1Introduction. This Service Level Agreement (SLA) acts as a contract between NHS Grampian and the pharmacy contractor and commits the contractor to provide the services as defined by the current supporting documentation which must be read in conjunction with this SLA. Naloxone supply is mandatory for those pharmacies signed up to deliver Level 1 Substance Misuse Service from Community Pharmacy. Staff should have completed the approved naloxone training (section 5) prior to signing up to this SLA. Services will be provided within the legal and ethical framework of pharmacy as a whole. A three months’ notice period must be provided if either party wishes to terminate this contract. Where a breach in terms of the SLA has occurred the 3 month notice period may not apply. 2Background to service In 2019 1,264 people in Scotland lost their lives as a result of a drug related death. This has more than doubled since 2014. 82 of these deaths were in Grampian, 68 of whom had opioids in their system which means that, if naloxone had been available, some of these lives could have been saved. Naloxone is a medication which can temporarily reverse the effects of opioid drugs. The Scottish Naloxone Take Home Programme aims to supply to and train the following groups on how to identify and respond to overdose and administer naloxone: people at risk of opioid overdose people in contact with those at risk (e.g. family members) services in contact with those at risk of opioid overdose Opioid overdose may be a risk for people prescribed opioid medications for any indication including pain or opioid dependence and/or addiction. Professionals should assess this risk and make naloxone available regardless of the indication. This SLA shares the principles of the Level 1 SMS service which outlines the recommended clinical support for delivery by community pharmacy contractors to people who use drugs and is supportive of NHS Grampian and Grampian Alcohol and Drug Partnerships’ goals to reduce harm and promote recovery. 3Service aims The aims of the service are: To provide overdose awareness and naloxone training to people at risk of, or who are likely to witness, opioid overdose To make naloxone as widely and easily available as possible. For this reason all community pharmacies who deliver level 1 SMS must sign up to this SLA. It is strongly recommended that all community pharmacies, including those who do not deliver level 1 SMS, sign up to this SLA. To supply naloxone in line with Guidance for Services In Grampian to Supply Naloxone to People at Risk of Opioid Overdose, Significant Others and Services in Contact with those at Risk NB: either Prenoxad® intramuscular injection or Nyxoid® nasal spray may be supplied. 4Service outline and standard Pharmacy contractors must ensure that pharmacy staff are able to deliver this service throughout opening hours: Offer the service to all eligible people attending the pharmacy. Where supply is requested, make this supply at the time of request wherever possible. Check the status of any existing supplies e.g. is the naloxone still in date, opened, needles used etc. and resupply where necessary. Use the “Take Home Naloxone Key Points Sheet” or the manufacturers product risk materials e.g Nyxoid 1.8 mg nasal spray, solution in a single-dose container - Risk Management Materials - (emc) (▇▇▇▇▇▇▇▇▇.▇▇▇.▇▇) to ensure those who are supplied with naloxone have a basic understanding of: the risks, signs and symptoms of drug overdose how naloxone works and how to use both naloxone products basic life support and the recovery position DURING COVID-19 DO NOT PLACE YOUR FACE NEAR THE CASUALTIES FACE TO CHECK FOR BREATHING. RESCUE BREATHS ARE NOT RECOMMENDED the importance of calling an ambulance Provide advice and support to anyone who returns having used the training and/or naloxone supply. Make a new or replacement supply of naloxone as appropriate. You should add a pharmacy address label to the product and annotate the date this item was issued. Display a suitable poster and maintain a supply of Prenoxad® and Nyxoid® information leaflets ▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇; Email: ▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇▇▇; Telephone: ▇▇▇▇▇ ▇▇▇▇▇▇ Complete the Record of Training and Supply including consent and enter information into the approved electronic database (currently neo360®) on the day of supply.
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