Brighton and Hove Pharmacy Enhanced Service (PLES 02)

Transcription

1 Brighton and Hove Pharmacy Enhanced Service (PLES 02) Smoking Cessation Service (2007/08) This enhanced service is aimed at clients who are non-complex cases and would like to be supported and be managed with single formulations of NRT. 1. Aims of the Service 1.1 The Smoking Cessation service in pharmacies will provide one to one support and advice to people who want to give up smoking. The service will help to increase choice and improve access to NHS Stop Smoking Services. 1.2 The pharmacy will help facilitate access to, and where appropriate supply, appropriate stop smoking drugs and aids. 1.3 The service will improve access to and choice of stop smoking services. 1.4 The service will help reduce smoking related illnesses and deaths by helping people to give up smoking 1.5 The service will help users access additional treatment by offering referral to specialist services where appropriate. 2. Criteria for exclusion from pharmacy service 2.1 Clients who are pregnant or breastfeeding 2.2 Clients under the age of Clients not sufficiently motivated to quit or use NRT 2.4 Clients with severe cardiovascular disease e.g. recent MI or cardiac event 2.5 Clients with a history of recent cerebrovascular disease 2.6 Clients who have failed to stop smoking despite using NRT for 3 months or longer. 2.7 Clients requiring treatment with Bupronorphine or varenicline 2.8 Client declines the service Actions if clients excluded from pharmacy service Refer to GP or specialist service as appropriate Author: N.Jabbar Mar 07 1

2 3. Service outline 3.1 Access to this service will be by : Pharmacy referral as a result of the Promotion of healthy lifestyles (Public Health) or Signposting Essential services; Self referral by the individual; or Referral by another health or social care worker 3.2 The initial consultation (30 mins) will include: An assessment of the person s readiness to make a quit attempt; and Completion of smoking cessation questionnaire and record of actions and advice given. (appendix 1) Description of what a typical treatment programme might look like, its aims, length how it works and its benefits A description of the effects of passive smoking on children and adults An explanation of the benefits of quitting smoking; A description of the main features of the tobacco withdrawal syndrome and the common barriers to quitting; A description of treatment options that have proven effectiveness; A carbon monoxide (CO) test and an explanation of its use as a motivational aid An assessment of the person s willingness to use appropriate NRT treatment The setting of a quit date The application of appropriate behavioural support strategies to help the person quit Discuss common side-effects:. Nausea Dizziness Headaches Cold and flu-like symptoms Palpitations Dyspepsia and other gastrointestinal disturbances Hiccups Insomnia, vivid dreams Myalgia Chest pain Blood pressure changes Anxiety and irritability Somnolence and impaired concentration Author: N.Jabbar Mar 07 2

3 Dysmenorrhea The session will conclude with an agreement on the chosen treatment pathway, ensuring the person understands the ongoing support and monitoring arrangements If a quit date is set at this point then a 4 week NRT supply can be made. If the client chooses to set a quit date in the future then they will need to return to the pharmacy, just before their set quit date, to collect their 4 week NRT supply. The attached formulary details the NRT treatments available on this protocol (Appendix 2) Supply of treatment must be recorded on the PMR and action sheet, attached to questionnaire Complete paperwork as necessary including current prescription charge collection or completion of exemption form (Appendix 3) In the event of an adverse reaction e.g. rash with patches, treatment should be stopped and advice sought from health professional. 3.3 Follow up consultations This will be agreed with the client. The first and 4 week follow up consultations will need to be face to face. Other consultations can be by telephone as agreed by both parties. Frequency of follow ups other than these specified to be agreed on an individual basis The 4-week follow up will include self-reported smoking status, followed by a CO test for validation. Completion of monitoring form (appendix 4), to be sent to Anna Fairhurst. The 3-month follow up will include a self-reported smoking status (can be by phone). If Client lapsed referral options as appropriate offered such as entry back into Pharmacy smoking cessation service or specialist service (contact no ). The number of clients still quit at 3 months need to be reported to Kate Lawson (Appendix 5) The 12-month follow up will include a self-reported smoking status. If lapsed appropriate referral options offered. The number of clients still quit at 12 months need to be reported to Kate Lawson (Appendix 5) 3.4 Payments for the service The Annual retainer will be a one off payment of 100. The initial consultation will be a payment of 10; the 4 week quit consultation will be 50. The week 12 and week 52 review will be a payment of 10 each. (appendix 6) Author: N.Jabbar Mar 07 3

4 Invoice for Cost of NRT Products to be completed (appendix 7). All invoices are required to be sent to shared business services at Wakefield and received by the 15 th of each month. 4 Terms and Conditions. For the pharmacy 4.1 The pharmacy should maintain appropriate records to ensure effective ongoing service delivery and audit. The monitoring form must be sent to the smoking cessation team every quarter for recording purposes into PCT statistics 4.2 The pharmacy reviews its standard operating procedures and the referral pathways for the service on an annual basis. 4.3 The pharmacy can demonstrate that pharmacists and staff involved in the provision of the service have undertaken PCT approved accreditation. This requires completion of: PCT s Supporting Behaviour Change Programme Contact Health Promotion Team at B&H PCT on Smoking Cessation Level 2 Training One day training programme delivered by the B&H smoking cessation team. Details of dates contact Anna Fairhurst CPPE Smoking Cessation CD Rom. Packs obtained from The pharmacy participates in an annual PCT organised audit of service provision. 4.5 The pharmacy co-operates with any local PCT-led assessment of service user experience, if required to do so. 4.6 The Pharmacy attends the contractor meeting organised by the PCT to review their service. 4.7 The part of the pharmacy used for provision of the service provides a level of privacy and safety and meets other locally agreed criteria. 4.8 The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service. 4.9 The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service are aware of and act in accordance with local protocols. For the PCT 4.10 The materials and equipment required, including CO monitors and disposable mouthpieces, are supplied free of charge to the pharmacy by the PCT 4.11 The PCT reimburses the pharmacy for the cost of NRT The PCT will provide a framework for the recording of relevant service information for the purposes of audit and the claiming of payment. Author: N.Jabbar Mar 07 4

5 4.13 The PCT will be responsible for the promotion of the service locally The PCT will provide health promotion material relevant to the service to pharmacies The PCT will need to provide details of relevant referral points which pharmacy staff can use to signpost service users who require further assistance The PCT will arrange at least one contractor meeting per year to promote service development and update the knowledge of pharmacy staff. Author: N.Jabbar Mar 07 5

6 Appendix 4 - Intermediate Smoking Cessation Services Monitoring Patient reference Number (not name). 2.0 Monitoring Information 2.1 D.O.B.. Postcode 2.2 Gender: Male Female 2.3 Ethinic Group 2.4 Pregnant: Children under five: 2.5 Occupation: Service Information 3.1 Date of Initial Assessment 3.2 Quit date: 3.3 Referrer: Treatment: Medical Treatment NRT Motivational support (with no treatment) 4.0 Four Week Follow-up Information 4.1 Has patient quit? Yes No 4.2 CO validation attempted? Yes No 4.3 CO validation confirm quit status if patient quit at four weeks? Yes No 4.4 Has patient cut down? Yes No 4.5 If yes, approximately how many? Lost to follow-up? Yes No 4.7 Left programme before completion? Yes No Please post to Anna Fairhurst at: Royal Sussex County Hospital, Author: N.Jabbar Mar 07 6

7 Eastern Road Brighton BN2 5BF Appendix 3 Author: N.Jabbar Mar 07 7

8 Author: N.Jabbar Mar 07 8