Accreditation process for Community Pharmacists wishing to provide by HC121109041445

VIEWS: 0 PAGES: 11

									                         Community Pharmacy Enhanced Services


Competencies and Training Framework
Enhanced                 Needle and Syringe Programme (NSP)
Service:                   Level 1: * Distribution of injecting equipment with written
                                     information on harm reduction plus distribution of
                                     health promotion information and sign posting.

                           Level 2: * Level 1 plus distribution of bespoke injecting
                                     equipment, plus health promotion advice or referral to
                                     specialist services.

Version:                 Version 3a
                         (See section 9 for how this version differs from the previous version)
Issue Date:              June 2012
Review Date:             June 2015
No. of pages:            11
Authorised by:           Harmonisation of Accreditation Group (HAG)
Replaces:                Version 2 (January 2010)

1.    Introduction
      Community Pharmacists wishing to provide a Needle and Syringe Programme (NSP)
      as an enhanced service must be accredited and have their names on an enhanced
      service provider list kept by the PCT on whose behalf they are providing the service.
      Throughout this document the abbreviation PCT is used in place of “Primary Care
      Trusts or other Commissioning Bodies”.

      The information in this document outlines the purpose and design of suitable local
      training, which will allow Community Pharmacists to become accredited and
      recognised by all PCTs that endorse the standards set by the Harmonisation of
      Accreditation Group (HAG).

      This ‘Competencies and Training Framework’ (C&TF) complements the NICE Public
      Health Guidance No. 18 on NSPs issued in February 2009 (which describes three
      levels of service for an NSP to people over the age of 18 who inject illicit substances
      and non-prescribed anabolic steroids). Pharmacists trained to Level 1 (as described
      in this document) will possess the necessary competences to deliver Level 1 NICE
      services plus distribution of health promotion information and sign posting.
      Pharmacists trained to Level 2 as described in this document will possess the
      necessary competences to deliver Level 2 & part Level 3 NICE services.

      This C&TF also supports the competencies required to achieve the Drug and Alcohol
      National Occupational Standards (DANOS).

      The HAG has approved the following process.
HAG COMPETENCIES & TRAINING FRAMEWORK                                            Page 1 of 11
Needle and Syringe Programme                                           Version 3a (June 2012)
2.   Core Competencies
     These core competencies have been mapped to the General Level Framework
     (available at www.codeg.org).

     LEVEL 1
     This level covers distribution of basic injecting equipment either loose or in
     packs, with written information on harm reduction (eg. safer injecting, overdose
     prevention) plus distribution of health promotion information and sign posting.
     General
       a) Understands the key aims of an NSP to:
            i) reduce the transmission of blood-borne viruses (BBV) and other infections
                  caused by sharing injecting equipment;
             ii) reduce other harms caused by injecting drugs;
             iii) sign post to other services.
       b) Aware of Sexual Health, Sexually Transmitted Infections, BBV, HIV and
          Hepatitis C transmission and Hepatitis B immunisation.
       c) Understands the terminology; nomenclature both official and “street”; definitions
          of drug dependence; the concept and the practice of harm reduction and what
          constitutes “dangerous practice”.
       d) Aware of the treatment of substance misuse and knowledge of commonly
          misused drugs with particular reference to drugs liable to be injected.
       e) Aware of commonly used anabolic steroids, the problems associated with their
          use & routes of administration [G1].
       f) Aware of the interaction of alcohol with treatment and patient outcomes.
       g) Able to communicate effectively with drug misusers with discretion, respect for
          their privacy and appreciates how to treat them in a non-stigmatising way..
       h) Understands current legislation, ethics, duty of care and the need to apply
          professional judgement for this client group.
       i) Able to support pharmacy team members in the delivery of a safe and effective
          NSP at Level 1.
       j) Knows how to risk assess the situation and when to ask for support and advice /
          signposting.

     Equipment Supply and Safe Disposal
      k) Understands the legislation and parameters associated with the supply of
         injecting paraphernalia (Legally permitted equipment as defined in the “Para 9a
         exemptions” of the Misuse of Drugs Act).
      l) Aware of the various types (and sizes) of needles, syringes and other injecting
         equipment associated with illicit drug use to be made available.
      m) Can define the term “coverage” (ie. the amount of equipment to supply in terms
         of the clients needs) and understands differences between opioid / Performance
         and Image Enhancing Drugs (PIED) and stimulant injectors equipment
         requirements.
      n) Understands the principles of risk minimisation to patients, staff and members of
         the public; use of appropriate protective equipment; and how to deal safely and
         effectively with spillages or contamination with potentially infected blood or body
         fluids.
      o) Understands the principles of safe disposal of used injecting equipment; is
         aware of actions to take in the event of needle stick injuries.

     Information Distribution & Signposting
       p) Able to promote safer injecting practice / reduced sharing of equipment and
          advice on how to dispose of needles and syringes safely through the supply of
          written information.
       q) Aware of other related services and knows how and when to refer / signpost
          clients regarding problems relating to their substance misuse or general health
          problems.


HAG COMPETENCIES & TRAINING FRAMEWORK                                         Page 2 of 11
Needle and Syringe Programme                                        Version 3a (June 2012)
     LEVEL 2
     This level covers distribution of ‘pick and mix’ (bespoke) injecting equipment
     plus health promotion advice (including advice and information on how to
     reduce the harms caused by injecting drugs) or referral to specialist services
     and expands on the Level 1 competencies. The following competencies also
     apply:

     General
      a) Able to counsel and advise individuals about their drug dependence.
      b) Able to advise on health promotion specific to this client group including Sexual
         Health, Sexually Transmitted Infections, Blood Borne Viruses (BBV), HIV and
         Hepatitis C transmission and Hepatitis B immunisation.
      c) Able to support pharmacy team members in the delivery of a safe and effective
         Level 2 NSP.

     Equipment Supply
       d) Understands the principles of and be able to deliver a bespoke “pick and mix”
          distribution service including the range of injecting paraphernalia to be available
          from a Level 2 NSP.

     Harm Reduction Advice
       e) Understands comprehensive harm-reduction services including advice on safer
          injecting practices; assessment of injection-site infections; advice on preventing
          overdoses; help to stop injecting drugs; and opioid substitution therapy services.
       f) Able to advise on safer practices including marking and segregating equipment,
          safe disposal of needles and syringes, and more dangerous practices (e.g. long
          needles, femoral injecting).
       g) Able to encourage people who inject drugs to move towards other less harmful
          methods of drug use e.g. smoking.

3.   Framework of Training
     3.1       Underpinning Knowledge
     A Centre for Pharmacy Postgraduate Education (CPPE) open learning programme
     provides pharmacists with the necessary knowledge to underpin the provision of a
     Needle and Syringe Programme as an enhanced service:

              CPPE Substance Use and Misuse Open Learning Programme (10 Hours)
     The Substance Use and Misuse Open Learning Programme and its assessment
     should be completed within three months of starting to provide an NSP. The CPPE
     programme provides pharmacists with a record of assessment, which must be
     retained by the pharmacist and copies sent to the accrediting PCT for full
     accreditation. Alternatively, individuals can also allow access to their online records by
     switching on the CPPE viewer via the My CPPE page on the CPPE website
     (www.cppe.ac.uk).

     Individual commissioners may agree to recognise other training courses provided that
     they deliver the equivalent knowledge and learning outcomes (see Section 8) as the
     CPPE programme stipulated above. The current versions of learning programmes
     must be completed as part of any training undertaken. The latest versions of CPPE
     Open Learning Programmes can be confirmed by accessing the CPPE website.

     Pharmacists wishing to deliver an NSP also need to familiarise themselves with the
     contents of the NICE Public Health Guidance 18 (February 2009).

     To support their Pharmacy Team Members in the delivery of a safe and effective NSP
     at Level 1, Pharmacists may find it helpful to sign post them to the following

HAG COMPETENCIES & TRAINING FRAMEWORK                                            Page 3 of 11
Needle and Syringe Programme                                           Version 3a (June 2012)
     associated CPPE learning programme:
         CPPE Substance use and misuse: fundamentals and practicalities for the
            pharmacy technicians

     3.2     PCT / Drug and Alcohol Action Team (DAAT) Commissioned
           Workshop/ CPPE Public Health Workshop

     Level 1
     Attendance at a local workshop is not considered a prerequisite in order for
     Pharmacists to commence providing a NSP at Level 1. Knowledge of local services
     should be provided by reference to the service specification of the PCT / DAAT.
     Pharmacists providing a Level 1 service should attend an update meeting each year
     (see details below).

     Level 2
     Attendance at a local workshop is considered a prerequisite in order for Pharmacists
     to provide a NSP at Level 2. PCTs / DAATs / Training Providers may wish to deliver
     this training over more than one session where appropriate and should decide on the
     most suitable format for workshops, which may vary according to local provision and
     need.

     a) Aims
     The aim is to enable Community Pharmacists to become competent to provide an
     NSP at Level 2 which covers the distribution of ‘pick and mix’ (bespoke) injecting
     equipment plus health promotion advice (including advice and information on how to
     reduce the harms caused by injecting drugs) and / or referral to specialist services.

     Pharmacists should ensure that pharmacy team members, who are involved in the
     delivery of the NSP at Level 2, receive appropriate training linked to their level of
     involvement.

     b) Objectives
     The workshop should build on the underpinning knowledge required to provide an
     NSP at Level 1. On completion of the training, pharmacists are able to:
        I. Deliver a bespoke “pick and mix” distribution service.
        II. Counsel and advise individuals about their drug dependence and health
             promotion specific for this client group.
        III. Advise on safer injecting practices, overdose prevention and safe disposal of
             equipment.
        IV. Have a more comprehensive understanding of the full range of injecting
             paraphernalia to deliver a bespoke service.

     c) Features of the Workshop
         I. A didactic session on the provision of an NSP at Level 2.
        II. The Workshop should include various relevant case studies.
       III. The Workshop may include various relevant role-play scenarios. Role-play
            should involve a facilitator observing and/or participating in a role-play
            involving each of the pharmacists with provision of appropriate feedback.
            Pharmacists’ performance must be to an acceptable standard.
       IV. Update on recent developments.

     Annual Update Meeting
     The National Treatment Agency recommends that the PCT / DAAT (or relevant
     commissioning body) should arrange at least one contractor meeting per year to
     promote service development, share experiences and update the knowledge of
     pharmacy staff. Pharmacists providing either Level 1 or Level 2 services should attend
     these meetings.
                      (** See Section 7: Cross Accreditation Process)
HAG COMPETENCIES & TRAINING FRAMEWORK                                         Page 4 of 11
Needle and Syringe Programme                                        Version 3a (June 2012)
4.   Summary of Assessment & Accreditation
     Level 1: Each pharmacist must have successfully completed the:

        *CPPE Substance Use and Misuse open learning programme                          and
         accompanying assessment.

     Temporary accreditation for the first three months may be achieved by written self-
     declaration to the PCT stating that the CPPE open learning programme has been
     commenced and will be completed within three months. Full accreditation is proven by
     possession of a current, expiry dated certificate provided by the accrediting PCT,
     which bears the HAG standard mark.

     Level 2: Each pharmacist must, in addition to the requirements for Level 1, have
     attended the PCT / DAAT Commissioned Workshop session(s) covering Level 2 to an
     acceptable standard.

     (* Or other appropriate training course as described in Section 3.1)

     Accreditation is proven by possession of a current, expiry dated certificate provided by
     the accrediting PCT, which bears the HAG standard mark. The certificate must list any
     Service Extensions and/or Prescription Only Medicines provided under Patient Group
     Directions, which were covered in the training.

     PCTs are recommended to maintain accreditation records for a minimum of three
     years.

5.   Maintenance of Accreditation
     Where changes are introduced to the commissioned service, relevant information
     must be provided by the PCT; pharmacists and staff will need to update themselves
     as part of their usual continuing professional development.

     Accreditation status must be reviewed at least every three years. This should be in the
     form of a self-declaration of competency (see appendices). Where there are concerns
     regarding poor performance, this should be addressed separately as a clinical
     governance matter.

6.   Service Extension Requirements
     Any Service Extensions, which are covered in a pharmacist’s training, must be listed
     on the Accreditation Certificate.

     6.1 Services for Under 18s
     The recommendations in the current NICE Guidance No. 18 relate to people over the
     age of 18 who inject illicit substances and non-prescribed anabolic steroids. Providing
     young people under 18 (particularly those under 16) with an NSP is legally and
     ethically difficult and involves a different service model. NICE has been asked
     consider producing separate guidance on NSPs for young people aged under 18.

     When a commissioned service is available to clients under 18 years, then in addition
     to the above, pharmacists must also complete:
          a) CPPE Safeguarding Children Open Learning Programme (new e-learning due
              in July 2012) / e-assessment (or other training courses provided that they
              deliver the equivalent knowledge and learning outcomes - see Section 8).
          b) Specific training for this client group must be provided by the PCT.

     The commissioning PCT / DAAT must resource the necessary training and
     assessment for pharmacists wishing to provide any of these extended services

HAG COMPETENCIES & TRAINING FRAMEWORK                                          Page 5 of 11
Needle and Syringe Programme                                         Version 3a (June 2012)
7.   Cross Accreditation
     Accredited Pharmacists must be advised by the accrediting PCT that if they
     wish to provide a Needle and Syringe Programme to another PCT, they must
     contact that PCT to find out if they are commissioning this service and for
     details about their service specification, paperwork, sources of support and
     payment systems before providing the service.

     PCTs may or may not be commissioning this service. If they are, local paperwork,
     sources of support, extent of the service, etc., may differ. PCTs should however
     recognise the accreditation certificate, which bears the HAG standard mark, and
     hence will only need to ensure that pharmacists understand differences of
     operation in their area.

8.   Learning Outcomes from Training Programmes (Section 3.1)

     8.1 CPPE Substance Use and Misuse Open Learning Programme
     After completing this programme pharmacists are able to:
          Be familiar with range of recent Government drug strategies including impact
             on the criminal justice system, care planning and the concept of harm
             reduction.
          List and discuss the key legislation concerning drugs and substances
          Describe substance misuse services including pharmacy services for
             substance misusers.
          Describe the terminology and definitions of substance misuse and the theories
             of drug dependency.
          Discuss the treatment of substance misuse including non-pharmacological and
             pharmacological treatment options, assessment, care planning and goal
             setting.
          Describe the provision of injecting equipment, medical complications of
             injecting, necessary advice and injecting paraphernalia.
          Appreciate the ethical aspects of supporting substance misusers including
             confidentiality, data protection and communication.
          Have an overview of commonly misused substances including their common
             street names, effects, adverse effects, risk of tolerances, mode of use and
             withdrawal symptoms.

     8.2 CPPE Safeguarding Children Open Learning Programme (new e-learning
     due in July 2012)
     After completing this programme pharmacists are able to:
          Summarise the background and policy surrounding child protection and the
             issues this raises for pharmacists and pharmacy technicians.
          Convey the importance of pharmacists and pharmacy technicians increasing
             their awareness of child abuse and working with other health professionals to
             develop best practice to deal with situations involving suspected abuse.
          Highlight situations in which they are best placed to observe signs of abuse
             and the legal issues to consider when making a referral.
          Identify sources of useful information and contacts for the development of local
             procedures for dealing with suspected child abuse observed in a pharmacy
             setting.

9.   How this version differs from the previous version
     The following is a summary of differences between this Version 3 and Version 2 that
     was published in January 2010.
      Core competencies are no longer being mapped to the RPS general pharmacist
        competencies (Section 2).

HAG COMPETENCIES & TRAINING FRAMEWORK                                         Page 6 of 11
Needle and Syringe Programme                                        Version 3a (June 2012)
         New Core Competency added: Aware of the interaction of alcohol with treatment
          and patient outcomes.
         CPPE are now delivering Public Health Workshops (Section 3.2).
         The Workshop “may” rather than “must” include various relevant role-play
          scenarios.
         CPPE assessment is now e-assessment and is undertaken on line (Section 3.1)
         The recommendations in the current NICE Guidance No. 18 relate to people over
          the age of 18 who inject illicit substances and non-prescribed anabolic steroids.
          Providing young people under 18 (particularly those under 16) with an NSP is
          legally and ethically difficult and involves a different service model. NICE has
          been asked consider producing separate guidance on NSPs for young people
          aged under 18. (Section 6.1)
         New CPPE e-learning Programme “Safeguarding Children and Vulnerable Adults”
          due in July 2012 (Section 6.1 / 8.2)
         Learning outcomes for the CPPE Open Learning Programmes have been
          checked and updated where necessary (Section 8).

10.   Copies of this document available from:
      All HAG documents, including this document are hosted, on the NW Pharmacy
      Workforce Website at: http://www.pharmacyworkforcenw.nhs.uk

      Enquiries about HAG to:
             Clive Moss-Barclay, Project Director
             North West Pharmacy Education, Training & Development.
             Email: clive.moss-barclay@salford.nhs.uk
             Tel: 0161 212 6042; Fax: 0161 212 6046.

      Local Service and Training Provision:
             Pharmacists requiring information about local service and training provision
             should contact their local PCT.




HAG COMPETENCIES & TRAINING FRAMEWORK                                         Page 7 of 11
Needle and Syringe Programme                                        Version 3a (June 2012)
SAMPLE LETTER TO ACCREDITED PHARMACISTS
(An editable copy can be downloaded from http://www.pharmacyworkforcenw.nhs.uk)



  Dear Pharmacist,

  Needle and Syringe Programme.
  Please find enclosed your Certificate of Accreditation which
  authorises you to provide a Needle and Syringe Programme at
  LEVEL1 / LEVEL 2 with the following extension: …………………….
  ……………. (Delete as appropriate) in ………………… PCT.
  I am pleased to advise you that our accreditation process for a
  Needle and Syringe Programme complies with the Competencies
  and Training Framework developed by the Harmonisation of
  Accreditation Group (HAG). This should enable you to provide a
  Needle and Syringe Programme to other PCTs which recognise the
  HAG standards, without the need to be re-accredited by each PCT.


  If you wish to provide a Needle and Syringe Programme outside
  of this PCT, you should first contact the relevant PCT(s) to find
  out if they are commissioning this service and for details about
  their service specification, paperwork, sources of support and
  payment systems.


  If you require any further assistance please do not hesitate to
  contact me.

  Yours sincerely,
(An editable copy can be downloaded from http://www.pharmacyworkforcenw.nhs.uk)




                                     Insert PCT Logo here



    Certificate of Accreditation for
 Community Pharmacy Enhanced Services
                          This is to certify that
                 Insert Pharmacist’s Name and
                     Registration Number
                       is accredited to provide a

                “Needle and Syringe
                   Programme”
             Level 1 or Level 2              (delete as appropriate)

          Covering the following Service Extension(s):
              a) ………………………………………………………


                            Insert Signature
                            Insert name of signatory here
                         Insert designation of signatory here
                               Insert name of PCT here
                              Insert contact details here

                  Issue Date:        …………...……… 20_ _
                  Review Date:       ………….………...20_ _

The above named person is accredited to provide this enhanced service within the
issuing PCT only. This accreditation may be recognised by other PCTs that, if the
Pharmacist wishes to provide this service, should be contacted for further
information.            Head of Medicines Management
                    Central Cheshire Primary Care Trust
  (An editable copy can be downloaded from http://www.pharmacyworkforcenw.nhs.uk)


                                                                               [ Insert PCT Logo here ]



                                 Community Pharmacy Enhanced Services
                                      MAINTENANCE OF ACCREDITATION
                                         SELF-DECLARATION FORM


  HAG recommends that accreditation status must be reviewed at least every three
  years. HAG also recommends that the individual pharmacist take responsibility to
  ensure that they maintain their accreditation status. This self-declaration form may be
  used by pharmacists to reflect on standards of service delivery; new guidance and
  legislation; and fitness to practise in relation to the specific service.

  The pharmacist should work through this form, reflect on the issues raised, comment
  on any actions required and sign the declaration at the end of the form. The completed
  and signed form may be used as evidence of maintenance of accreditation for the
  PCT.

Enhanced service being delivered: “Needle and Syringe Programme at Level ….”
Date of initial accreditation or last self declaration:


      Complete BOTH sections in Part A and tick a minimum of
                   THREE sections in Part B.
  The information that you provide below must relate to the time period since your initial
           accreditation or last self-declaration of maintenance of accreditation.

                            Part A (Complete both A.1 and A.2)
                                   Core Statements                                   Yes   No     Comments
A.1    I have reviewed the most recent service documentation for the provision
       of this enhanced service (e.g. handbook revisions, etc.) and I confirm that
       I have implemented any necessary changes in service delivery.
A.2    I have reviewed guidance and legislation relevant to the provision of this
       enhanced service. List here with approximate review dates:



          Part B (Tick all that apply – must be a minimum of THREE)
                               Additional Statements                                 Yes        Comments
B.1    I have completed at least one entry in my CPD record relating to this
       enhanced service within the last 12 months.

B.2    I have undertaken a minimum of 12 relevant consultations in the last 12
       months.

B.3    I have undertaken the following training courses or programmes which
       are relevant to this enhanced service
       List the courses here with approximate dates:
                               Additional Statements                              Yes   Comments
B.4   I have revisited the Standard Operating Procedures I have in place within
      the pharmacy to support the delivery of this service.



B.5   I have completed an audit of this enhanced service in the last 12 months
      and acted appropriately on the outcomes.

B.6   I have undertaken training / development with the pharmacy team in the
      last 12 months to update them on this enhanced service.



  I have reviewed the most recent version of the HAG Competencies and Training Framework*
  for this enhanced service & believe that I continue to demonstrate competence in these areas.

  I declare that I am competent to continue the provision of this service.



  Pharmacist’s signature: ………………………………………. Date: ……………………………


  Print name: ……………………………………………………… Registration No.……………..


Please return this form to:   [Insert PCT address here]




  (*All HAG documents, including “Competencies and Training Frameworks”, are hosted on the NW
  Pharmacy Workforce Website at: http://www.pharmacyworkforcenw.nhs.uk)

								
To top