NUMSAS & NUMSAS – NHS 111 Online


NUMSAS

Service Objectives

  • manage appropriately NHS 111 requests for urgent medicine supply;
  • reduce demand on the rest of the urgent care system;
  • resolve problems leading to patients running out of their medicines; and
  • increase patients’ awareness of electronic repeat dispensing.

Service Specification

The most update to date version can be found on the NHSE Website.

NUMSAS training module

A training module has been developed for NHS 111 health advisors and pharmacy teams to help describe the NHS Urgent Medicine Supply Advanced Service (NUMSAS) and to illustrate the change in the patient journey since its introduction: http://www.england.nhs.uk/numsas111/

Community Pharmacy Toolkit

A Toolkit for Pharmacy Staff is available here.

Other Resources

Full details of this service are available on the PSNC website.

Emergency Supply Rules


NUMSAS NHS111 Online 

Pharmacies  are now able to receive referrals to NUMSAS via NHS111 online in addition to the NHS111 telephone service and you will start to see referrals from the online portal arriving in your PharmOutcomes inbox.

Instead of the patient phoning through to NHS 111 they will be able to access a referral using the  NHS111 online portal.

In line with the existing 111 telephony service the pharmacist is required to access the patient’s SCR, conduct a face to face consultation with the patient and the referral won’t state the medicine required by the patient, therefore it will not screen out requests for CDs.

How is this different? 

When the referral arrives in PharmOutcomes, the referral will have a reference number which will enable you to locate the correct referral in your inbox when the patient presents in pharmacy.

This briefing from NHSE provides more details of the service.

If you have any questions or queries please contact Bruce Prentice and NHS England.


NUMSAS FAQs

Key elements of NUMSAS which often prompt questions to the LPC are around the use of SCR and which medicines can be supplied.

With the addition of NHS111 on-line referrals,  we would like to ensure all contractors are aware of the following key elements of the service.

Use of the Summary Care Record (SCR)
It is a requirement of the NUMSAS SLA that the pharmacist must check the SCR unless there is a good reason not to do so. Please remind all pharmacists including locums of the need to have a working smartcard with access to SCR. This will ensure your pharmacy is able to meet its contractual obligations and deliver the service 100% of the time.

Supply of schedule 2 or 3 CDs.
Emergency supplies of Schedule 2 or 3 CDs cannot be supplied in an emergency without a valid prescription, except for phenobarbital or phenobarbital sodium for the purpose of treating epilepsy. This legal requirement also applies to NUMSAS.

With the re-classification of Pregabalin and Gabapentin contractors may notice an increase in medication they are unable to supply. In this instance the pharmacist must contact the local GP OOH service to ensure the patient is contacted by another appropriate healthcare professional.

Supply of schedule 4 and 5 CDs
The quantity of medication that can be supplied appears to be causing confusion for some contractors. For schedule 4 and 5 CDs normal emergency supply regulations apply and therefore a maximum of 5 days supply may be made if clinically appropriate.

What is the appropriate action to take if the NUMSAS referral is for a medicine liable to misuse?
The pharmacist needs to balance the potential for misuse versus the need and the impact on the patient of not supplying a medicine or appliance. A limited supply of 1 or 2 days of the medication, until the next working day for GP practices, could be considered providing it is allowable under the emergency supply regulations.

How many days’ worth of treatment can be supplied?
The pharmacist should apply their professional judgement to determine the most appropriate length of treatment to supply and take into consideration the time it will take for the patient to obtain a further supply from their GP practice; whilst ensuring the quantity supplied is in line with the provisions of the Human Medicines Regulations.

We hope this information will support you with your delivery of the service. If you have any further questions please do not hesitate to contact the LPC.