NHS Circular: PCA(P)(2005) 20 abcdefghijklm = eé~äíü=aéé~êíãéåí= = aáêéåíçê~íé=çñ=mêáã~êó=`~êé=c=`çããìåáíó=`~êé= = mêáã~êó=`~êé=aáîáëáçå= = pí=^åçêéïdë=eçìëé= = oéöéåí=oç~ç= = bafk_rode= = ben=pad= Dear Colleague NEW COMMUNITY PHARMACY CONTRACT: PROGRESS REPORT AND IMPLEMENTATION PROGRAMME Purpose 1. To update NHS Boards and community pharmacy contractors on progress and developments with regard to the Department s plans to implement the new community pharmacy contract, and to advise the initial actions they need to take as part of the implementation programme. Background 2. Previous Health Department Letters (HDL 2004(36) and HDL 2005(34)) outlined the background to the new community pharmacy contract. In summary it will comprise four core elements, the Chronic Medication Service (CMS), Minor Ailments Service (MAS), Acute Medication Service (AMS) and Public Health Service (PHS). 3. Discussions between the Department and the contractors representative body, the Scottish Pharmaceutical General Council (SPGC), on the service and financial details are continuing. However, it has been agreed (a) that the contract will be implemented on a phased basis from April 2006 and (b) that the phasing will be aligned to the availability of the e- infrastructure required to support each of the core elements. 4. In practical terms this means that MAS and PHS will be implemented from April 2006 and that AMS and CMS will become fully operational from April 2007. Further details are provided in Annex A. The phasing reflects the expected timetable for software developments to support AMS and CMS but it also provides community pharmacy contractors with time to plan and prepare for the delivery of these services. 30 November 2005 Addresses For action Chief Executives, NHS Boards Director of Practitioner Services Division, NHS NSS For information Directors of Finance, NHS Boards Chief Executive, NHS NSS Professional Enquiries to: Alison Strath Room GE-07 St Andrew's House EDINBURGH EH1 3DG Tel: 0131-244 2823 Fax: 0131-244 2375 Éã~áäW ^äáëçåkpíê~íü]ëåçíä~åçköëáköçîkìâ= Policy Enquiries to: Duncan Clark Primary Care Division Room 1 East Rear St Andrew's House EDINBURGH EH1 3DG Tel: 0131-244 2274 Fax: 0131-244 2326 Éã~áäW= aìåå~åk`ä~êâ]ëåçíä~åçköëáköçîkìâ= = ÜííéWLLïïïKëÅçíä~åÇKÖçîKìâ= abcde abc a
Implementation Programme 5. HDL 2005(34) invited NHS Boards to submit business cases for funds under the Community Pharmacy IM&T Facilitation Programme. This initiative is targeted at ensuring that all community pharmacists have access to training and support in using NHSnet and mail facilities, and in use of the epharmacy applications for each of the core services. 6. HDL 2005(48) informed NHS Boards of the operational requirements to prepare for implementation of the Minor Ailments Service element of the new community pharmacy contract. It mainly addressed the administrative component needed to support the MAS system. 7. The Department now wishes to set in motion an implementation programme for the services themselves that will span the period from now until full implementation from April 2007. In so doing we wish to ensure that the process is managed in a consistent way across Scotland and that all key stakeholders are able to engage in the programme. 8. The main driver for implementation will be the use of appropriately trained and practising community pharmacists (practitioner champions). They will be expected to develop expertise in the new contract and then support other community pharmacists by cascading their knowledge and experience to their peer group in their practice locality. 9. In order to facilitate this process the Department will be allocating ring fenced resources to NHS Boards. Each Board will receive their share based on the indicative allocation for pharmacy services. The resources are being made available to cover or contribute to the time and travel costs of the practitioner champions in delivering the role summarised above. Annex C contains further details on the allocations. 10. This first tranche of resource will be for the implementation for emas and PHS for 2005-06 and details will follow accordingly on AMS and CMS. The funding position for 2006-07 will be reviewed in light of those details and the practical experience of emas and PHS implementation. 11. It is important that the implementation programme supports all community pharmacists i.e. individual community pharmacy contractors, small chains, the pharmacy multiples and regular locums. To this end, the practitioner champions will support implementation on a locality or geographical basis, taking in all the pharmacies in that area. 12. Area Pharmacy Contractor Committees will be responsible for identifying the practitioner champions. In doing so they will work closely with NHS Boards to agree the appropriate number of places and address any local variances. Annex B provides further details of the suggested champion specification. 13. The first of a series of implementation workshops for both practitioner champions and representatives from NHS Boards will take place on Tuesday 17 January 2006. Further details will follow. In addition, a number of presentations/workshops for specific key audiences are planned. abcde abc a 2
14. To oversee the process the Department has established an internal Implementation Management Group (IMG) and the framework for delivery will comprise: local practitioner champions initially to gain expertise in the contract elements personally and then to facilitate, train and support their peers; locally established health board implementation groups whose primary function will be to support the local practitioner champions; the establishment of a key stakeholder group to provide advice to both the IMG and local implementation groups; the use of NES Pharmacy to train/support the practitioner champions and, more generally, all community pharmacy practitioners in implementing the new contract; the appointment of a project manager, reporting to the IMG, to plan, monitor and manage the implementation timetable and processes; and the establishment of a new contract implementation website on Scottish Health on the Web (SHOW). 15. Further details are provided in Annex A. 16. Given the current implementation timetable, the focus will initially be on emas and PHS. In this regard the proposed timeline is: from December: Implementation Programme commences; SEHD meetings with NHS Board stakeholders; emas software deployment and training; from January: NES Pharmacy National Course on MAS; NES Pharmacy training for practitioner champions; national workshop on the new contract and implementation issues; from February: national public awareness initiatives on the new contract; March: NES Pharmacy MAS implementation resource pack issued; contractors commence patient registrations for MAS; April: Implementation of MAS (as emas) and PHS. abcde abc a 3
Action Chief Executives are to: note arrangements for implementation of the new community pharmacy contract; bring this Circular to the attention of all community pharmacy contractors in their respective Board areas; establish a local implementation group whose function will be to support the local practitioner champions and address any local implementation issues; and supply the Department with the membership details by 21 December 2005. Community Pharmacy Contractors are to: note arrangements for implementation of the new community pharmacy contract; note arrangements to establish local implementation committees and community pharmacy practitioner champions; note details in Annexes A, B and C; identify, agree and appoint peers to act as practitioner champions; and supply the SPGC and the appropriate pharmacy lead in their NHS Board with their practitioner champion s contact details by 19 December 2005. Yours sincerely Hamish Wilson Head of Primary Care Division Bill Scott Chief Pharmaceutical Officer abcde abc a 4
ANNEX A NEW COMMUNITY PHARMACY CONTRACT: PROGRESS AND IMPLEMENTATION PROGRAMME Purpose This Annex provides summary detail of progress being made on the epharmacy front to support implementation of the new community pharmacy contract, and on the plans for a contract implementation programme Current Position It has been agreed with the contractors representative body, the Scottish Pharmaceutical General Council (SPGC), that the new contract will be implemented on a phased basis from April 2006. It has also been agreed that the phasing will be aligned to the availability of the e-infrastructure required to support each of the core elements of the new contract, i.e. Minor Ailments Service (MAS) Public Health Service (PHS) Acute Medication Service (AMS) Chronic Medication Service (CMS) Contractors and their PMR system suppliers have been advised that their operating systems, including linked printers, will require to meet all currently published specification requirements by and ideally before April 2006. The N3 (NHSnet) connection programme for community pharmacy, including migration to N3 where required, will be completed by the end of the year. This means that all independent contractors will be operational with final connection for the multiples being dependent on their respective head office timetables. The electronic patient registration system to underpin MAS is now in place. The main PMR system suppliers have commenced beta testing of their supporting software for emas, or are in the process of doing so, and, therefore, the plan is to introduce this service in April 2006. Initially, the PHS element of the contract will not require any specific e-infrastructure. Therefore, the intention is that this service will also be introduced in April 2006. The e- infrastructure for CMS and AMS is currently being developed and whilst the current plan is to have this completed for late summer next year, the intention is that they will not be introduced fully until April 2007. Given the above, the implementation support activity will focus initially on MAS and PHS within the following timeline: from December: Implementation Programme commences; SEHD meetings with NHS Board stakeholders; emas software deployment and training; from January: NES Pharmacy National Course on MAS; NES Pharmacy training for practitioner champions; national workshop on the new contract and implementation; from February: national public awareness initiatives on the new contract; abcde abc a 5
March: NES Pharmacy MAS implementation resource pack issued; contractors commence patient registrations for MAS; April: Implementation of MAS (as emas) and PHS. Discussions between the Department and SPGC on the service and financial details are continuing. With regard to finance, separate and specific advice for health boards regarding the new contract arrangements will be issued as soon as appropriate. Implementation Programme Principles The new community pharmacy contract is a national contract and, therefore, it is important that information and communications to contractors are delivered in a uniform and consistent way. Accordingly, implementation will be co-ordinated at a national level by the Department, through an internal Implementation Management Group (IMG) adopting the following principles: all community pharmacists are to be offered the same level and standard of support; implementation will be facilitated by community pharmacy practitioners - practitioner champions trained by NES Pharmacy and supported locally by their NHS Boards; wider implementation training/support achieved by cascade; pharmacy practice models for the new contract to be underpinned by epharmacy support; pharmacy practice and epharmacy to be integrated before the point of implementation. Selection The Department will be allocating ring fenced resources to NHS Boards based on their indicative allocation for pharmacy services in order to support the implementation programme. Annex C contains further details. Community pharmacists will be asked to identify within their peer groups in each NHS Board a number of practising community pharmacists to become practitioner champions to initiate implementation of the new contract. The number of individuals will be agreed between the local Area Pharmacy Contractor Committee (APCC) and NHS Board. The selection process will be overseen by the APCC and names supplied to both SPGC and Directors of Pharmacy, or their equivalent, at NHS Board level. A suggested personal specification for the practitioner champion can be found in Annex B. abcde abc a 6
Strategy The available funding will be used to cover or contribute to the time and travel costs of the practitioner champions in delivering the implementation programme. NES Pharmacy will provide training to support the practitioner champions in their role in local implementation delivery. The practitioner champions will be expected to develop expertise in the new contract and then support other community pharmacists by cascading their knowledge and experience to their peer group on a locality basis using a centrally created implementation model. Practitioner champions, supported by their local implementation group, will co-ordinate the cascade training and be the local links with the Department when necessary. The practitioner champions will also help implement the epharmacy elements underpinning the new contract, supported by their local community pharmacy IM&T facilitator/s. This first tranche of resource will be for the implementation for emas and PHS with further details to follow regarding AMS and CMS. Co-ordination and Planning The Departmental IMG will oversee all aspects of implementation The SEHD will establish a wider stakeholder group to secure buy-in from both community pharmacy contractors and the NHS, and to provide advice to the IMG and to local implementation groups. The core membership of the stakeholder group will include representatives from SPGC, NES Pharmacy, the NHS and patients. Each NHS Board will set up a local implementation group whose function will be to support the local practitioner champions and to ensure the co-ordination and delivery of any local activities required to support the implementation programme. The core membership of this group should include all the local practitioner champions, representatives from the Area Pharmaceutical Committee (APC) and the APCC, the Director of Pharmacy, the Medical Director, appropriate representatives from Primary Care and IM&T and a patient representative. The Department will also be providing a series of implementation workshops for both practitioner champions and representatives from NHS Boards. The first one will take place on Tuesday 17 January 2006. Further details will follow. In addition, a number of presentations/workshops for specific key audiences are planned. abcde abc a 7
Project Management The Department is appointing a project manager, through NHS National Services Scotland (NSS), to produce a project plan and timetable for implementation and thereafter co-ordinate, monitor and report on activity. Virtual Support A new community pharmacy contract website is being set up on Scottish Health on the Web (SHOW) to allow the practitioners champions to share their experiences and learning. It will act as a virtual support group to share best practice, log problems, provide solutions and report progress. It will also act as an information provider for wider stakeholders. NHS Board Action establish a local implementation group whose function will be to support the local practitioner champions and address any local implementation issues; and supply the Department with the membership details by 21 December 2005. Community Pharmacy Contractor Action identify, agree and appoint peers to act as practitioner champions in line with NHS Board timescales; and supply the SPGC and the appropriate pharmacy lead in their NHS Board with their practitioner champion contact details by 19 December 2005. SEHD/Primary Care Division November 2005 abcde abc a 8
ANNEX B PRACTITIONER CHAMPIONS: ROLE & PERSONAL SPECIFICATION Role The practitioner champions will be expected to develop expertise in the new contract and then support other community pharmacists by cascading their knowledge and experience to their peer group on a locality basis using a centrally created implementation model and with support from their NHS Board via the local implementation group. Personal Specification Essential Qualifications Member of the RPSGB On the practising register Experience Wholly or mainly employed in community pharmacy Skills Good communication skills Knowledge Awareness of the present and potential future role for community pharmacy services Desirable Experience of teaching, facilitating and/or mentoring Facilitation / mentoring skills Leadership Time management Knowledge and understanding of the principles of the new community pharmacy contract abcde abc a 9
ANNEX C PRACTITIONER CHAMPIONS: FUNDING ALLOCATIONS The main driver for implementation of the new community pharmacy contract will be the use of appropriately trained community pharmacy practitioner champions. They will be expected to develop expertise in the new contract and then support other community pharmacists by cascading their knowledge and experience to their peer group on a locality basis using a centrally created implementation model. In addition they will be supported by their NHS Board via the local implementation group. The Department will allocate ring fenced resources to NHS Boards in order to facilitate this process in the remainder of 2005-06. Each Board will receive the following share which is based on their indicative allocation for pharmacy services. The resources are to be used to cover or contribute to the time and travel costs of the practitioner champions in supporting the implementation programme. The first tranche of resources is for the implementation of PHS and emas. Details with regards to the implementation of AMS and CMS will follow later. The funding position for 2006-07 will be reviewed in light of those details and the practical experience of emas and PHS implementation. RESOURCE ALLOCATION Argyll & Clyde 22,000 Ayrshire & Arran 19,000 Borders 5,000 Dumfries & Galloway 7,000 Fife 17,000 Forth Valley 14,000 Grampian 22,000 Greater Glasgow 50,000 Highland 8,000 Lanarkshire 29,000 Lothian 34,000 Orkney 1,000 Shetland 1,000 Tayside 20,000 Western Isles 1,000 TOTAL 250,000 abcde abc a 10