PRJ2144 Access to Palliative and End-of-Life Care Medicines Through Community Pharmacies in North East London - Market Engagement

Background:

End-of-life care services requires specialist medicines that are not routinely available in all community pharmacies, and this may cause delay in treatment for patients.

Timely access to Palliative and End-of-Life Care (PEoLC) medications in the community is therefore essential for effectively managing symptoms at home for patients nearing the end of life.

Outline:

The service commissioned will provide and maintain an adequate number of strategically located providers across NEL to meet the needs of the population effectively.

Facilitate easy and timely access to PEoLC medicines, enabling patients to achieve good symptom control and maintain it consistently. To provide service provision of PEoLC medicines to patients in NEL during service provider's normal opening-hours and OOHs.

Aims:

• To ensure equitable access to the service across NEL to meet local population needs.
• Help prevent crises or emergency hospital visits, including potential admissions, caused by the lack of timely access to PEoLC medications.
• Align with the goals of the NHS Long Term Plan, the National Palliative and End-of-Life Care Strategy, and the NEL Palliative and End-of-Life Care Strategy to enhance end-of-life care provision.
• Suppliers providing these services will be strategically located to ensure coverage across all areas within NEL.
• The provider will be required to maintain a stock of PEoLC medicines as per the agreed list developed. Services are to be provided from provider's premises that are included on NHS England's pharmaceutical list in NEL.
• NEL ICB will reimburse the pharmacy provider for the initial stock
• The Supplier must ensure robust processes are in place to monitor drug expiry and replenishment , as necessary for any stock that becomes out of date and is replaced, the provider is required to submit out-of-date submission for reimbursement. The pharmacy provider will supply a copy of the invoice for the claim if requested by NEL ICB.
• In circumstances where the Provider is unable to supply the PEoLC medicines, the Provider must direct/signpost the family member/ carer/ healthcare professional to the nearest Supplier, checking first that they have the required item(s) in stock.
• In circumstances where the Provider is unable to direct/signpost the family member/ carer/ healthcare professional to the nearest Provider due to a national supply issue, the Provider must contact the prescriber notifying them of the supply issue.

Access to the service during normal opening hours:

• The provision of this service must operate during the service provider's normal opening hours and bidder to indicate if they are willing to participate in the out-of-hours service.
• The provider shall ensure that NEL residents and healthcare professionals can contact the service during the normal opening hours.
• To maintain appropriate records to cover ordering, receipt and expiry date checks to ensure effective, ongoing service delivery.
• The provider is responsible for dispensing the items from the PEoLC stock in response to NHS prescriptions presented to the pharmacy, in line with the dispensing service.
• The Provider will have and update a specific standard operating procedure (SOP) to meet these service requirements, including a process for OOH and delivery of medicines and reflect changes in practice or guidelines where appropriate.

The option for the receipting of the prescription will follow existing pathways and these are:

• The FP10 prescription is electronically transmitted to the Provider or
• The FP10 prescription is taken to the Provider by a family member/ carer/ healthcare professional.
• The provider will ensure that pharmacists and staff involved in the provision of the service have received the appropriate training and can deliver the service during the hours commissioned for this service if chosen to provide OOHs service provision to support service.
• The pharmacist will provide information and advice relating to the use of EoLC medicines to family members/ carers/ healthcare professionals.

Access to the service during OOHs:

• The Provider will receive referrals to access the service from various providers for residents within NEL.
• The OOH period for this service is defined as 18:00hrs - 09:00hrs (next day) and weekends and Public Holidays/ Bank- Holidays.
• The OOHS service provider will be required to provide a direct contact number (preferably a mobile number) to be contacted during the OOH period.
• To be able to dispense the medication as soon as possible and within a maximum expected time of 1 hour following the receipt of a valid prescription by the provider.

Delivery Service OOHs:

• A member of the family/ carer/ healthcare professional collects the medicine from the community pharmacies and takes the dispensed items to the patient or
• Provider to deliver medication to patient's home (this should be completed within two hours of receiving prescription) or
• A courier is arranged for the medicines to be delivered to the patient's home for medicines.
• The delivery service will only be for medicines dispensed by the Provider under the terms of the contract and will only take place OOH to residents within NEL.
• The Commissioner must be informed each month of the number of deliveries that have been made.
• No member of the Provider's delivery personnel is required nor expected to enter the patient's home to provide the delivery service.
• The Provider will keep an accurate record of all home deliveries and shall provide this information without delay to the Authority upon reasonable request.
• All deliveries shall be made under appropriately controlled conditions to suit the nature of the products being delivered.

The indicative maximum financial envelope for this procurement will be £72,386 per annum. This indicative value is based on 36 providers in hours (9:00 hrs-18:00 hrs) of which 7 also provide out of hours (18:00 hrs - 9:00 hrs the next day, …