Community Pharmacy – helping provide better quality and resilient urgent care

In November 2015, NHS England published Quick Guide: Extending the role of community pharmacy in urgent care, to highlight to System Resilience Groups and local commissioners the extended role that community pharmacy teams can play to relieve pressure on urgent care.

The quick guide, which is one of a series of documents that has been produced to support the Commissioning Standards Integrated Urgent Care, explains how pharmacy teams can reduce demand on other urgent care services. It includes examples of services that have already been delivered by pharmacy teams, which could be commissioned on a local basis to relieve the pressures urgent care is facing, as well as highlighting nationally commissioned services.

Previous publications to support extending the role of community pharmacy in urgent care

In early December 2013, NHS England published Community Pharmacy – helping with winter pressures, which provided suggestions on how local commissioners (Clinical Commissioning Groups and local NHS England teams) could make better use of community pharmacy services to support urgent healthcare provision. Detailed proposals for three services (‘flu vaccination, emergency supplies of medicines and provision of self-care support for winter ailments) that commissioners could consider locally were included in an accompanying appendix.

Updated versions of these documents were published by NHS England in November 2014:

Community Pharmacy – helping provide better quality and resilient urgent care

Appendix 1 – Community Pharmacy – helping provide better quality and resilient urgent care: three services for commissioners to consider
In this Appendix there are references to indicative fee levels agreed by PSNC and NHS England in 2013; PSNC has subsequently withdrawn its support for these indicative fee levels.

Implementation plans and associated template documents have been developed for each of the suggested services, in order to facilitate rapid commissioning where a need is identified locally; these documents are available via the links below. As a national Flu Vaccination Service was implemented in 2015, the flu vaccination documents have been removed from the website, but copies are still available on request from Rosie Taylor, Head of Service Development.

Commissioning an emergency supplies of medicines at NHS expense service from community pharmacies

The amendments to the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2013 published on 16th December 2013 allow Emergency Supply at NHS expense to be commissioned by local NHS England teams as an Enhanced Service from community pharmacies.

This amendment, which was requested by PSNC, creates greater flexibility in the way local NHS England teams can commission an Emergency Supply service from community pharmacies. Prior to the amendment, it was only possible for local NHS England teams to commission an Emergency Supply service from community pharmacies using a Patient Group Direction (PGD) as the legal basis for making the supply of an urgently required medicine.

The ability to use the emergency supply provisions within the Human Medicines Regulations 2012, instead of a PGD, should make the commissioning of such a service easier to undertake for local NHS England teams and community pharmacy. PSNC recommends that where an emergency supply service is commissioned from community pharmacies, it is done so as an Enhanced Service using the provision in the Human Medicines Regulations 2012.

Implementation Plan (updated Feb 2014)

Template service agreement & specification (Emergency Supply Toolkit Document 1) (Updated Oct 2016)

Sample emergency supply Patient Group Direction (Cornwall & Isles of Scilly)

Sign-up and assurance sheet (Emergency Supply Toolkit Document 2)

Emergency Supply Record form (Emergency Supply Toolkit Document 3)

GP notification template (Emergency Supply Toolkit Document 4)

Urgent Repeat Medication Requests: Guide for NHS 111 Services. How to refer directly to pharmacy and optimise use of GP out of hours services (NHS England, March 2015)

Commissioning a community pharmacy service to support low income families or patients in areas of social deprivation to self-care

Implementation Plan

Template service agreement & specification (Winter Ailments Toolkit Document 1)

Sign-up and assurance sheet (Winter Ailments Toolkit Document 2)

Winter ailments service record form (Winter Ailments Toolkit Document 3)

How were these documents developed?

NHS England staff, including representatives from a number of Area Teams (now known as local NHS England teams) worked with PSNC, two LPCs, and representatives from Clinical Commissioning Groups, urgent care providers and a number of other pharmacy and related organisations to collaboratively develop the documents in response to the pressures the NHS is expected to face over the winter. The three suggested services and associated template documents draw on experience gained from local commissioning of these services to save time for commissioners that wish to implement these services rapidly.

Any queries on the above template documents can in the first instance be directed to Rosie Taylor, Head of Service Development at PSNC.

More information and PSNC Briefings on urgent and emergency care