Pharmacy services

Summary

The request sought a breakdown of pharmacy services, remuneration details, and payment data for the last three years from Manx Care. The authority disclosed service volume statistics for the period April 2018 to March 2021 and a service specification document, but withheld specific remuneration details and full payment records citing partial exemptions.

Key Facts

• Manx Care contracts pharmacies to provide essential, advanced, and enhanced services.
• Data provided covers service volumes from April 2018 to March 2021.
• The response includes a detailed specification for the Emergency Hormonal Contraception service.
• Pharmacists must complete specific training (Safeguarding, Consultation skills) to be accredited.
• Remuneration details and specific payment amounts for the last three years were partially withheld.

Data Disclosed

• 2022-05-05
• 2022-06-01
• Apr18 to Mar21
• 1st April 2019
• 1st April 2022
• 1st April 2023
• 362,204
• 278,326
• 181,322
• 154,438
• 122,742
• 120,805
• 120,517
• 99,156
• 98,406
• 93,052
• 75,318
• 73,607
• 53,535
• 51,959
• 49,665
• 48,342
• 45,372
• 300
• 750
• 1,500

Exemptions Cited

• Part exempt

Original Request

Pharmacies are contracted by Manxcare to provide essential services, advanced services, and enhanced services. 1. Please give a breakdown of all of the essential services, all of the enhanced services, and all of the advanced services. 2. Please provide details of renumeration for the same and copies of the Salad (service level agreements) 3. Please provide details of payments made to each pharmacy for the same for the last three years Thank you

Data Tables (5)

Full Response Text

FOI 2430637 Appendix 1 - Services Provided by Community Pharmacies for Apr18 to Mar21 Pharmacies Supervised Consumpton Monitored Dose Service Emergency Hormonal Contraception Minor Ailment Scheme Not Dispensed Needle Exchange Nursing Home Payments FLU Out of Hours Clear Douglas 1,883 41,656 5,182 678 193 0 0 0 0 Clear Michael St 756 29,546 1,383 1,575 0 0 0 244 0 Clear Atholl Place 1,687 58,663 3,598 6,185 330 902 0 1,600 0 Clear P.Erin 647 92,195 1,081 2,078 1,964 1,453 0 0 0 Clear PSM 0 35,250 1,373 1,246 1,095 0 0 0 0 Boots 5,205 77,396 36,715 5,851 0 14,136 30,289 40,245 0 Castle 0 0 0 0 0 0 0 0 0 Costains 0 70,022 1,216 2,331 352 0 0 3,196 0 Hemensleys 10,080 55,185 6,428 2,681 143 0 6,668 7,153 385 Karsons Onchan 994 119,993 4,407 5,661 1,205 0 0 10,677 0 Kinrades 13,668 67,602 4,838 5,173 171 9,595 0 635 275 Laxey 0 16,588 0 0 1,755 0 0 0 0 Karsons Kirk Michael 0 30,565 868 1,693 2,701 0 0 2,715 0 Lloyds Anagh Coar 8,621 6,854 4,634 3,630 0 6,224 0 1,848 0 Lloyds W/B Road 12,348 116,832 8,023 2,127 88 0 0 2,152 0 Lloyds Shoprite Douglas 3,261 72,795 8,516 4,457 76 0 0 4,337 0 Lloyds Onchan 147 93,525 763 575 0 0 0 1,523 0 Lloyds Governors Hill 1,029 3,037 2,638 1,248 33 0 0 647 0 Lloyds Castletown 574 61,155 4,253 2,763 5,143 2,547 0 717 0 Lloyds Port Erin 1,295 51,064 1,717 676 83 600 0 5,511 0 Lloyds Shoprite Ramsey 679 0 4,965 1,543 55 0 0 808 0 Lloyds P'ment Street 1,904 312,849 3,096 760 0 2,837 0 2,697 0 Lloyds St Paul's Sq 1,859 0 3,148 1,314 6 0 0 563 0 Enhances Services FOI 2430637 Appendix 1 - Services Provided by Community Pharmacies for Apr18 to Mar21 Pharmacies Clear Douglas Clear Michael St Clear Atholl Place Clear P.Erin Clear PSM Boots Castle Costains Hemensleys Karsons Onchan Kinrades Laxey Karsons Kirk Michael Lloyds Anagh Coar Lloyds W/B Road Lloyds Shoprite Douglas Lloyds Onchan Lloyds Governors Hill Lloyds Castletown Lloyds Port Erin Lloyds Shoprite Ramsey Lloyds P'ment Street Lloyds St Paul's Sq Nicotine Replacement Therapy New Medicine Service Medicine Use Reviews Rota Service Quality Payments Collaborative Payment Perspex Screen PPE Total 2,147 0 3,462 0 1,500 750 300 57,751 3,542 0 224 9,845 1,500 750 300 49,665 6,792 100 700 9,945 1,500 750 300 93,052 4,033 5,597 2,688 6,231 1,500 750 300 120,517 1,140 3,037 1,232 6,613 1,500 750 300 53,535 8,975 13,971 32,668 10,325 1,500 750 300 278,326 0 0 0 3,964 0 250 0 4,214 1,214 5,205 12,320 0 1,500 750 300 98,406 1,169 12,430 17,870 0 1,500 750 300 122,742 1,084 1,594 6,272 0 1,500 750 300 154,438 2,087 0 28 0 1,500 750 300 106,621 754 0 0 0 1,500 750 300 21,647 3,504 1,904 1,843 0 1,500 750 300 48,342 3,505 2,410 33,331 0 1,500 750 300 73,607 2,074 2,555 31,541 1,032 1,500 750 300 181,322 1,348 4,387 32,626 10,708 1,500 750 300 145,060 849 2,168 29,342 0 1,500 750 300 131,442 1,804 4,209 28,177 0 1,500 750 300 45,372 4,433 1,920 34,750 0 1,500 750 300 120,805 3,038 2,823 29,800 0 1,500 750 300 99,156 9,943 5,115 30,751 18,908 1,500 750 300 75,318 4,984 4,394 25,102 1,032 1,500 750 300 362,204 3,019 3,881 35,620 0 1,500 750 300 51,959 Essential Services Advanced Services

Emergency Hormonal Contraception Valid from: 1st April 2019 Review date: 1st April 2022 Expiry date: 1st April 2023 1 Isle of Man Community Pharmacy Service Specification
Emergency Hormonal Contraception April 2022 Version 1. Draft sent out for consultation Version 2. Updated following feedback Version 3. Updated with PharmOutcomes FOI 2430637 Appendix 2 – Service Specifications Emergency Hormonal Contraception Valid from: 1st April 2019 Review date: 1st April 2022 Expiry date: 1st April 2023 2

BACKGROUND

The purpose of the community pharmacy Emergency Hormonal Contraceptive (EHC) service is to provide advice and support to women of any age, and supply emergency contraceptive when deemed appropriate. This service ensures emergency contraceptive is available every day of the week at prime hours at locations across the Isle of Man.

The participating pharmacies must comply with all aspects of the service specification and have all the current Declaration of Competence (DoC) requirements in place for all pharmacists undertaking the service.

It is the professional responsibility of all pharmacists undertaking the service to provide evidence to Manx Care of their Declaration of Competence (DoC) and completion of the appropriate CPPE learning package on Emergency Hormonal Contraception.

Manx Care requires all pharmacists undertaking any locally commissioned service in a community pharmacy to undertake the following on a minimum of a two year basis:

Safeguarding Training (CPPE)

Consultation skills training (CPPE)

Manx Care defines an ‘accredited pharmacist’ as one who has completed the above training and submitted evidence to Manx Care, and who has signed the Competence for Community Pharmacy PGD Form.

Please note: if pharmacists who are not accredited perform the service Manx Care reserves the right to remove service provision from this pharmacy premises and the individual contractor; in addition Manx Care may refer this to GPhC for ‘Fitness to Practice’.

SERVICE DESCRIPTION

1.1 Accredited pharmacists will supply either the Levonorgestrel or the Ullipristal (Ella One®) emergency contraceptive in line with the requirements of the locally agreed Patient Group Direction (PGD) to females at risk of unwanted pregnancy due to unprotected sexual intercourse. Fraser Guidelines will be adhered to and the patient will be required to sign a consent form.

1.2 There will be no charge to the patient.

1.3 Pharmacists and support staff will offer a user-friendly, non-judgemental, patient centred and confidential service.

1.4 Patients excluded from the service will be referred to local services that will be able to assist them as soon as possible e.g. GP or family planning clinic.

1.5 The patient will be supplied with the contact details of alternative sources of support if the pharmacist cannot undertake the service.

1.6 The pharmacist must offer guidance on on-going contraceptive needs and how to access them.

FOI 2430637 Appendix 2 – Service Specifications Emergency Hormonal Contraception Valid from: 1st April 2019 Review date: 1st April 2022 Expiry date: 1st April 2023 3

AIMS AND INTENDED SERVICE OUTCOMES

2.1 To reduce unintended pregnancies in all age groups by: Promoting self-care through the pharmacy, including provision of advice and where appropriate medicines and/or appliances without the need to visit the GP practice as an urgent case

Supplying appropriate medicines free of charge in line with the service specification and PGD

Increase the use of EHC by women who have had unprotected sex

Ensure provision of services at the weekend at various sites across the Isle of Man

To improve the access to emergency contraceptive and sexual health advice

SERVICE OUTLINE

3.1 The part of the pharmacy used for provision of the service provides a sufficient level of privacy and safety, and this should be a designated consultation room.

3.2 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.
3.3 The pharmacy should maintain appropriate records to ensure effective ongoing service delivery and audit. 3.4 The accredited pharmacist must personally speak with and counsel the patient requesting EHC. 3.5
The accredited pharmacist must obtain the information outlined in the client record form before making any recommendations regarding the provision emergency contraception.
3.6
All support staff must be trained to refer each request for EHC to an accredited pharmacist, or if there is no accredited pharmacist present, to at least 2 other sources providing the service in the nearby area. 3.7 The service will be provided in accordance with Fraser Guidance for the treatment of females aged under 16 years.
3.8 The pharmacist must be aware of the safeguarding process in the area and engage actively with teams. 3.9 Within the consultation the pharmacist must follow the PharmOutcomes proforma. 3.10 Patients should be offered a female chaperone if the pharmacist is male in accordance with their chaperone policy.

FOI 2430637 Appendix 2 – Service Specifications Emergency Hormonal Contraception Valid from: 1st April 2019 Review date: 1st April 2022 Expiry date: 1st April 2023 4

ELIGIBILITY/ FUNDED PREMISES

4.1 Any pharmacy contractor wishing to provide the EHC service must declare this to Manx Care and receive approval to do so.

4.2 All premises providing EHC must have a confidential consultation room.

4.3 Pharmacists will share relevant information with other health care professionals and agencies, in line
with locally determined confidentiality arrangements. This data will be anonymised and used for service planning. 4.4 Manx Care will provide details of relevant referral points which pharmacy staff can use to signpost service users who require further assistance.
4.5 Manx Care and the IOM Contractors Association will be responsible for the promotion of the service locally, including the development of publicity materials, which pharmacies will be given to use to promote the service to the public.

PROVIDER RESPONSIBILITIES e.g. CONSULTAITON ROOM/ CHAPERONE/ SUPPORT STAFF
5.1
The pharmacy premises must have a separate consultation room to carry out the service. 5.2
All staff must maintain confidentiality and a patient centred and non-judgemental environment for the patient. 5.3
Refer service users to local sexual health services for any follow up relating to contraception or sexually transmitted infections where appropriate.

5.4 All staff must comply with their pharmacy chaperone policy.

RECORD KEEPING [RETURN OF DATA TO MANX CARE]
6.1
PharmOutcomes proforma must be completed for each consultation. 6.2
Appropriate records of the supply must be kept for 2 years. 6.3 All staff must comply with GDPR requirements 6.4
All records must be uploaded onto PharmOutcomes each month, in order for Manx Care to access the data. 6.4
All records and record keeping should comply with the GPhC ‘Standards of Good Professional Practice’.

CONFIDENTIALITY AND DATA PROTECTION
FOI 2430637 Appendix 2 – Service Specifications Emergency Hormonal Contraception Valid from: 1st April 2019 Review date: 1st April 2022 Expiry date: 1st April 2023 5

7.1 The contractor will ensure that the accredited pharmacist and pharmacy staff respect client confidentiality. Information should not be disclosed to any third party without the client’s consent unless there are over riding child protection concerns when an appropriate referral must be made.
7.2
All staff must comply with the requirements of GDPR.

FEES [AMOUNT AND SUBMISSION DATES]
8.1
Payments are made to the pharmacy contractor who employs an accredited pharmacist to provide EHC via a PGD service. They are as follows: A consultation fee of £13.50 per patient regardless of a supply of EHC

A product fee for either Levonorgestrel (Levonelle®) or Ullipristal (Ella One®) 8.2 Claims must be submitted onto PharmOutcomes no later than the 5th day of the following month to which the claim relates.

SERVICE DESCRIPTION [HOW IS THIS CARRIED OUT AND BY WHOM- INCLUDE SUPPORT STAFF]
9.1 Accredited pharmacists will supply Levonorgestrel (Levonelle®) or Ullipristal (Ella One®) in line with requirements of the locally agreed Patient Group Direction to females at risk of unwanted pregnancy due to unprotected sexual intercourse.
9.2 The supply will be made free of charge to the client. 9.3
Pharmacies will offer a user-friendly, patient centred, client centred and confidential service. 9.4
Clients who do not meet the criteria of the PGD will be referred to another local service that will be able to assist them as soon as possible, e.g. GP or Family Planning Service.

GENERAL PROVISIONS [INSURANCE, SUPPORT STAFF]
10.1 All pharmacists must be accredited via Manx Care and using the Declaration of Competence system.
10.2 All staff engaged in the service must have carried out Safeguarding Training and Data Protection Training. 10.3 All pharmacists must be covered by their own personal indemnity insurance.

FOI 2430637 Appendix 2 – Service Specifications Emergency Hormonal Contraception Valid from: 1st April 2019 Review date: 1st April 2022 Expiry date: 1st April 2023 6

GOVERNANCE 11.1 Manx Care reserves the right to carry out post payment verification checks within any pharmacy providing the service 11.2 If deviations from the service specification are identified, Manx Care reserves the right to remove service provision from the pharmacy premises and the individual contractor; in addition Manx Care may refer this to the GPhC under ‘Fitness to Practice’.

REFERENCES – with acknowledgements and thanks to: Stockport – Public Health Enhanced Service Specification Emergency Hormonal Contraception
Dorset County Council – Service Specification for the provision of emergency h contraception in Bournemouth, Dorset and Poole Milton Keynes – Pharmacy Local Enhanced Service – Emergency Hormonal Contraceptive Service
Wigan Borough Clinical Commissioning Group – Service Specification – Emergency Hormonal Contraception Service

FOI 2430637 Appendix 2 – Service Specifications 1 Minor Ailment Service Valid from: 1st April 2019 Review date: 1st April 2021 Expiry date: 1st April 2023

Isle of Man Community Pharmacy Service Specification
Minor Ailment Service [MAS]

April 2022

Version 1. Draft sent out for consultation Version 2. Update following feedback Version 3. Updated with PharmOutcomes

FOI 2430637 Appendix 2 – Service Specifications 2 Minor Ailment Service Valid from: 1st April 2019 Review date: 1st April 2021 Expiry date: 1st April 2023

BACKGROUND:

The purpose of the community pharmacy Minor Ailment Scheme (MAS) is to allow community pharmacists to manage patients with minor, self-limiting conditions, which could otherwise impact significantly on GP and emergency services (A&E and MEDS) workload. Community Pharmacists are highly trained, competent professionals who are ideally placed to provide help and advice to patients with a minor ailment and can address a patient’s health needs through promotion of self-care. This serves to increase patient choice to access primary care in alternative settings. The MAS also a

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