Services Delivered Under ICPSA
As part of an integrated health service, a range of pharmacy services are available to individuals and whanau in communities across Aotearoa. Find out more about each service listed in Schedule 3 of the ICPSA contract.
Opioid Substitution Treatment Services provide appropriate access to comprehensive, integrated, and continuing alcohol and drug services guided by harm reduction philosophies. Opioid Substitution Treatment Services applies only to services associated with methadone or Suboxone (buprenorphine+naloxone) prescribed for the treatment of opioid dependence, and does not cover services associated with the use of methadone or Suboxone for other indications, such as pain. Opioid Substitution Treatment service users may also qualify for CDOS.
Co-Dispensing (CDOS) Operational Guidelines
|CDOS Operational Guidelines|
For more information about this service, refer to Schedule 3A.1 in the ICPSA.
This service enables Service Users to have appropriate access to services for which the preparation of an aseptic preparation, including a syringe driver for approved pumps.
For more information about this service, refer to Schedule 3A.2 in the ICPSA.
This service is specific to the preparation of eye drops and other products requiring sterile manufacturing, and does not apply in respect of Pharmaceuticals that require aseptic preparation.
For more information about this service, refer to Schedule 3A.3 in the ICPSA.
This service is for patients prescribed Clozapine.
Clozapine Dispensing Information for Community Pharmacists
The best and safest solution is to work with the individual’s Multi-Disciplinary Team (MDT) and/or their residential care facility manager to ensure the dispensing cycle and tests align. See the top tips section (below) to support you.
Remember - Dispensing should generally take place within 24-72 hours of the date of the most recent blood test for the relevant individual. This requirement may vary according to the hospital or health service protocol that applies in your locality. You will need to customise procedures for your pharmacy accordingly.
What you need to be doing?
- Register the individual in your medicines supplier’s monitoring website
- Record the date of each Clozapine dispensing in your suppliers website
- Adhere to the national or local Clozapine Protocols.
Each of the above actions are outlined in the Clozapine Protocols to ensure that individuals' Clozapine dispensing is recorded and can be monitored and viewed by the prescriber and MDT to make sure there is continuity of care.
To maintain the continuity of supply of Clozapine for each individual, improve your workflow and promote your clinical value with the MDT use the following tips:
1. Proactive care - Strengthen the relationship with the MDT by proactively monitoring and care planning for the individual. Proactive care means making sure you become an active member of the MDT that anticipates and plans for problems.
Ways you can provide proactive care:
- Set up reminder systems for you, your patient and their MDT about the impending need for a blood test or new prescription to ensure smooth delivery of care
- Check the individual’s blood tests before their next dispensing. You could do this before they present their Clozapine prescription. This way you can have an early conversation with their MDT when blood tests are overdue or causing concern.
- Plan ahead for any possible disruptive issues that individual might encounter and contact their prescriber to prevent this.
- Contact the individual's prescriber to discuss and agree contingency plans if blood test history suggests
- impending neutropenia (because they are trending down or classed as an amber)
- or neutropenia (a red result).
2. Assess their eligibility for registration into the Long Term Conditions Service (LTC).
If you spend a significant amount of time with this individual managing their access and adherence to medication, they may qualify for this Service based on medicines adherence issues.
Clozapine Services Resources for Pharmacists
For more information about this service, refer to Schedule 3A.4 in the ICPSA.
Eligible Service users are Service Users who are either aged 65 years and over, or pregnant women.
For more information about this service, refer to Schedule 3A.5 in the ICPSA.
The LTC service is designed to support patients with identified medicine adherence issues become self-managing through the delivery of a pharmacist medicines management service.
Who is eligible for the LTC Service
What does the LTC Service provide for patients?
The assessment is used to identify factors that contribute to a patient’s adherence with their medicine regime and the actions that the pharmacist and the patient will work together to address the adherence issues. Eligible patients will also benefit from the pharmacist working more closely with the prescriber to enhance the patient’s medication use and adherence of medicines. Pharmacist recommendations made to prescribers may also improve the clinical or cost effectiveness of treatment. Registered patients will be encouraged to use one pharmacy for dispensing, but may still receive medications from another pharmacy.
This free service provides extra medicines adherence support for patients with long term conditions via initiatives such as:
- Medicines management plans
- Monthly contact
- Synchronisation of their medicines
- Text message reminders when their repeat prescription is due.
Visiting LTC Service Users
People registered for the Long Term Conditions Service may have reasons for visiting another pharmacy. Generally, it is to get medicine for ‘acute instances’ when a person is discharged from hospital or has had a specialist appointment. Either way, it can complicate the care the registered LTC Service pharmacy provides, as it is impossible to know that there has been a change to the Service User’s medicines regimen.
How Pharmacists can help improve the safety of those registered with the LTC service.
Should a new Service User present at your pharmacy with a hospital discharge or specialist prescription for an ongoing condition please use the diagram below for the best practice ways to minimise future complications for them. This diagram provides a helpful guide: Visiting LTC Service Users Diagram PDF
LTC Resources for Pharmacists
|What you need to know about writing SOAP notes|
|SOAP Note Examples|
For more information about this service, refer to Schedule 3B.1 in the ICPSA.
Residents in Community Residential Care facilities are eligible to use this service.
|CRC Facilities List|
|CRC Fact Sheet|
|CRC Operational Guidelines|
For more information about this service, refer to Schedule 3B.2 in the ICPSA.
Residents in Aged Residential Care facilities are eligible to use the service.
A ‘reasonable interpretation’ of the Age Related Residential Care Service Specifications has been created to support you work with GPs and ARRC facilities to provide pharmacy services. It provides guidance to help you understand what services you are and are not funded to provide and what is realistically expected of you. Contact your DHB Portfolio Manager for more information.
For more information about this service, refer to Schedule 3B.3 in the ICPSA.
This service is for Service Users who are Eligible Persons who are prescribed Special Foods.
For more information about this service, refer to Schedule 3B.4 in the ICPSA.
The Community Pharmacy Anti-Coagulation Management Service (CPAMS) provides point of care international normalised ratio (INR) testing and dose adjustments for warfarin patients. An accredited pharmacist performs this service.
Patients on warfarin referred by their GP.
How is the service delivered?
A GP must refer patients to use the service. Instead of going to the laboratory for each test, an accredited community pharmacist can measure INR levels using just a small sample of blood from a finger prick.
Which community pharmacies are providing CPAMS?
Download the latest up to date list.
|CPAMS Providers List (July 2018)|
How CPAMS is being delivered
View the latest national CPAMS Quality Report to see how community pharmacies are delivering the Service. The Report uses INR Online (software provider) data so show quality measures of care based on:
- The number of bleeds
- Time in Therapeutic Range (TTR)
- Timeliness of testing
|National Quality Report January to June 2018|
A pharmacy specific report based on the same quality measures of care is also available so you can compare and self assess your pharmacy's service delivery. This is available from your DHB Portfolio Manager. We encourage pharmacies to keep a copy of the definitions to hand when viewing their own data and the Report. The definitions explain the method used to calculate the results and information in the Report.
CPAMS Resources for pharmacists working with patients
|CPAMS fact sheet for patients|
|Suggestions for getting started|
|CPAMS fact sheet for primary & community care|
|Patient registration and consent form|
|CPAMS case studies|
|Letter to patients - template for pharmacists|
Information to help pharmacists get started with CPAMS
For more information about this service, refer to Schedule 3B.5 in the ICPSA.
Evidence-based interventions are the focus of the Smoking Cessation Services that includes providing information about access and use of approved cessation pharmacotherapies, and behavioural support, which may be delivered in many ways including telephone, online, and face to face (individually or group based).
For more information about this service, refer to Schedule 3B.6 in the ICPSA.
There is provision within the contract for new local services to be developed by District Health Boards working collaboratively with local community pharmacies and pharmacists, other health providers, and community groups.
If you wish to get involved in development of new local services, please contact your local DHB Pharmacy Portfolio Manager.