Locally Commissioned Services

SMI SCREENING AND INTERVENTION PILOT

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Contact

Central Health Solutions
Len Dalton
email: len@1centralhealth.co.uk

Documents


Service Specification

Health Information Form

Activity Tracker Form

SMI Health Intervention Activity

Alcohol Use Test

Patient Leaflet

LINKS

Central Health Solutions/SMI

SMI Government Briefing

PHE SMI Profiling tool

Mental Health by David Tait

“Approximately 1 in 4 people in the UK will experience a mental health problem each year. “


Frequently Asked Questions and Additional Support


  • What is SMI?
  • What are the aims and objectives of the SMI service?
  • What’s the period of the service agreement?
  • What are the required service deliverables?
  • What does the service intervention include?
  • What are the roles and responsibilities?
  • Who can provide this service?
  • What are the inclusion criteria?
  • What are the training requirements?
  • What Quality Payments are available?
  • How does the Pharmacy get paid?
What is SMI?

What are the aims and objectives of the SMI service?

The principal aims of this service is to:
• increase awareness of increased physical health risks within the SMI population
• Support the NHSE initiative to increase the number of physical health interventions
undertaken
• Give pharmacy teams a better understanding of the needs of these patients
• Encourage more support in relation to medicine optimisation and compliance
• Promote healthy behaviour changes and engagement with community-based support
to improve physical health.

The service objectives are:
• Promote healthy lifestyles and medication adherence among people with SMI
• Target the areas in Coventry and Warwickshire shown to have the highest number of SMI patients: Coventry, Leamington & Warwick, Stratford, Nuneaton, Bedworth and Rugby
• Increase the number of physical health interventions and providing additional information to the GPs
o Increasing numbers of health interventions will support earlier diagnosis or prevention of physical health conditions in SMI patients
o Ultimately the health check service, once commissioned, is likely to support reduction in emergency admissions to hospital for this group of patients due to physical health problems.

What’s the period of the service agreement?

This Agreement shall commence with effect from 10/05/2019 and shall continue for one year subject to either party at any time giving not less than one month’s written notice to the other party to terminate this Agreement without penalty, or in the event of termination for breach (see termination on breach). This Agreement may be renewed on one or more occasions, if both parties agree, not less than one months before the date of termination, which it shall be renewed and a review date should be set.

What are the required service deliverables?

The Pharmacies will identify service users who meet the criteria. The pharmacies will have had a Pharmacist and member of the pharmacy team attend the training on 3rd April 2019, who will cascade the training to other relevant members of the pharmacy team. Mop up training sessions may be offered later in the year if needed to support further pharmacies
to provide the service. A bursary will be made available of £100 per pharmacy attending the training who are eligible to participate in the service after the first referral is made.

Appropriately trained pharmacy staff will carry out the intervention and discuss the increased physical health risks and the importance of good physical health.

Pharmacy staff will gain consent from the service user to share their data with their GP as part of the intervention

Once consent has been obtained, information must be recorded on to the intervention information form (appendix 1). This information can be completed electronically or on paper, which can be scanned. A copy must be sent to the GP by secure means, using Shared Pharmacy NHS email to the agreed GP secure NHS mail. A copy should be made available
for the patient and a copy retained and securely stored for the pharmacy records (these may be electronic if preferred).

A trained member of the Pharmacy Staff will complete the intervention with the service user. An activity sheet (appendix 2) is also provided for logging interventions completed and anonymised data which will be used to complete the smart survey returns (appendix 3) to support payment process.

Completion of the intervention will trigger a local quality payment of £10 to the pharmacy which will claimed as set out in section 7.

Patient selections: The pharmacy team will determine which patients meet the inclusion criteria, based on the patients’ regular medication including any referrals from other healthcare professionals. The basis of this will be explained at the training.

What does the service intervention include?

The Health Champions or trained member of the pharmacy team will:
• Ensure that all mandatory health campaigns are fully supported with well- maintained health information zones and provide brief opportunistic advice
a. General raising awareness through displaying materials, putting information in prescription bags to promote the SMI Health Check Service, once commissioned.
b. Data entry of advice & intervention provided to include:
i. Health indicators recorded e.g.:
1. Smoking status (Non- smoker, current smoker, smoker referred
to Stop Smoking Service)
2. Alcohol consumption (Audit C – 3 question score – appendix 4)
3. BP / BMI (where measured)
ii. Healthy lifestyle advice shared (topics)
iii. Referral to other health services (e.g. Healthy Lifestyle Service, Fitter
Futures, Social Prescribing)
iv. Confirmation of any pharmacy services or compliance support provided (e.g. MUR, Stop Smoking, MDS etc)

Pharmacist:
• Support the team in identifying suitable patients
• Medicines Use Reviews (medication understanding & compliance reviews) will also be provided, where appropriate, to patients with SMI opportunistically on dispensing of regular prescription medication

What are the roles and responsibilities?

Pharmacies:
• Ensure that the part of the pharmacy used for the provision of the service provides sufficient level of safety and privacy
• Sign up to Contract through Central Health Solutions and provide bank account
details for payment
• Ensure that pharmacy staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service, including sensitive, client-centred communication skills.
• Maintain appropriate records to ensure effective ongoing service delivery and audit. Records are confidential and should be stored securely and for a length of time in line with local NHS and Local Authority record retention requirements.
• Where there is a need to share relevant information with other health care professionals and agencies, ensure that this is in line with local and national confidentiality and data protection arrangements, including the need for the permission of the person to share the information.
• Complete the online survey and information documentation at required frequency and seek permission ahead of completing more than 30 interventions.
• Pharmacist and Member of Pharmacy Team has attended a training session which
will cover:
• Coaching on approaching SMI patients to provide advice
• SMI – which patients are we targeting and some clinical updates on
treatments
• Understanding the increased physical health risk for SMI patients
• Data collection, GP information and reimbursement

Commissioner:
• Provide the necessary training
• Provide the Contracting mechanism
• Reimburse the Pharmacies as set out in Section 7 and 8
• Provide Audit C scratch cards
• Provide signposting materials
• Provide list of GP NHS email addresses
• Provide clear guidance on eligibility criteria
• Provide leaflets for patients

LPC
• Support the training events
• Support Central Health Solutions collate the survey information and accreditation
• Support pharmacy teams and Central Health Solutions in implementing the service
as needed.

Who can provide this service?

This service may only be provided by an accredited pharmacist/pharmacy staff, who has/ have completed the training detailed in the service specification. The accredited staff will normally be available five days a week.

The Provider will ensure that all members of pharmacy staff are trained in the operation for the scheme and full details will be made available to locum pharmacists to ensure continuity of provision of the service.

For the purpose of this Agreement, ‘staff’ includes persons employed or engaged by the Provider, to provide the services in this Agreement.

What are the inclusion criteria?

Pharmacy Inclusion Criteria (all must be met)
• Accredited Healthy Living Pharmacy
• Private Consultation Room available
• Currently undertake advanced services including MURs
• Priority pharmacies are those located in Coventry, Rugby, Nuneaton, Bedworth,
Leamington / Warwick or Stratford (see section 7).
• Pharmacist and a member of staff have attended the training on April 3rd 2019. Or
have received additional training sanctioned by the contractors Local Pharmaceutical
Committee at the time of signing this agreement
• Have access to NHS shared email to send referrals
• Been accredited to provide the service
• Agree to complete smart survey each month with activity data

Patient Inclusion Criteria (all must be met)
• Live in and/or are registered with a GP in Coventry or Warwickshire
• Medication supports diagnosis of SMI or patient indicates has a SMI
• Given consent to share their data with their GP

What are the training requirements?

Pharmacist and a member of the pharmacy staff must attend the training event before providing the service. A certificate will be provided which should be shared with the Commissioners on request.

The pharmacy must be registered as an HLP level 1 and have at least one trained health champion.

The Provider will furnish on demand, a list of the staff available to provide the service.

Where required, arrangements must be made for a suitable chaperone, acceptable to the person accessing the service, to be present. The cost of the chaperone will be borne by the Provider.

What Quality Payments are available?

NOTE: There is a fixed budget for this pilot. In the first instance this equates to approximately 1200 – 1500 interventions. Initially up to 35 pharmacies will be able to participate across Coventry and Warwickshire where more pharmacies express interest the pharmacies will be selected by the Commissioner based on location and population need.

The first local quality payment will be £100 per pharmacy sending a pharmacist and a member of staff to the required training to provide the service. This will be payable after the first intervention has been made.

Further local quality payments of £10 will be paid for each intervention up to 30 interventions initially.

Payments will be made by Central Health Solutions each month, following completion of required survey at the end of each month.

The Commissioner reserves the right to restrict or increase the number of interventions available to be claimed by each pharmacy to remain within budget whilst allowing high performing pharmacies to undertake more interventions.

Any MURs undertaken should be claimed through the normal mechanism and would form part of the 200 available for each pharmacy under the standard Advanced Service (April – September) regulations.

How does the Pharmacy get paid?

Activity Survey to be completed every month following service start where there has been activity to allow tracking of total number of interventions.

No patient identifiable data should be sent as part of the claim.

Payments will be as follows:
• First intervention following training will trigger £100 payment
• Each subsequent intervention will be paid at £10, monthly in arrears.

Claims for payment shall be made by submitting a claim form in an approved format to the Commissioner as defined in the service specification, within one month of the provision of the service. The claim form must be submitted electronically and appropriate auditable records retained in the pharmacy . Claims beyond this period may, at the sole discretion of the Commissioner, be allowed for good cause.

Claims submitted in accordance with the requirements of this agreement will be paid by BACS within 30 days of a valid month end submission .


Reference
(1) www.mind.org.uk

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