Community Pharmacy Hepatitis C Testing Service
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Questions and Answers

What is the name of the service for people who are not engaged in community drug and alcohol treatment services?

Community Pharmacy Hepatitis C Antibody Testing Service

The Community Pharmacy Hepatitis C Antibody Testing Service is an Advanced service commissioned under the NHS Community Pharmacy Contractual Framework.

True

What does PWID stand for?

People who inject drugs

People who inject drugs (PWIDs) account for 10% of all new HCV infections.

<p>False</p> Signup and view all the answers

What is the aim of the Community Pharmacy Hepatitis C Antibody Testing Service?

<p>To increase levels of testing for HCV amongst PWIDS</p> Signup and view all the answers

What are some of the intended outcomes of the Community Pharmacy Hepatitis C Antibody Testing Service? (Select all that apply)

<p>Increase the number of diagnoses of HCV Infection</p> Signup and view all the answers

Prior to providing the service, the pharmacy contractor must be satisfactorily complying with their obligations under Schedule 4 of the Pharmaceutical Services Regulations, in respect of the provision of Essential services.

<p>True</p> Signup and view all the answers

The pharmacy contractor does not need to notify the ODN if they intend to provide the service.

<p>False</p> Signup and view all the answers

The pharmacy contractor should be satisfied that all pharmacy staff involved in the provision of the service are competent to do so.

<p>True</p> Signup and view all the answers

The pharmacy must have a consultation room, which complies with the requirements of the regulations.

<p>True</p> Signup and view all the answers

All pharmacy staff involved in the provision of this service should ensure they are familiar with and adhere to the standard operating procedure.

<p>True</p> Signup and view all the answers

The pharmacy contractor must ensure that pharmacists, pharmacy technicians and their teams providing the service are competent to do so.

<p>True</p> Signup and view all the answers

The pharmacy contractor must ensure that staff are appropriately trained and made aware of the risks associated with the handling and disposal of clinical waste and that correct procedures are used to minimise those risks. A needle stick injury procedure must be in place.

<p>True</p> Signup and view all the answers

The pharmacy contractor must ensure that staff involved in the provision of this service are advised that as there is a small risk that they could come into contact with blood borne viruses, they should therefore consider being vaccinated against Hepatitis B and be advised of the risks should they decide not to do so.

<p>True</p> Signup and view all the answers

The service will commence on 1st September 2020.

<p>True</p> Signup and view all the answers

The service will be time limited, the first instance will run until 31st March 2022.

<p>True</p> Signup and view all the answers

Prior to 31st March 2022, a review will be undertaken to ascertain whether the service is effective in testing this difficult-to-reach patient cohort and successfully directing those PWIDs who test positive towards further PCR testing and treatment.

<p>True</p> Signup and view all the answers

The review will be informed observational data and the NHS England and NHS Improvement registry.

<p>True</p> Signup and view all the answers

If the efficacy of the service model is suitably demonstrated, the service may be extended into 2022/23.

<p>True</p> Signup and view all the answers

The service will continue after 31st March 2025.

<p>False</p> Signup and view all the answers

The pharmacy contractor should seek to ensure that the service is available throughout the pharmacy's contracted opening hours.

<p>True</p> Signup and view all the answers

If the pharmacy is also commissioned to deliver an NSP service, it will be particularly important to ensure that the testing service is offered at a time that PWIDs visit to exchange their injecting equipment.

<p>True</p> Signup and view all the answers

The pharmacy's NHS website profile should be edited to indicate that a blood-borne virus testing service is provided.

<p>True</p> Signup and view all the answers

If the pharmacy temporarily or permanently ceases to provide the service, they should, as soon as possible, update their NHS website profile to reflect that the service is no longer available.

<p>True</p> Signup and view all the answers

The pharmacy contractor must ensure the service is accessible, appropriate, and sensitive to the needs of all service users.

<p>True</p> Signup and view all the answers

The pharmacy contractor cannot refuse to provide the service to an eligible PWID if the PWID or any other person accompanying the PWID, threatens violence or commits or threatens to commit a criminal offence.

<p>False</p> Signup and view all the answers

The pharmacy contractor must notify NHS England and NHS Improvement, giving at least one month's notice prior to cessation of the service.

<p>True</p> Signup and view all the answers

The pharmacy contractor must offer eligible PWIDs, aged 18 years and over, the opportunity of having a POCT, which tests for HCV antibodies, at the pharmacy.

<p>True</p> Signup and view all the answers

People eligible for a POCT under this service, are PWIDs who are engaged in community drug and alcohol treatment services.

<p>False</p> Signup and view all the answers

PWIDs who are engaged in community durg and alcohol treatment services are eligible to receive a test for HCV antibodies through this service.

<p>False</p> Signup and view all the answers

People who are not PWIDs and who may, through another intervention, be identified as being at high risk of HCV should be referred to the relevant service.

<p>True</p> Signup and view all the answers

A pharmacy contractor may determine a PWID's eligibility to receive the service based on their knowledge of the individual.

<p>True</p> Signup and view all the answers

Appropriate efforts should be made to confirm that the PWID is not engaged in community drug and alcohol treatment.

<p>True</p> Signup and view all the answers

DAAs are recommended for treatment of pregnant women or breastfeeding mothers.

<p>False</p> Signup and view all the answers

The POCT to be used by pharmacy contractors is the InTec Rapid Anti-HCV Test. All POCT materials must be stored in accordance with the manufacturer's instructions.

<p>True</p> Signup and view all the answers

Following the pre-test discussion, the pharmacist or pharmacy technician should confirm whether the PWID gives their consent to be tested.

<p>True</p> Signup and view all the answers

The pharmacist or pharmacy technician should advise the PWID of the outcomes of the test.

<p>True</p> Signup and view all the answers

The pharmacy contractor does not need to have in place an escalation process, should the PWID fail to return for their results.

<p>False</p> Signup and view all the answers

The pharmacy contractor is required to make arrangements for the removal and safe disposal of any clinical waste related to the provision of this service.

<p>True</p> Signup and view all the answers

The pharmacy contractor must maintain appropriate records to ensure effective ongoing service provision and to support post-payment verification.

<p>True</p> Signup and view all the answers

Appropriate records and documentation should be kept for a minimum of two years after the test takes place.

<p>True</p> Signup and view all the answers

Where the PWID provides consent for their information to be recorded on the Hepatitis C Registry, the details set out in Appendix C must be entered by the pharmacy contractor into the Registry.

<p>True</p> Signup and view all the answers

Where there is a positive antibody result, the General Practitioner should be notified of the test undertaken, the result and any onward referral, using the form in Appendix E.

<p>True</p> Signup and view all the answers

The pharmacy contractor is not required to report any patient safety incidents.

<p>False</p> Signup and view all the answers

Pharmacies may be required to provide reports for service evaluation and monitoring purposes.

<p>True</p> Signup and view all the answers

Claims for payments for this service should be made monthly, via the MYS portal. Claims should reach the NHSBSA by the 5th day of the following month after completion of a POCT, in accordance with the usual Drug Tariff claims process.

<p>True</p> Signup and view all the answers

The NHSBSA will make appropriate payments claimed by the pharmacy contractor as described above, in the same payment month as other payments for NHS Pharmaceutical Services and the payments will be separately itemised on the FP34 Schedule of Payments.

<p>True</p> Signup and view all the answers

Payment will be £36 per POCT performed on an eligible PWID, plus the cost of the POCT

<p>True</p> Signup and view all the answers

The pharmacy contractor will be reimbursed for POCTs provided to PWIDs or other members of the public outside of the eligibility criteria.

<p>False</p> Signup and view all the answers

Pharmacy contractors will be required to purchase the POCTs in advance of starting to provide the service and will be reimbursed as set out in paragraph 11.3, once a claim for performing a POCT has been received.

<p>True</p> Signup and view all the answers

Study Notes

Service Specification

  • This document details the Community Pharmacy Hepatitis C Antibody Testing Service (Advanced Service)
  • Service implemented by NHS England and NHS Improvement
  • Date of document: August 2020

Version Control

  • Shows the different versions of the service specification and the dates of each draft
  • Created by NHS England and NHS Improvement/PSNC
  • Includes new service status comments

Contents

  • Outlines various sections of the document
  • Covers introduction, description, service outcomes, prerequisites, duration, availability, provision, records, data, governance, reporting, monitoring, and payment
  • Lists various appendices detailing Forms, registers and contact information.

Introduction and Background Information

  • Hepatitis C Virus (HCV) is a bloodborne virus, predominantly transmitted through contact with infected blood.
  • High-risk groups include people who inject drugs (PWIDs),
  • National data indicates that PWIDs account for 90% of new infections.
  • Chronically infected cases, i.e., those who cannot clear the virus, develop cirrhosis in 10-20%.
  • Linked to liver failure, death and hepatocellular carcinoma in some cases.
  • United Kingdom Government is committed to eliminating HCV as a public health threat by 2030
  • NHS England established 22 Operational Delivery Networks (ODNs) to enhance HCV treatment and testing.
  • High effectiveness of available Hepatitis C Direct Acting Antiviral (DAA) medicines (over 95%).

Service Description

  • The Community Pharmacy service is an advanced service, commissioned under the NHS Community Pharmacy Contractual Framework
  • Aims to increase HCV testing amongst PWIDs who are not involved in drug and alcohol treatment services.
  • Objectives include increasing diagnoses, lowering treatment costs, and reducing transmission.

Prerequisites for Service Provision

  • Pharmacists must be compliant with Pharmaceutical Services Regulations (Schedule 4) and have proper clinical governance systems.
  • Pharmacy must register electronically with NHS England and NHS Improvement via the MYS platform.
  • All pharmacy staff involved must be trained/competent.
  • Requirements for a designated, confidential consultation area, suitable for administering Point-of-Care Tests (POCTs), which provides for privacy and infection control
  • A standard operating procedure (SOP) must be in place, adhering to health and safety and infection control guidelines. This is especially important during any pandemic.
  • Staff must be competent in the procedures, including training/videos about use of the POCT.
  • Staff must be properly trained, and aware of clinical waste handling and disposal risks including needle stick injury procedures

Service Duration

  • Service commences September 1, 2020
  • Initial duration until March 31, 2022 which may be extended based on reviews on effectiveness
  • Review to assess effectiveness and patient outcomes; possible extension in 2022 / 2023
  • Service will end March 31, 2025

Service Availability

  • Service available during pharmacy contracted hours and for NSP services during times PWIDs visit the pharmacy for services
  • The pharmacy's NHS website profile should indicate provision of bloodborne virus testing.
  • Accessibility/sensitivities to all clients must be considered.
  • No exclusions based on demographics. Exclusion only if violence or crime threatened/committed.

Service Provision

  • Eligible PWIDs (18 years and above) can access HCV antibody tests at participating community pharmacies.
  • POCT in a designated consultation room performed by trained staff.
  • Testing for PWIDs not in community drug and alcohol services.
  • Referrals through the correct Operational Delivery Network (ODN), if necessary.
  • Specific guidance for pregnant/breastfeeding women.
  • Appropriate pre-test counselling and consent from the PWID.
  • Positive results to be notified to general practitioners (GP) and appropriate ODNs, depending on consent.
  • Information about results, implications, and treatment options is part of the procedure.
  • Procedures for removal and disposal of clinical waste.

Records and Data Sharing

  • Pharmacies must maintain records for effective service provision, in line with ongoing monitoring and validation.
  • Records must be kept for at least 2 years beyond the test date.
  • Data will be securely stored and comply with data protection regulations.
  • Data entry into the NHS Hepatitis C IT Registry, provided by NHS England and NHS Improvement, if consent is given.
  • Records should provide for post-payment verification.

Governance

  • Pharmacies must report patient safety incidents in line with the clinical governance framework for pharmacies.

Reporting and Monitoring

  • Pharmacies may be required to provide reports on service evaluation/monitoring.
  • Monitoring periods will be agreed upon with Pharmaceutical Services Negotiating Committee (PSNC).

Payment

  • Monthly claims for this service should be submitted to NHS Business Services Authority (NHSBSA) via MYS.
  • Payment deadline: 5th day of the succeeding month.
  • Payment amounts (POCT fee + VAT) should be separately itemised.
  • Payment will not be made if claims are submitted late.
  • Reimbursement will be made for POCTs, providing the service was only offered to PWIDs (as stated in the service criteria).

Appendices

  • Contain forms and information for consent, clinical records, ODN referrals, general practice notifications, and contact details for specific ODNs.

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Description

This quiz covers the Community Pharmacy Hepatitis C Antibody Testing Service, including its implementation by NHS England and its various components. It explores service outcomes, prerequisites, and governance as well as the importance of this service in high-risk groups. Stay informed about the essential practices in hepatitis C testing and the significance of public health initiatives.

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