Sheffield LPC

Commissioner

Clinical Commissioning Group (CCG)

Method of commissioning

Local Authority contract

Source of funding

Service type

Stop smoking

Other organisations involved

Dates

Start date:
End date:

Status

Ongoing

Training

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