Leeds PCT Minor Ailments Scheme Guidance Notes

Eligibility Patients wishing to use the service must be registered with a Leeds PCT GP practice. Confirmation of patient registration with a Leeds PCT GP practice must be established at the pharmacy by presentation of evidence produced by the patient, e.g. medical card, repeat prescription tear-off slip, pharmacy patient medication record (PMR) showing evidence of a prescription dispensed in the last 6 months.

Registration Patients are not required to formally register with the scheme.

Consultation and Treatment The service can only be provided for patients presenting with symptoms of the minor ailments listed minor ailment as listed. (Appendix 1) For patients under the age of 16 the parent/guardian can accept transfer into the scheme on behalf of the patient. Only the products listed in the formulary can be provided as part of the scheme. The medicines available within the scheme must not be supplied outside their licensed indications. Eligible patients will only be provided with medicines to manage the minor ailment if, in the professional opinion of the pharmacist, there is a current clinical need for the medication, and the medicine required is not contraindicated. Patients should only be supplied with medication if they present at pharmacy. Medication should not be supplied to a third party. Patients are at liberty to decline to participate in the scheme. The Pharmacist should carry out a professional consultation which should involve:      

Patient assessment in relation to the presenting complaint Provision of advice Supply of appropriate medication (OTC pack only) from the agreed formulary Record of advice and treatment Completion of exemption/consultation form Any medication supplied under the scheme must be labelled with full dosage instructions

Exemption/Consultation Form Any medication supplied to patients exempt from prescription charges under the current guidelines will be provided free of charge. Evidence of exemption must be seen in the same way as if the patient was presenting with a prescription. The patient should be asked to read the exemption declaration form (Appendix 2) and then sign the exemption/consultation form. Exemption/consultation forms should be retained at the pharmacy. Details of any payments associated with the minor ailments scheme must be recorded and submitted to the PCT at monthly intervals

Key Points for Participating Pharmacies The pharmacist must comply with all existing standards and codes of good practice, both national and local e.g. in the form of Standard Operating Procedures, as appropriate. Participation in the Minor Ailment scheme does not abrogate pharmacists from their professional responsibilities. The Professional lead at each community pharmacy will be responsible for completing the CPPE Minor Ailments module within three months of participating in the pilot and forward the evidence of completion to the PCT. The pharmacist must ensure, where there is a clinical need, that appropriate medication is supplied, that the patient is advised how to take/use the medication, and is provided with a patient information leaflet as appropriate. Patients who present with a minor ailment outside the scope of the scheme, or for whom the listed formulary product(s) is (are) not appropriate or contra-indicated, will be signposted and assisted in accessing the most appropriate treatment from an alternative healthcare professional. Patients who, in the opinion of the pharmacist, need an urgent GP appointment will be directed to the GP either by phone or by using a pharmacy referral form. (Appendix 3) Only the medicines listed in the formulary in the quantities stated can be issued to an eligible patient following a consultation. Further supplies of this medication following a subsequent professional consultation should only be supplied if, in the opinion of the pharmacist, it is considered appropriate. The possibility of abuse of the scheme and/or medication must be borne in mind and reported to the GP and PCT as appropriate. The pharmacist should endeavour to keep the consultation process as confidential as possible and as such a private consultation area would be desirable to achieve this aim.

Service Funding The pharmacy payment structure consists of: 

Consultation fee of £3.00 per consultation



Reimbursement of medication cost based on the Chemist and Druggist and Drug Tariff (January 2008 edition) plus VAT (currently 15%). Prices are subject to change to reflect price fluctuations. Participating pharmacists will be eligible to claim a consultation fee for instances where a consultation has taken place with a patient, but a decision has been made not to supply medication under the scheme. However details of the consultation must still be recorded on the PMR and on the forms to be submitted to the PCT

Payment Schedule Claims for payment should be sent to Gazala Khan Head of Community Pharmacy Services 2nd Floor Stockdale House Headingley Business Park Victoria Road LS6 1PF

Appendix 1

Minor Ailment Formulary sheet Ailment Oral cold sores

Product and Unit Aciclovir cream 5% BP 2g

Sore throat

Aspirin dispersible tablets 300mg (32)

Hay fever

Beclometasone nasal spray 50mcg/metered

Hay fever

Cetirizine tabs 10mg (7)

Hay fever

Cetirizine tabs 10mg (30)

Hay fever

Cetirizine syrup

Hay fever

Chlorphenamine tabs 4mg (30)

Hay fever

Chlorphenamine SF Oral Solution 2mg/5ml 150ml

Hay fever

Sodium Cromoglycate eye drops 2% 10ml

Mouth ulcers Thrush

Anbesol liquid 6.5ml Canesten Combi ®(1)

Thrush

Clotrimazole Pessary 500mg

Thrush

Clotrimazole Cream 1% 20g

Thrush Diarrhoea and vomiting Diarrhoea and vomiting

Fluconazole capsule 150mg (1) Loperamide capsules (6) Oral rehydration sachets (6)

Indigestion

Gaviscon Advance 250ml Peptac Suspension Gaviscon 250 ® Tablets 8/12

Allergic /dry skin conditions Allergic skin conditions

Aqueous cream BP (500G)

Back pain/headache/colds and flu Back pain/headache/colds and flu Back pain/headache/colds and flu Colds and flu/backpain/headache

Co-codamol tablets 8/500 (30)

Hydrocortisone cream 1% 15g

Ibuprofen tablets 200mg 24 48 Ibuprofen oral suspension sugar free 100mg/5ml 100ml

Paracetamol tablets 500mg (32)

Colds/flu/relief of pain children 3months to 6 years Colds/flu relief of pain children 6 to 12 years Constipation Nasal congestion

Paracetamol SF suspension 120mg/5ml 70ml Paracetamol SF suspension 120mg/5ml 100ml

Threadworms Athletes foot

Mebendazole tablets 100mg Ovex Pk 4 Pripsen Pk 8 Miconazole 2% cream 30g

Dry cough

Pholcodine linctus BP 5mg/5ml 140ml *

Cough

Simple linctus BP 200ml*

cough

Simple linctus paediatric BP 200ml*

Nasal congestion

Pseudoephedrine linctus 140ml

Nasal congestion

Pseudoephedrine tablets 60mg (12)

Nasal congestion

Sodium Chloride nasal drops 0.9%

Warts/verrucas

Salactol ® Paint 10ml

Nappy rash

Sudocrem 125g

Nasal congestion

Xylometazoline paediatric 0.05% nasal drops 10ml *

Nasal congestion

Xylometazoline nasal spray 0.1%, 10ml *

Conjunctivitis/superficial eye infections

Chloramphenicol eye drops 0.5%

Head lice

Bug Buster Kit

Head lice

Head lice comb

Paracetamol SF Suspension 250mg/5ml 100ml Senna 7.5mg tablets (20) Menthol and Eucalyptus inhalation BP 1980 100ml*

Appendix 2 Exemption/Consultation Form The patient does not have to pay because he/she: A is under 16 years of age B is 16, 17 or 18 and in full-time education C is 60 years of age or over D has a valid maternity exemption certificate E has a valid medical exemption certificate F has a valid prescription prepayment certificate G has a valid war pension exemption certificate L is named on a current HC2 charges certificate X was prescribed free-of-charge contraceptives H *gets income support (IS) K *gets income-based jobseekers allowance (JSA (IB) M *is entitled to or named on a valid NHS Tax Credit exemption certificate S *has a partner who gets Pension Credit guarantee credit (PCGC) *Name Date of Birth: NI no: *Print the name of the person (either you or your partner) who gets IS, JSA (IB), PCGC or Tax Credit To the Patient - Please complete declaration:I have consulted the pharmacist under the Minor Ailments Scheme and confirm that I am exempt from prescription charges for the reason specified above. I confirm that: I have received advice and I have / have not (delete as appropriate) received a supply of medication from the pharmacist under the Minor Ailments Scheme I declare that the information I have given on this form is correct and complete. I understand that if it is not, appropriate action may be taken. I confirm proper entitlement to exemption. To enable the NHS to check I have a valid exemption and to prevent and detect fraud and incorrectness, I consent to the disclosure of relevant information from this form to and by the PCT, the NHS Counter Fraud and Security Management Service, the Department for Work and Pensions and Local Authorities.

Signed Patient)…................................................ Date................................ IMPORTANT – Your Pharmacist is providing treatment and/or advice under the Minor Ailments Scheme in line with the symptoms you have described. If your symptoms persist you should seek further advice from your doctor. Please advise the doctor which pharmacy you have attended and what advice and/or treatment you have already received from the Pharmacist. By signing this form you are giving permission for your pharmacist to: 1. Make a written note of personal information relating to your health. 2. Share information about your health and any medication supplied with your GP and PCT as necessary. Evidence of Exemption Seen: YES / NO(delete as appropriate)

Signed Patient ................………………... Signed Pharmacist ............…………………..

Exemption/Consultation form (continued). To be completed by the pharmacist Patient Details (Affix bag label or enter details) Patient name ------------------------------------------------------------------------------------Address -----------------------------------------------------------------------------------------G P Practice -----------------------------------------------Would the patient usually have consulted with their GP for this ailment? Yes/No* (*please delete as appropriate)

Patients Presenting Symptoms (please tick) Athletes Foot Warts Verrucae Back Pain Colds & Flu Skin allergies Cough Hay Fever Headache Indigestion/Heartburn Conjunctivitis/ superficial minor eye infections

Nappy rash Mouth Ulcers and Teething Nasal Congestion Sore Throat Stomach Upset Threadworms Thrush Oral Cold Sores Head Lice Toothache

Details of product supplied or action taken (advice or referral* please tick) Medication Supplied – affix Rx label Advice only* Referral* To be completed by pharmacist – tick evidence for patient access into scheme A B D E

PHARMACY PMR MEDICAL CARD SURGERY CONFIRMED REGISTRATION OTHER – please specify

Signed (Pharmacist): ……………………………………Date……….

Appendix 3

Leeds Primary Care Trust LEEDS PCT MINOR AILMENTS SCHEME

PHARMACISTS TO GP RAPID REFERRAL FORM Patient Name:

Patient Address:

TO THE GP This patient has present with symptoms unsuitable for treatment under the Pharmacy First service and has been advised to make an appointment today.

Notes

Pharmacists Name, Address and Telephone Number (or Pharmacy stamp)

Date and Time: PLEASE FAX THIS FORM TO THE GP SURGERY OR GIVE TO THE PATIENT TO TAKE TO THE SURGERY.

Appendix 4 Pharmacist Monthly Claim Form (with effect from April 2009 ) Pharmacy Name and Address: Month: Product and Unit

Cost Price £

Aspirin dispersible tablets 300mg (32) Anbesol 6.5ml Aqueous cream BP 500g Beclometasone nasal spray (200 dose) Bug buster kit Canesten Combi ®(1) Cetirizine tabs 10mg (30) Cetirizine liquid Chloramphenicol eye drops 0.5% 10ml Chlorphenamine tabs 4mg (28) Chlorphenamine Oral Solution 2mg/5ml 150ml SF Choline Salicylate 8.7% oromucosal gel 15g SF Clotrimazole Pessary 500mg (1) Clotrimazole Cream 1% 20g Co-codamol Tablets 8/500 (30) Oral rehydration sachets (6) Fluconazole Capsule 150mg (1) Gaviscon Advance ® 250ml Gaviscon Advance ® Tablets pack of 12 Head Lice Comb Hydrocortisone cream 1% 15g Ibuprofen tablets 200mg (24) (48) Ibuprofen oral suspension sugar free 100mg/5ml 100ml Loperamide caps 2mg (6) * Loratadine 10mg (30) Menthol and Eucalyptus inhalation 100ml* Mebendazole tablets 100mg (Ovex pack of 4) (Pripsen pack of 8) Miconazole 2% cream 30g Paracetamol tablets 500mg (32) Paracetamol SF suspension 120mg/5ml 150ml Paracetamol SF Suspension 250mg/5ml 200ml Peptac ® Suspension 500ml Pholcodine linctus BP 5mg/5ml 200ml * Pseudoephedrine linctus 140ml Pseudoephedrine tablets 60mg Salactolol paint 10ml Senna 7.5mg Tablets (20) Simple linctus BP 200ml* Simple linctus paediatric BP 100ml* Sodium Chloride nasal drops 0.9% Sodium Cromoglicate eye drops 2% 10ml Sudocrem 125g

0.35 1.34 3.18 5.81 4.31 6.26 5.80 2.97 3.06 1.98 2.28 1.79 4.95 3.92 1.19 2.02 2.04 2.39 1.43 1.25 2.95 0.70 1.40 3.48 1.80 2.39 0.66 3.41 3.42 1.97 0.26 0.65 1.13 2.16 0.59 1.70 1.48 1.93 0.65 0.64 0.17 1.86 2.46 1.70

Record Number of Units Supplied, e.g. IIII I

Total Number of Units Supplied

Total Cost £

Xylometazoline paediatric 0.05% nasal drops 10ml * Xylometazoline 0.1% Adult nasal drops 10ml * Xylometazoline nasal spray 0.1%, 10ml * TOTAL COST

1.59 1.91 1.91

VAT @ 15.0% Number of consultations MONTHLY TOTAL

I certify that we have carried out the consultations and supplied items as detailed above in accordance with the Leeds PCT Minor Ailments Scheme and wish to claim payment in respect of the above. I confirm that the information given above is correct to the best of my knowledge. Records of the above consultations and supplies have been retained at the pharmacy and will be made available to officers of the PCT following any reasonable request.

PHARMACY STAMP

Pharmacist Signature ……………………………………………… Date ………………………………..

Please return completed claim form to: Gazala Khan Head of Community Pharmacy Services 2nd Floor Stockdale House Headingley Business Park Victoria Road LS6 1PF 

Drugs of Limited Clinical Value – use is only justified in certain circumstances. (Prices based on Chemist and Druggist March 2009 Drug Tariff)