PROCEDURE FOR REPORTING UNPLANNED TEMPORARY SUSPENSION OF PHARMACEUTICAL SERVICES DURING CONTRACTED OPENING HOURS
Responsible Director: Responsible Directorate: Author(s): Date Approved: Committee: Version: Revision Date:
Carol McKenna Commissioning and Strategic Development Lisa Meeks 10th January 2012 SMT 1 10th January 2014
This document sets out the process Calderdale, Kirklees and Wakefield District Cluster Partnership will implement following the temporary suspension of pharmaceutical services including unauthorised closure during opening hours.
This document doesn't cover the process for pharmacy contractors who wish to vary opening hours, whether this be for a permanent amendment to opening hours or an application to close for a planned reason e.g. refurbishment. In these circumstances contactors should contact the PCT to confirm the process to be followed.
Pharmacy closures which relate to paragraph 24A Declared Emergencies are outside of this procedure. If a contractor judges that the pharmacy needs to amend their hours due to a Declared Emergency, the contractor should contact the relevant PCT manager with at least 24 hoursâ€™ notice. Declared Emergency provisions would include a flu pandemic but do not apply to temporary emergencies caused for example by adverse weather conditions such as snow or flooding.
Pharmacy Contractor Obligations
It is a requirement under the NHS (Pharmaceutical Services) Regulations 2005 Terms of Service Schedule 1 Part 3, paragraph 22(7) & 22(9) that pharmacy contractors notify the PCT of any temporary suspension of pharmaceutical services (i.e. failure to open during their agreed opening hours), regardless of whether this affects their core or supplementary hours. The same applies to appliance contractors under paragraph 10(7) of Schedule 3.
The PCT MUST be notified on EVERY OCCASION when a pharmacy has to close or is unable to give a full Pharmaceutical service during normal trading hours. This would include if a pharmacy is late in opening/ providing NHS Pharmaceutical Services due to the late arrival of a pharmacy locum. If a pharmacy temporarily suspends services this could be viewed as a breach of contractual obligations, and will result in a review of the situation by the PCT Pharmacy Panel / Contracts Team using the procedures as outlined below.
Pharmacy contractors within Calderdale, Kirklees and Wakefield may use the notification form at appendix 1 of this document (Reporting Of Temporary Suspension Of Pharmaceutical Services During Contracted Hours) for reporting such instances to the PCT.
In addition to pharmacy contractors formally notifying the PCT of a temporary suspension of pharmaceutical services, the PCT will also investigate any complaints regarding opening hours made by patients or otherwise.
NHS pharmacies must have a pharmacist on the premises at all times that NHS pharmaceutical services are provided. This is the case during both the core and declared supplementary hours. Although the Responsible Pharmacist regulations allow for a pharmacy to operate while the responsible pharmacist is
absent, in order to comply with the NHS Terms of Service, a pharmacist must be present to cover the responsible pharmacistâ€™s absence during all opening hours. If the responsible pharmacist is absent, without cover from another pharmacist, this constitutes a suspension of pharmaceutical services and should be reported using the form at appendix 1. 2.6
The PCT will formally record any temporary suspension of pharmaceutical services and will also record instances where the contractor failed to notify the PCT of temporary suspension of pharmaceutical services. The records may be used in conjunction with any performance issues. Extenuating Circumstances
Contractors are reminded that they have a duty to ensure delivery of NHS pharmaceutical services to patients but also must consider the safety of their staff (as employers), customers and patients.
With this in mind Calderdale, Kirklees and Wakefield District Cluster Partnership recognises that there may be circumstances where a pharmacy contractor may not be able to open for their contractual hours or is unable to give a full Pharmaceutical service as this would compromise safety. Whilst the list of circumstances where this may occur is not exhaustive this could occur for example in: Severe weather Civil unrest (including riots)
It is for the contractor to decide whether or not the circumstances are such that the pharmacy needs to temporarily suspend services e.g. close the pharmacy. The contractor must be able to justify the decision to suspend pharmaceutical services and, if at all possible, mitigate against any negative impact on patients.
If a contractor takes the decision to temporarily suspend the provision of pharmaceutical services they are required to notify the PCT of that suspension as soon as practical and to use all reasonable endeavours to resume service provision as soon as is practicable (paragraph 22(9), Schedule 1 of the NHS (Pharmaceutical Services) Regulations 2005, as amended).
Contractors are asked to consider the following points when considering suspending pharmaceutical services: Inform patients- for example displaying a notice that is visible when the pharmacy is closed. The notice should inform patients of the details of the times of temporary suspension, when the pharmacy is due to re-open and details of other pharmacies which are open in the locality. Consider drug and substance misuse clients- this should include an assessment of the number of clients who are to collect medication on the day of the temporary suspension of services and informing their prescriber/ clinic that they will be unable to collect doses. Consider impact on patients- including any outstanding â€œurgent / critical prescriptionsâ€? awaiting collection. Consideration should be given to transferring prescriptions that have not been dispensed to another pharmacy in the area who is open in an effort to maintain patient care. If this option is used the pharmacy must ensure that patients are clearly signposted to the alternative pharmacy.
Inform local GP practices and Out Of Hours providers of the details of the temporary suspension. Advise GP practices/ OOH services to signpost patient to non-affected pharmacies to have any urgent medications dispensed. For non-urgent requests, patients may be advised to wait until the pharmacy can re-open safely. Work collaboratively with other pharmacies to ensure a service is maintained in each area if at all possible and keep the PCT informed of any proposed changes. Secure records- Ensure that physical records such as dispensed prescriptions and prescriptions awaiting supply under the repeat dispensing service, are out of sight and in locked storage. Secure medicines- Ensure any controlled drugs are kept locked in the controlled drugs (CD) cabinet. Consider storing other medicines liable to misuse in the CD cabinet. Business Continuity Plans- refer to the pharmacy's business continuity plans for further details. PHARMACIES MUST ONLY CLOSE IN EXCEPTIONAL CIRCUMSTANCES. 3.6
Contractors should endeavour to provide a full Pharmaceutical service as soon as possible. Depending on the circumstances, if at all possible the pharmacy should re-open later in the day of the temporary closure.
The Reporting Of Temporary Suspension Of Pharmaceutical Services During Contracted Hours form (appendix 1) should be completed on EVERY OCCASION when a pharmacy has to close or is unable to give a full Pharmaceutical service during normal trading hours. This must be completed and returned within 24 hours of the closure. Where possible, the Pharmacy Lead for each respective PCT should also be notified by telephone.
The Pharmacy Leads for each PCT are: Calderdale PCT – Ruth Buchan, 01422 281474 Kirklees PCT – Lisa Meeks, 01484 464272 Wakefield PCT – Julie Howard, 01924 317576
Action the PCT May Take Where Temporary Suspension of Pharmaceutical Services Has Been Identified.
If it has been identified that a temporary suspension of pharmaceutical services has occurred, without prior agreement with the PCT, the PCT will take the following action:
4.1.1 Liaise with the contractor or designated responsible person and establish the cause of the temporary suspension of pharmaceutical services. Determine: if it was an isolated incident if it is likely to happen again could the closure have been planned did the contractor notify the PCT as soon as was practical did the contractor resume provision of pharmaceutical services as soon as was practicable
4.1.2 If it is found the temporary suspension of pharmaceutical services was for a reason beyond the control of the contractor, the PCT will take no further action. 4.1.3 If it is found the contractor is likely to breach the condition (i.e. failure to open during agreed opening hours) repeatedly without good cause, or the breach is considered a serious breach and consequently, the safety of a patient is at risk, the PCT will request the pharmacy contractor to provide the following written documentation: The pharmacy daily opening hours on a weekly basis for a period of between 1 and 3 months. The hours the Community Pharmacist has been on duty during this period as detailed above. It should be clearly identifiable when the pharmacist has taken any breaks including lunch that resulted in a break in pharmaceutical services. (Where a break in pharmaceutical services has occurred, the duration of the break must be deducted from the total opening hours for that day. This would include a responsible pharmacist break taken during contracted hours with no other pharmacist to cover the break).NB â€“ In the event of a pharmacist working extended hours, and it has been identified that patient safety has been put at risk; the PCT will take this into consideration when investigating performance issues. A declaration that during the opening hours a full pharmaceutical service was available For the avoidance of doubt, repeated temporary closures caused by a pharmacist/ locum arriving late may not be considered to be beyond the control of the contractor. 4.1.4 From the information provided above, an action plan designed to resolve the issue(s) will be developed and agreed by both parties. o Contractors shall be informed in writing by the PCT of the issue(s) that require addressing and the timescale for resolution. o It is the responsibility of the contractor to develop a robust action plan which will identify how the issue(s) will be resolved. The action plan will then be considered by the PCT and agreed if appropriate. o The agreed action plan will be documented and signed by both parties. o The contractor has a minimum period of 3 months in which to resolve any issue(s) identified in the action plan. o The date the action plan is agreed and signed will form the start date of the minimum 3 month period referred to in the above bullet point. 4.2
If PCT officers dealing with the matter assess that the contractor is not suitably engaging with the processes outlined in this section, a referral to the PCT performance panel will be made for the panel to consider if formal action, as outlined in section 5, is necessary.
In all the above cases, the relevant PCT performance panel will be notified and kept updated with current issues.
Action the PCT May Take in the Event of Continued Non-Compliance If after following the steps highlighted in section 4 no improvement in the contractorâ€™s performance can be demonstrated, the PCT performance panel may: Pursue a case for breach of Terms of Service by referring this to another PCT to appoint a disciplinary committee to consider the matter under the NHS (Service Committee and Tribunal) Regulations 1992 as amended, or Wish to review the contractorâ€™s continuing Fitness to Practise using the procedures in the NHS (Pharmaceutical Services) Regulations 2005, as amended.
In the case of a 100 hour contract, the PCT disciplinary committee will determine if it should see fit to implement Regulation 45 (8) (a) (removal of a contractor from the pharmaceutical list) as outlined in the Procedure for Monitoring Pharmacies that Open for 100-hour document. The PCTs Right to Monitor
The PCT reserves the right to undertake unannounced visits and/or telephone calls to verify the actual hours of service a pharmacy is undertaking. 7
This procedure will be distributed to all Community Pharmacy contractors and the relevant Local Pharmaceutical Committees. Where applicable, the PCT would advise that the local Pharmacy Manager shares this Procedure with their head office and/or Superintendent Pharmacist.
8 Review Calderdale, Kirklees and Wakefield District Cluster Partnership will review this procedure on a two yearly basis in conjunction with the local LPCs.
NHS Central Lancashire for sharing their Procedure for Monitoring Opening Hours document
10 Further information for contractors Guidance on Service Continuity Planning for Pharmacy- This guidance designed to help community pharmacies continue operating in emergency circumstances has been co-developed by the Royal Pharmaceutical Society of Great Britain, the Pharmaceutical Services Negotiating Committee and Community Pharmacy Wales.
http://www.psnc.org.uk/publications_detail.php/84/guidance_on_service_continuity_p lanning_for_pharmacy_ Precautions for community pharmacies during times of social unrest â€“ advice for pharmacists: issued 09 August 2011http://www.rpharms.com/supportupdates/precautions-for-community-pharmacies-during-times-of-social-unrest.asp Pharmacy closures during riots: PNSC advice: http://www.psnc.org.uk/news.php/1107/pharmacy_closures_during_riots Additionally the National Pharmacy Association have issued guidance for their members. NPA Information Department 01727 891800
REPORTING OF TEMPORARY SUSPENSION OF PHARMACEUTICAL SERVICES DURING CONTRACTED HOURS PHARMACIES MUST ONLY BE CLOSED IN EXCEPTIONAL CIRCUMSTANCES This form should be fully completed on EVERY OCCASION when a pharmacy has to close or is unable to give a full Pharmaceutical service during normal trading hours. Completed forms to be returned within 24 HOURS to Lisa Meeks by either: FAX: 01484 464509, E-MAIL: firstname.lastname@example.org, OR POST: Lisa Meeks, NHS Kirklees, Broad Lea House, Dyson Wood Way, Huddersfield, HD2 1GZ
Pharmacy Name Pharmacy Address
Date of Closure
Times Pharmacy closed
Reason for Closure If pharmacy closed as pharmacist is absent please provide details of absent pharmacist including GPhC number and if employee pharmacist
Describe the alternative arrangements made for patients (e.g. collection & delivery of prescriptions via another branch) Provide a brief assessment of potential impact on patients, e.g. drug and substance misuse clients Additional information e.g. If the pharmacy is remains closed outline expected date and time of opening
Date, time & method PCT notified: Name of PCT person notified Declaration I confirm that the pharmacy named above was unable to fulfil its contracted/supplementary hours on …………………………….. due to the circumstances listed above. All measures identified above were undertaken. Name:……………………………