Advanced Services – now part of the Quality Payment Scheme Gateway Criteria
Medicines Use Review (MUR) & Prescription Intervention Service.
The pharmacist conducts an adherence focussed medicines review with the patient. The review assesses the patient’s use of their medicines and attempts to identify and address any problems they may be experiencing. Where necessary, a referral is made to the patient’s GP. The service aims to increase the patient’s knowledge of their medication and improve their adherence to the regimen. The MUR can be conducted on a regular basis, e.g. every 12 months, or on an ad hoc basis, when a significant problem with a patient’s medication is highlighted during the dispensing process. At least 70 % of the MURs provided each year must be for patients who fall within one of the national target groups: patients with respiratory disease (e.g. asthma and COPD) , patients recently discharged from hospital , patient taking a ‘high risk’ medicine (NSAIDs, anticoagulants, antiplatelets and diuretics) or patients at risk of or with diagnosed CVD taking four or more prescribed medicines.
MURs are conducted in a private consultation area which ensures patient confidentiality. The pharmacy provides a quarterly summary report to NHS England, if requested, of MUR consultations conducted. This supports monitoring of the service to determine its effectiveness and value to the NHS.
New Medicine Service (NMS)
This service is designed to improve patients’ understanding of a newly prescribed medicine for a long term condition, and help them get the most from the medicine. Research has shown that after 10 days, two thirds of patients prescribed a new medicine reported problems including side effects, difficulties taking the medicine and a need for further information. The NMS has been designed to fill this identified gap in patient need. The pharmacist will provide the patient with information on their new medicine and how to use it when it is first dispensed. The Pharmacist and patient will then agree to meet or speak by telephone in around a fortnight. At this second stage of the service the pharmacist will discuss with the patient how they are getting on with their new medicine. Further information and advice on the use of the medicine will be provided and where the patient is experiencing a problem the pharmacist shall seek to agree a solution with the patient. A final consultation (typically 21-28 days after starting the medicine) will be held to discuss the medicine and whether any issues or concerns identified during the previous consultation have been resolved. If the patient is having a significant problem with their new medicine the pharmacist may need to refer the patient to their GP. The NMS is conducted in a private consultation area which ensures patient confidentiality. The pharmacy provides a quarterly summary report to NHS England of NMS consultations conducted, if requested. This supports monitoring of the service to determine its effectiveness and value to the NHS.
Appliance Use Review Service.
This service is similar to the MUR service, but it aims to help patients better understand and use their prescribed appliances (e.g. stoma appliances) rather than their medicines by: establishing the way the patient uses the appliance and the patient’s experience of such use , identifying, discussing and assisting in the resolution of poor or ineffective use of the appliance by the patient,advising the patient on the safe and appropriate storage of the appliance and proper disposal of the appliances that are used or unwanted The service is conducted in a private consultation area or in the patient’s home.
Stoma Appliance Customisation Service .
This service involves the customisation of a quantity of more than one stoma appliance, based on the patient’s measurements or a template. The aim of the service is to ensure proper use and comfortable fitting of the stoma appliance and to improve the duration of usage, thereby reducing waste.
For further information on the provision of Advanced service please follow this link to the PSNC website.
NHS Urgent Medicine Supply Advanced Service (NUMSAS)
On 20th October 2016, the Department of Health (DH) and NHS England announced that as part of the 2016/17 and 2017/18 community pharmacy funding settlement, money from the Pharmacy Integration Fund (PhIF) would be used to fund a national pilot of a community pharmacy Urgent Medicine Supply Service. The service is being commissioned as an Advanced Service and it will run from 1st December 2016 to 31st March 2018 with a review point to consider progress in September 2017.
The decision comes after PSNC proposed a community pharmacy emergency supply service as part of its counter proposal to the NHS and Government, but was clear that any new national service would need additional funding rather than being funded from within the existing community pharmacy funding envelope.
DH then proposed that the PhIF could be used to fund a pilot scheme to test and evaluate such a service in order to inform possible future commissioning. For further information on this pilot and it’s roll out in Suffolk click here