Quality Payment Workshop 3 Healthy Living Pharmacy and Level 2 Safeguarding

Agenda 7.30 Domestics 7.35 SCR 7.45 Safeguarding 8.05 HLP 9.15 Close

SCR How many of you have used SCR? If you haven’t used SCR yet why?? If are using SCR – what benefits have you seen? Lets look at some case studies …………

SCR Case Study 1 Patient presents for a Ventolin inhaler emergency supply and there already on your PMR system.  Would you use the SCR and why? Thoughts as to why you would May have been stopped by the GP May have just had a script issued and taken to another pharmacy Could it have been used as a one off for a chest infection Have they not received a script in the last 6 months and have been abusing the Emergency Supply system You could be liable for causing patient harm if you didn’t access the record to obtain the full history for the patient prior to making the supply

SCR Case Study 2 Middle aged son presents in pharmacy to request a decongestant for his poorly father (will not be able to give consent as he is deaf and unable to communicate on the phone) who is staying with him for the weekend.  Do you access  the record? Thoughts on why you would The patient isn’t present and cannot give you authority to access his SCR You can access if it is in the best interest of the patient even if they cannot give consent You would want to satisfy yourself as to what other medication the father is taking You find out he is taking multiple anti-hypertensives You could potentially be liable for causing patient harm if you did NOT access the record and subsequently sold a decongestant

SCR Case Study 3 Patient presents in the pharmacy on a Saturday afternoon to collect a prescription.  You normally collect these on behalf of the patient during the week but the script isn’t in the pharmacy.  You are not sure whether it’s EPS or FP10, so would you check the SCR? Thoughts on why you would By reviewing the SCR you can confirm if a prescription has been issued Once you know it has been issued you could also check the EPS Tracker Once you know its has been issued, you could consider if an emergency supply is appropriate.

Safeguarding Community pharmacy contractors passing the gateway criteria will receive a Quality Payment if they meet one or more of the Quality Payment criteria. One of the Quality Payment criteria is: ‘On the day of the review 80% of registered pharmacy professionals working at the pharmacy have achieved level 2 safeguarding status for children and vulnerable adults in the last two years.

Quality Payment criterion points and value Number of review points at which it can be claimed Two Points at any one review point 5 Total points over the two review points 10 Value of total points £640

Who is a Registered Pharmacy Professional? Registered pharmacy professionals are pharmacists and pharmacy technicians.(NB Not Pre regs although good practice to get them to complete the training) The Quality Payment requirement is that at least 80% of registered pharmacy professionals working at the pharmacy on the day of the review have undertaken the training and assessment within the last two years. This includes locums, so contractors should encourage temporary staff, such as locum pharmacists, to undertake the training and assessment Number of hours worked is irrelevant

Training CPPE Safeguarding children and vulnerable adults e-learning and e-assessment meets the level 2 requirements. Currently local Safeguarding training provided for Sexual health Services etc. does not meet criteria

CPPE Training New Package Better than old one – more user friendly Takes about 2.5-3 hours to complete Three E tests at end. Will be level 1 tests shortly

Four Sections Background to safeguarding children and vulnerable adults Heightening awareness of abuse and neglect in children and vulnerable adults Working together to safeguard children and vulnerable adults Case Studies

Hints and Tips Know your different laws e.g. what is statute and what is not, understand what the different bodies are responsible for. As you only have limited time write notes of key pieces of information so you can refer to them quickly When answering case studies keep in mind which one of these scenarios could end up with the person in A and E Print your certificate and put in your evidence file in Pharmacy so readily available if you are inspected.

HLP Quality Payment Summary – 20 points = approx. £1380 Healthy Living Pharmacy level 1 (self-assessment) Number of reviews – one

What is a HLP ? The HLP concept provides a framework for commissioning public health services through three levels of increasing complexity and required expertise with pharmacies aspiring to go from one level to the next.   There are three levels of service delivery within the HLP framework: Level 1: Promotion – Promoting health, wellbeing and self-care (in July 2016, Level 1 changed from a commissioner-led process to a profession-led self-assessment process); Level 2: Prevention – Providing services (commissioner-led); and Level 3: Protection – Providing treatment (commissioner-led).

HLP is an organisational development framework underpinned by three enablers of : workforce development – a skilled team to pro-actively support and promote behaviour change, improving health and wellbeing; premises that are fit for purpose; and engagement with the local community, other health professionals (especially GPs), social care and public health professionals and local authorities.

Healthy Living Pharmacy

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How are you going to get accredited?

Key requirements Key requirements that must be met before becoming a HLP Level 1 The following requirements must be met before a pharmacy can be registered as a HLP Level 1, therefore contractors should ensure that they meet the requirements before they start working their way through the quality criteria: The pharmacy has a consultation room which is compliant with the Advanced Services standards and is appropriate for the services on offer; In the past year, the pharmacy has participated in the provision of both (MURs) and (NMS), and has proactively engaged in health promoting conversations; In the past year, the pharmacy has participated in the provision of the NHS Community Pharmacy Seasonal Influenza Vaccination Advanced Service or has actively referred patients to other NHS providers of vaccinations; The pharmacy complies with the General Pharmaceutical Council’s Standards for Registered Premises and Standards of Conduct, Ethics and Performance; and The pharmacy complies with the NHS Community Pharmacy Contractual Framework (CPCF) requirements.

Criteria 27 Quality criteria need to be met These criteria outline what is required for the assessment of compliance and set out the behaviours, activities and physical environment required. Contractors must be able to provide evidence for each criteria. There is suggested evidence in the documentation produced by NHS England. Contractors do not need to complete all the suggested evidence but they must be able to include one piece for each of the 27 criteria. One piece of evidence can be used to support more than one criterion if appropriate. Certain pieces of evidence Are REQUIRED eg Healthy Living champion training (RSPH Level 2)/Leadership Training

HLP Flow Diagram COMPLETE HLP ASSESSMENT of Compliance on Royal Society of Public Health Website Quality assurance provider (RSPH) will HLP register pharmacy and provide HLP Logo Set up Healthy Living Zone and Portfolio Collect evidence/Signposting information/Training/JSNA and PNA Agree written Action Plan with whole Team Complete Training - Leadership and Healthy living Champion Read HLP Quality Criteria and complete HLP 2016 Quality Criteria on PharmOutcomes (under Assessments)

Quality Criteria and Action Plan Read through criteria and tick off the ones you already meet using the list on PharmOutcomes or use the PSNC workbook. All the ones you need to collect evidence for or need actions to be taken agree with your team a written action plan of when and who is going to undertake the task.(This will form part of your evidence) Remember to go back regularly to tick ones now achieved and review action plan Avon LPC website has templates and information that will support you

Training To achieve HLP status you have to have completed the following training courses; Leadership - a member of the Pharmacy team needs to have attended a recognised Leadership Course that covers all the criteria stated in the NHS England Assessment of compliance Document. Healthy Living Champion - each pharmacy must have a Full Time (F/T) equivalent Healthy Living Champion who has completed the Royal Society of Public Health’s Level 2 Understanding Health Improvement.

Training Courses Leadership – CPPE will be running Leadership days. (Booking not open yet) Dates Thursday 9th March BAWA Sunday 2nd April Bradley Stoke Avon Healthy Living Champion Courses- These are now FREE following a Health Education England grant. We will support a maximum of 2 members of the team (to a make up a FTE) (Book through Avon Health Services) 2 half days 9.30am-2.30pm Dates 5th/6th April Bristol 26th/27th April All Non Bristol

Training - additional packages Event / Support Description of Outcome etc. Cost to Member Non Member HLP Champion & Public Health Accredited Two Half Days course with Public Health Exam and Certificate issued      FREE FREE   Supply HLP Folder with templates. All templates will be supplied. All you will need to do is add the evidence you collect e.g. photo's, certificates, letters etc.     £40   £50 Half Day Visit (4 Hours) Brief HLP to your team, share best practice, advice on location for Healthy Living Zone and ensure team knows what they have to do achieve HLP Status and evidence required. Includes HLP folder with templates.      £160   £200 Second Visit (this needs to be in conjunction with Half Day visit) 4-6 weeks after first visit Check you are on track. Give appropriate advice and support. Review portfolio.    £80  £100

Healthy Living Zone (HLZ) It should be a clearly defined area Ensure information appeals to a wide range of the public and reflects your community A HLZ can be a display board, wall, table or an area of the pharmacy Displays need not be expensive Leaflets / posters are available from charities, resource centre etc. Do not advertise products eg Nicorette etc. Make it interesting and eye catching Think of additional materials you can use for impact –coloured card/table cloths/tar cubes/ empty bottles/balloons and other accessories Most importantly, have fun putting it together and remember to make a record of your displays as evidence for your HLP accreditation. Form available on Avon LPC website.

Already Support people to live healthier lives Advice on healthy lifestyle issues as part of NHS services -As part of essential services -Embedded within MUR and NMS service Six public health campaigns per year. Use these as part of your displays And a range of locally commissioned services eg Support to Stop smoking, Sexual Health

Ideas for your HLZ

Portfolio Having a portfolio for HLP simply means having an A4 ring binder / lever arch file or similar with all the information you need in one place – both your formal documents and your evidence. Divide into sections: You will need to ensure it is logical and that you cross reference your criteria to the evidence. E.g. -Certificates -Evidence including reports/photos of public health campaigns, Letters, newspapers, customer feedback, -Training Matrix

Evidence Need to collect evidence as you go along Ensure it is in a logical order and links to the criteria Suggested portfolio guide on Avon LPC website or use PSNC workbook

Evidence Action Plan Certificates of any training eg leadership, healthy living champion training, CPPE package on Public Health, smoking advisor training, Training matrix showing confidentiality training, JSNA,safeguarding etc. Minutes of meetings that include discussion about Health promotion led by champion Photos and description of what you did for a health promotion Evidence of regular checks on show material (2 monthly)

Evidence (cont.) Letters to local organisations eg GPs, schools, playgroups, charities, youth centres, libraries telling them about your health champion and what promotions you are supporting JSNA/PNA front pages and team aware of local priorities Details of local organisations eg healthwatch, drug and alcohol service List of local commissioners and contact details Details of local groups eg walking groups, courses offered by local community centres, local wellbeing colleges Details of recycling schemes, pictures of Doop bins Details of where IG toolkit is

Range of Tools on Avon LPC website

Tools (cont)

Assessment of Compliance When all 27 quality criteria have been met, use the RSPH self-assessment tool (available at: tinyurl.com/RSPHAoC) to make notes on how the pharmacy team meet each criterion. NB This is only currently open until 28th April 2017. New guidance will be issued after 28th April 2017 as to how you register as a HLP pharmacy. A pharmacy professional should complete Part 1 of the assessment of compliance at: tinyurl.com/RSPHAoC which relates to key requirements that the pharmacy must have in place before HLP Level 1 status can be granted A pharmacy professional should complete Part 2 of the assessment of compliance which is the section of the framework that asks to state the evidence they possess in the pharmacy; which they can use to demonstrate compliance with the requirements   Complete Part 3 which requires the pharmacy professional to declare compliance with the HLP Level 1 quality criteria and to submit this electronically    

Assessment of Compliance (Cont.) Once submitted, a copy of the completed form will be sent to the pharmacy email address that the pharmacy professional provided in Part 3. A copy of this email should be retained in the pharmacy so it is available for inspection RSPH will then review the submitted information and will endeavour to contact contractors by mail or email within 10 working days after they have received an online assessment of compliance form to confirm registration and provide the HLP logo and certificate

Any Questions