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Scotland’s chronic medication service is outlined

Scotland’s chronic medication service (CMS) — a core service under the community pharmacy contract — will formalise pharmacists’ role in the management of long-term conditions, according to a provisional outline of the service, published last week.

Negotiations are still ongoing and the service specification for CMS has not yet been finalised. However, this initial summary, published on the Scottish Government’s new contract website, suggests CMS will involve three stages.

The first stage is for patients to register for CMS with a pharmacy of their choice. It will only be possible to register with one pharmacy at a time, and registration will include the patient making an informed consent declaration. Once a patient has registered, an electronic registration message will be sent to the patient’s GP practice.

Pharmaceutical care planning

Stage two of CMS revolves around pharmaceutical care planning. “Initially the pharmacist assesses registered patients to identify and prioritise individuals or patient groups with unmet pharmaceutical care needs in order to target patients most in need of their support.

The pharmacist then undertakes to identify and record the patient’s pharmaceutical care needs, care issues, any desired outcomes and the actions required to deliver those outcomes. These are documented in a pharmaceutical care plan,” the website states.

Serial dispensing will fit into the third stage of CMS. Under a shared care agreement, a GP will be able to produce a serial prescription for either 24 or 48 weeks to be dispensed at time intervals determined by the GP. Each time a CMS prescription is dispensed, the GP will automatically receive an electronic message.

GPs will be able to cancel items electronically, preventing further dispensing of that item. When the final instalment on a serial prescription has been dispensed, the pharmacist will send the GP an electronic “end of care treatment summary” that will include a request for a renewal of the serial prescription.

End of care treatment summary

The end of care treatment summary will include information on patient compliance and recommended actions for the GP. “This stage is supported by CMS disease specific protocols in order to determine any specific reporting or referral criteria for a number of pertinent disease conditions,” the website states.

Alex MacKinnon, head of corporate affairs, Community Pharmacy Scotland, commented: “The summary illustrates the direction of travel of our negotiations with the Scottish Government. CPS is still working with the Government to produce the final service specification.”

Citation: The Pharmaceutical Journal URI: 10041864

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