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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.

This page is being updated. For publications listed here, please refer to the Publications and Resources page. If you can't find a document, please email pharmacy@tas.health.nz 

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Opioid Substitution Treatment Services (including Co-Dispensing)

Aseptic Services

Sterile Manufacturing Services

Clozapine Services (Monitored Therapy Medicine Services)

Influenza Immunisation Services

Long Term Conditions (LTC) Pharmacy Services

Community Residential Care (CRC) Pharmacy Services

Age-Related Residential Care (ARRC) Pharmacy Services

Community Pharmacy Anti-Coagulation Management Services (CPAMS)

Smoking Cessation Services

Local Commissioning


Opioid Substitution Treatment Services (including Co-Dispensing)

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

When you are identifying a person for registration using the CDOS Operational Guidelines you need to note that where the wording used is ‘same time’ this equates to the ‘same visit’ to qualify as co-dispensed. For example if a methadone user has also been prescribed other medicines, at least one of these must be dispensed by your pharmacy at the same time and on the same visit to qualify as co-dispensed. This also needs to occur at least weekly (or for more frequently). A person may present with a variety of different support needs. Therefore, if the person falls outside of these requirements and you believe that you are co-dispensing medicines to them, you should contact your DHB Portfolio Manager for guidance.
CDOS Operational Guidelines

For more information about this service, refer to Schedule 3A.1 in the ICPSA. 


Aseptic Services

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.


Sterile Manufacturing Services

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.


Clozapine Services (Monitored Therapy Medicine Services)

This service is for patients prescribed Clozapine. 

Clozapine Dispensing Information for Community Pharmacists

To ensure the safety of all individuals prescribed Clozapine, you must follow the Clozapine Protocol outlined in Schedule C2 of your Community Pharmacy Services Agreement and the guidelines provided by the hospital/health service protocol and/or your supplier/manufacturer.

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?

  1. Register the individual  in your medicines supplier’s monitoring website
  2. Record the date of each Clozapine dispensing in your suppliers website 
  3. 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. 

Top tips

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

Clozapine Protocol

For more information about this service, refer to Schedule 3A.4 in the ICPSA. 


Influenza Immunisation Services

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.


Long Term Conditions (LTC) Pharmacy Services

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

The eligibility of a patient for  the service is managed through the LTC Service Eligibility Assessment Tool, which sets a nationally consistent set of criteria for entry to the service. Eligibility is based on a pharmacist-led eligibility assessment which applies a standard set of agreed criteria. Each DHB has an LTC cap. Contract-holders can contact  their DHB Portfolio Manager for further details.

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

LTC Service Protocol
Guide to the Long Term Conditions Service
Quick version of the Guide to the LTC Service
Eligibility and Assessment Tool
Mental Health Criteria
LTC Mental Health Info Sheet
Patient Registration Form
LTC Service Patient Leaflet
Medicines Reconciliation
Medicines Synchronisation 
Transferring Registrations
What you need to know about writing SOAP notes
SOAP Note Examples

More LTC Service Patient Casestudies

For more information about this service, refer to Schedule 3B.1 in the ICPSA. 


Community Residential Care (CRC) Pharmacy Services

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.


Age-Related Residential Care (ARRC) Pharmacy Services

Residents in Aged Residential Care facilities are eligible to use the service. 

‘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.


Special Foods Services

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.


Community Pharmacy Anti-Coagulation Management Services (CPAMS)

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.

 Who is eligible for the 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

Standard Operating Procedure  
Service Specifications  
GP Referral Form  
Letter to General Practice - template for pharmacists  
CPAMS Invoicing and Reporting Requirements  
Standing Orders for CPAMS  
Pre-requisites for providing the Service   
Advice on INR test options for patients away from home   
CPSA 2012 - Variation for pharmacies undertaking CPAM

For more information about this service, refer to Schedule 3B.5 in the ICPSA. 


Smoking Cessation Services

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.


Local commissioning

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.