Services Database Concordance Support (Portsmouth City Area)

The aim of the service is to help support independent living in those patients referred to the pharmacy by the Intermediate Care Pharmacist.

The pharmacy may support the patient with advice, education, and agreed compliance aids including Monitored Dosage Systems as specified by the Intermediate Care Pharmacy team.

The service offers three levels of support:

• Level 1 – Medication administration record charts part A
  Medication administration record charts will be a printed record describing the complete list of prescribed medication taken/used by the patient and will include sufficient instructions to enable the carer to support medicine taking at the right dose and at the right time.
• Level 2 - Monitored Dosage System. part a
  The preferred monitored dosage system (MDS) to be used is Nomad® Clear 2 and/or Nomad® Duo. This system must be used wherever possible to support consistency with secondary care and the training of carers in MDS use. If a requirement for a compliance aid is identified then this will be provided with training for the patient and/or carer if appropriate. Prescriptions supplied with a treatment period of 28 days will be funded to support the delivery of this service. Prescriptions written for 7 day treatment periods will not attract additional funding.
• Level 3 - Assistive Technology medication device (service description is in part b of this specification)
  The preferred monitored dosage system to be used will be supplied by and its use designated by the Intermediate Care Pharmacy team. Funding will apply for all devices regardless of prescription prescribing period. But the prescriber will be advised to write prescriptions for 28 day periods.

The contractor will ensure that the patient or carer, as far as possible fully understand and are comfortable with their medication regimen.

• How and when the device will be made available
• How to use the device
• Contact details for the pharmacy for any issues or problems
• Disposal of used/ unwanted muds systems which still contain medication
• Particular attention must be given for those medicines not included in the MDS such as eye drops, inhalers and ‘when required’ medication. The patient and/or their carer must understand how to manage these medicines and how they will be re-ordered and supplied.
• Provide a compliance chart that lists all medicines taken.

The contractor will discuss, as appropriate, any difficulties experienced with the medication regimen with the patient's GP and/or the Intermediate Care Pharmacy service. For example, when a MDS is returned with a number of medicines not taken or concerns raised by delivery staff.

After the initial three months the contractor will be expected to undertake a Medicines Use Review (MUR) for each patient who is able to attend the pharmacy and is in receipt of this service.

The contractor is advised to deliver a MUR service to housebound patients.

In these circumstances the contractor must follow NHS England guidance. The link to the national policies that cover MURs is as follows: https://www.england.nhs.uk/pharm-adv-serv/

The pharmacy should be able to demonstrate that pharmacists and staff involved in the provision of the service have undertaken CPD relevant to this service. A recommendation is to complete the CPPE pack – Patient Centered Care.