Common use of Service Specification Clause in Contracts

Service Specification. An ‘authorised person’ in this service specification is a person acting under arrangements with the CCG for the purpose of coordinating access to this service. The pharmacy will be contacted by an authorised person when they identify a service user who requires help with medication and the introduction of a Medicine Record Chart. The pharmacy should not start the service until it has received written confirmation from an authorised person. The pharmacy should annotate the patient medication record (PMR) that the patient requires a Medicine Record Chart preparing with each dispensed medication. The pharmacy should prepare a duplicate label for each dispensed medication and attach it to the Medicine Record Chart. The issuing of labels NOT attached to the chart is not permissible. Once the label has been attached to the chart the letters Medicine Record Chart should be written starting on the left hand side of the chart and continuing onto the label. If more than one chart is needed for a service user, then the charts should be numbered to indicate that more than one chart is in use e.g. 1 of 1, 1 of 2 etc. The pharmacy should keep the prepared chart together with the dispensed medication for collection or delivery to the service user. If medication is prescribed at a different time to regular prescriptions then the Medicine Record Chart should be returned to the pharmacy for labels to be attached. For mid-cycle requests that follow into the next cycle e.g. a seven day course of antibiotics prescribed on day 26, the pharmacy should print two extra labels at the time of dispensing – one to attach to the current Medicine Record Chart and the other to add to the new cycle chart. Where possible, there should be only one Medicine Record Chart in use at any one time. The exception to this may include the prescribing of ‘just in case’ medications; see below. Where you need to vary from this guidance, this must be risk assessed and only done in exceptional circumstance For medications prescribed ‘just in case’ e.g. a course of antibiotics and steroids for a COPD exacerbation, a separate Medicine Record Chart should be supplied to keep with the medication until needed. This Medicine Record Chart should be clearly marked by th e pharmacy to indicate that there is more than one chart in use.  In the case where a Medicine Record Chart is missing i.e. if in error it was not supplied at the time of dispensing a new cycle of medication or if following the supply it has been mislaid, the pharmacy may issue a replacement Medicine Record Chart within a few days of dispensing the new medication cycle. The pharmacy will need to assure themselves that there have been no prescribing changes before an Medicine Record Chart is produced. The pharmacy should clearly annotate the Medicine Record Chart to indicate that it is a duplicate. In this instance the label dates on the medication and the chart will not correlate. If the pharmacy cannot confirm that there have been no changes to the servic e user’s medication, then a replacement Medicine Record Chart must not be provided and the care worker must be advised to request a new prescription for all medications. As part of the clinical check of the Medicine Record Chart, when the pharmacy are adding a label to the Medicine Record Chart for a new medication and it is confirmed by the prescriber that a previous medication has been discontinued, it is good practice for the pharmacy to clearly annotate the chart to show which medication has been discon tinued. It is good practice to ensure that all labels on medications for administration by carers contain full written dose instructions. If any medications are prescribed ‘as directed’ the pharmacy is encouraged, where possible, to support good practice and contact the prescriber for the full correct dose. If prescribed medication doses require a carer to ‘half a tablet’ it is good practice for the pharmacy to refer back to the prescriber for an alternative formulation where possible to avert the need for a carer to split tablets. For the exception when there is no alternative, the dose instructions should clearly state that ‘half’ a tablet is to be administered. Enough medication must be prescribed for the duration of treatment to allow for safe dispos al of the unwanted ‘half’. Pharmacists are under no obligation to half the tablet or supply a tablet cutter. This must be funded by the service user/care provider. All warfarin labels on a Medicine Record Chart should ensure that dose instructions direct the carer to administer the most up to date dose in accordance with the yellow anticoagulation booklet or letter. Domiciliary care worker agencies must liaise with the community pharmacy before a patient is established on a Medicine Record Chart, and continue to work closely with the pharmacy of choice. Supply of Medicine Record Chart will be recorded on the service user’s patient medication record within the pharmacy A record of any relevant interventions will also be kept.

Service Specification. An ‘authorised person’ in this service specification is a person acting under arrangements with the CCG for the purpose of coordinating access to this service. The pharmacy will be contacted by an authorised person when they identify a service user who requires help with medication and the introduction of a Medicine Record Chart. The pharmacy should not start the service until it has received written confirmation from an authorised person. The pharmacy should annotate the patient medication record (PMR) that the patient requires a Medicine Record Chart preparing with each dispensed medication. The pharmacy should prepare a duplicate label for each dispensed medication and attach it to the Medicine Record Chart. The issuing of labels NOT attached to the chart is not permissible. Once the label has been attached to the chart the letters Medicine Record Chart should be written starting on the left hand side of the chart and continuing onto the label. If more than one chart is needed for a service user, then the charts should be numbered to indicate that more than one chart is in use e.g. 1 of 1, 1 of 2 etc. The pharmacy should keep the prepared chart together with the dispensed medication for collection or delivery to the service user. If medication is prescribed at a different time to regular prescriptions then the Medicine Record Chart should be returned to the pharmacy for labels to be attached. For mid-cycle requests that follow into the next cycle e.g. a seven day course of antibiotics prescribed on day 26, the pharmacy should print two extra labels at the time of dispensing – one to attach to the current Medicine Record Chart and the other to add to the new cycle chart. Where possible, there should be only one Medicine Record Chart in use at any one time. The exception to this may include the prescribing of ‘just in case’ medications; see below. Where you need to vary from this guidance, this must be risk assessed and only done in exceptional circumstance For medications prescribed ‘just in case’ e.g. a course of antibiotics and steroids for a COPD exacerbation, a separate Medicine Record Chart should be supplied to keep with the medication until needed. This Medicine Record Chart should be clearly marked by th e the pharmacy to indicate that there is more than one chart in use.  • In the case where a Medicine Record Chart is missing i.e. if in error it was not supplied at the time of dispensing a new cycle of medication or if following the supply it has been mislaid, the pharmacy may issue a replacement Medicine Record Chart within a few days of dispensing the new medication cycle. The pharmacy will need to assure themselves that there have been no prescribing changes before an Medicine Record Chart is produced. The pharmacy should clearly annotate the Medicine Record Chart to indicate that it is a duplicate. In this instance the label dates on the medication and the chart will not correlate. If the pharmacy cannot confirm that there have been no changes to the servic e service user’s medication, then a replacement Medicine Record Chart must not be provided and the care worker must be advised to request a new prescription for all medications. As part of the clinical check of the Medicine Record Chart, when the pharmacy are adding a label to the Medicine Record Chart for a new medication and it is confirmed by the prescriber that a previous medication has been discontinued, it is good practice for the pharmacy to clearly annotate the chart to show which medication has been discon tinueddiscontinued. It is good practice to ensure that all labels on medications for administration by carers contain full written dose instructions. If any medications are prescribed ‘as directed’ the pharmacy is encouraged, where possible, to support good practice and contact the prescriber for the full correct dose. If prescribed medication doses require a carer to ‘half a tablet’ it is good practice for the pharmacy to refer back to the prescriber for an alternative formulation where possible to avert the need for a carer to split tablets. For the exception when there is no alternative, the dose instructions should clearly state that ‘half’ a tablet is to be administered. Enough medication must be prescribed for the duration of treatment to allow for safe dispos al disposal of the unwanted ‘half’. Pharmacists are under no obligation to half the tablet or supply a tablet cutter. This must be funded by the service user/care provider. All warfarin labels on a Medicine Record Chart should ensure that dose instructions direct the carer to administer the most up to date dose in accordance with the yellow anticoagulation booklet or letter. Domiciliary care worker agencies must liaise with the community pharmacy before a patient is established on a Medicine Record Chart, and continue to work closely with the pharmacy of choice. Supply of Medicine Record Chart will be recorded on the service user’s patient medication record within the pharmacy A record of any relevant interventions will also be kept.

Service Specification. An ‘authorised person’ in this service specification is a person acting under arrangements with the CCG for the purpose of coordinating access to this service. The pharmacy will be contacted by an authorised person when they identify a service user who requires help with medication and the introduction of a Medicine Record Chart. The pharmacy should not start the service until it has received written confirmation from an authorised person. The pharmacy should annotate the patient medication record (PMR) that the patient requires a Medicine Record Chart preparing with each dispensed medication. The pharmacy should prepare a duplicate label for each dispensed medication and attach it to the Medicine Record Chart. The issuing of labels NOT attached to the chart is not permissible. Once the label has been attached to the chart the letters Medicine Record Chart should be written starting on the left hand side of the chart and continuing onto the label. If more than one chart is needed for a service user, then the charts should be numbered to indicate that more than one chart is in use e.g. 1 of 1, 1 of 2 etc. The pharmacy should keep the prepared chart together with the dispensed medication for collection or delivery to the service user. If medication is prescribed at a different time to regular prescriptions then the Medicine Record Chart should be returned to the pharmacy for labels to be attached. For mid-cycle requests that follow into the next cycle e.g. a seven day course of antibiotics prescribed on day 26, the pharmacy should print two extra labels at the time of dispensing – one to attach to the current Medicine Record Chart and the other to add to the new cycle chart. Where possible, there should be only one Medicine Record Chart in use at any one time. The exception to this may include the prescribing of ‘just in case’ medications; see below. Where you need to vary from this guidance, this must be risk assessed and only done in exceptional circumstance For medications prescribed ‘just in case’ e.g. a course of antibiotics and steroids for a COPD exacerbation, a separate Medicine Record Chart should be supplied to keep with the medication until needed. This Medicine Record Chart should be clearly marked by th e the pharmacy to indicate that there is more than one chart in use.  In the case where a Medicine Record Chart is missing i.e. if in error it was not supplied at the time of dispensing a new cycle of medication or if following the supply it has been mislaid, the pharmacy may issue a replacement Medicine Record Chart within a few days of dispensing the new medication cycle. The pharmacy will need to assure themselves that there have been no prescribing changes before an Medicine Record Chart is produced. The pharmacy should clearly annotate the Medicine Record Chart to indicate that it is a duplicate. In this instance the label dates on the medication and the chart will not correlate. If the pharmacy cannot confirm that there have been no changes to the servic e service user’s medication, then a replacement Medicine Record Chart must not be provided and the care worker must be advised to request a new prescription for all medications. As part of the clinical check of the Medicine Record Chart, when the pharmacy are adding a label to the Medicine Record Chart for a new medication and it is confirmed by the prescriber that a previous medication has been discontinued, it is good practice for the pharmacy to clearly annotate the chart to show which medication has been discon tinueddiscontinued. It is good practice to ensure that all labels on medications for administration by carers contain full written dose instructions. If any medications are prescribed ‘as directed’ the pharmacy is encouraged, where possible, to support good practice and contact the prescriber for the full correct dose. If prescribed medication doses require a carer to ‘half a tablet’ it is good practice for the pharmacy to refer back to the prescriber for an alternative formulation where possible to avert the need for a carer to split tablets. For the exception when there is no alternative, the dose instructions should clearly state that ‘half’ a tablet is to be administered. Enough medication must be prescribed for the duration of treatment to allow for safe dispos al disposal of the unwanted ‘half’. Pharmacists are under no obligation to half the tablet or supply a tablet cutter. This must be funded by the service user/care provider. All warfarin labels on a Medicine Record Chart should ensure that dose instructions direct the carer to administer the most up to date dose in accordance with the yellow anticoagulation booklet or letter. Domiciliary care worker agencies must liaise with the community pharmacy before a patient is established on a Medicine Record Chart, and continue to work closely with the pharmacy of choice. Supply of Medicine Record Chart will be recorded on the service user’s patient medication record within the pharmacy A record of any relevant interventions will also be kept.

Service Specification. An ‘authorised person’ in this service specification is a person acting under arrangements with the CCG for the purpose of coordinating access to this service. The pharmacy will be contacted by an authorised person when they identify a service user who requires help with medication and the introduction of a Medicine Record Chart. The pharmacy should not start the service until it has received written confirmation from an authorised person. The pharmacy should annotate the patient medication record (PMR) that the patient requires a Medicine Record Chart preparing with each dispensed medication. The pharmacy should prepare a duplicate label for each dispensed medication and attach it to the Medicine Record Chart. The issuing of labels NOT attached to the chart is not permissible. Once the label has been attached to the chart the letters Medicine Record Chart should be written starting on the left hand side of the chart and continuing onto the label. If more than one chart is needed for a service user, then the charts should be numbered to indicate that more than one chart is in use e.g. 1 of 1, 1 of 2 etc. The pharmacy should keep the prepared chart together with the dispensed medication for collection or delivery to the service user. If medication is prescribed at a different time to regular prescriptions then the Medicine Medi cine Record Chart should be returned to the pharmacy for labels to be attached. For mid-cycle requests that follow into the next cycle e.g. a seven day course of antibiotics prescribed on day 26, the pharmacy should print two extra labels at the time of dispensing – one to attach to the current Medicine Record Chart and the other to add to the new cycle chart. Where possible, there should be only one Medicine Record Chart in use at any one time. The exception to this may include the prescribing of ‘just in case’ medications; see below. Where you need to vary from this guidance, this must be risk assessed and only done in exceptional circumstance For medications prescribed ‘just in case’ e.g. a course of antibiotics and steroids for a COPD exacerbation, a separate Medicine Record Chart should be supplied to keep with the medication until needed. This Medicine Record Chart should be clearly marked by th e b y the pharmacy to indicate that there is more than one chart in use.  In the case where a Medicine Record Chart is missing i.e. if in error it was not supplied at the time of dispensing a new cycle of medication or if following the supply it has been mislaid, the pharmacy may issue a replacement Medicine Record Chart within a few days of dispensing the new medication cycle. The pharmacy will need to assure themselves that there have been no prescribing changes before an Medicine Record Chart is produced. The pharmacy should clearly annotate the Medicine Record Chart to indicate that it is a duplicate. In this instance the label dates on the medication and the chart will not correlate. If the pharmacy cannot confirm that there have been no changes to the servic e se rvice user’s medication, then a replacement Medicine Record Chart must not be provided and the care worker must be advised to request a new prescription for all medications. As part of the clinical check of the Medicine Record Chart, when the pharmacy are adding a label to the Medicine Record Chart for a new medication and it is confirmed by the prescriber that a previous medication has been discontinued, it is good practice for the pharmacy to clearly annotate the chart to show which medication has been discon tinueddi scontinued. It is good practice to ensure that all labels on medications for administration by carers contain full written dose instructions. If any medications are prescribed ‘as directed’ the pharmacy is encouraged, where possible, to support good practice and contact the prescriber for the full correct dose. If prescribed medication doses require a carer to ‘half a tablet’ it is good practice for the pharmacy to refer back to the prescriber for an alternative formulation where possible to avert the need for a carer to split tablets. For the exception when there is no alternative, the dose instructions should clearly state that ‘half’ a tablet is to be administered. Enough medication must be prescribed for the duration of treatment to allow for safe dispos al di sposal of the unwanted ‘half’. Pharmacists are under no obligation to half the tablet or supply a tablet cutter. This must be funded by the service user/care provider. All warfarin labels on a Medicine Record Chart should ensure that dose instructions direct the carer to administer the most up to date dose in accordance with the yellow anticoagulation booklet or letter. Domiciliary care worker agencies must liaise with the community pharmacy before a patient is established on a Medicine Record Chart, and continue to work closely with the pharmacy of choice. Supply of Medicine Record Chart will be recorded on the service user’s patient medication record within the pharmacy A record of any relevant interventions will also be kept.