Shared learning database
Type and Title of Submission
Putting NICE guidelines into practice managing a Pharmacy Needle and Syringe ProgrammeDescription:
When taking over the operational management of the Pharmacy Needle and Syringe programme (PNSP) scheme within South Staffordshire, there was a need to address a number of challenges and make the scheme compliant with NICE guidance. The challenges included - Ensuring the membership to the scheme met local needs and was sufficient - Reviewing the costs and efficiency of supply, distribution and waste collection - Introducing an effective support system for the pharmacies on the scheme - Eliminating some of the practices that contradicted NICE guidance such as limiting distribution and insisting on returns - Ensuring pharmacies submitted monthly statistics, recording the equipment given out and returned as required by the NTA.Category:
Health and wellbeingDoes the submission relate to the general implementation of all NICE guidance?
NoDoes the submission relate to the implementation of a specific piece of NICE guidance?
YesFull title of NICE guidance:
PH18 - Needle and syringe programmesCategory(s) that most closely reflects the nature of the submission:
Is the submission industry-sponsored in any way?
Description of submission
The aim was to implement NICE guidelines into the management and delivery of a Pharmacy Needle and syringe programme. This would effectively improve the quality of the pharmacy scheme in Staffordshire, eliminating ineffective practice.Objectives
To have a PNSP which: 1. Provided a broader range of injecting equipment to suit different types of injecting drug use. 2. Ensuring staff providing the PNSP have appropriate training, focusing on improving knowledge around safe injecting practice, but also emphasising changing attitudes towards the service user group and how this can improve outcomes and referral into local treatment. 3. Supporting the Pharmacies to ensure that best practice and NICE guidelines are followed at all times.Context
After taking over the management of the Pharmacy Needle and Syringe Programme a stakeholder survey was completed by the Pharmacies and the scheme was then assessed to identify if there was any current compliance with NICE guidelines and areas for necessary improvement. The previous providers had allowed any interested pharmacies to sign up, which had resulted in an overspent budget and a geographical distribution of pharmacy outlets, which did not meet the needs of the large rural county. Historically, the exchange packs had come in two standard varieties, the pharmacies involved in the scheme had limited the amount of needles given out to 1 pack (10 needles) per visit, and would only provide new equipment if the service user brought a used pack back. No training had been given to pharmacy staff and there was a focus on the localised registration of individuals onto the scheme at each pharmacy, yet no quantitative or qualitative data was submitted to the DAAT. In the development of the new scheme NICE guidelines would be used to structure the programmeMethods
1.Pharmacy membership - was reviewed and chosen for geographical coverage, a mapping exercise was completed to make sure that the PNSPs were geographically distributed, based on equity of access. Low performing pharmacies, (i.e.no recorded interventions in the previous 6 months; minimal activity and closely located to another more active pharmacy) were removed from the scheme. 2.Supply & costs - A review was completed. 3.Communication and management - A named contact was given to each pharmacy. A team of 6 staff collaborate to manage and support the scheme. 4.Data submissions - A simple, user friendly data sheet was designed for the pharmacies to records statistical information required by the NTA. 5.Equipement distributed - Four types of pharmacy exchange packs were designed to meet the needs of the following service users i. Injecting Heroin users (1ml) ii. Injecting stimulant users (1ml) iii. Injecting Heroin users (2ml) iv. Performance enhancing drug users Labels are periodically printed with harm reduction messages and attached to packs by the supplier. 6.Implementation of scheme - A welcome and information pack was sent to each pharmacy on the scheme. Visits to all pharmacies were arranged to meet and interview the staff, discuss the data collection requirements, explain the ordering and support system we would provide. 7.Support and engagement for training - A link was developed with the LPC and it was agreed they would fund the cost of the training venue and refreshments in return for us designing a specific training package to meet the pharmacy staff needs. The training package was designed to cover 2 x 3hr sessions. Topics included were a. Basic Drug Awareness b. History of NSP c. Legal aspects / NICE guidance underpinning NSP services d. Design of the NSP packs Interactive exercise in cooking up and using the equipment in the packs Services are available in the locale, opening times and referral procedures.Results and evaluation
- Pharmacy staff were interviewed at the beginning and end of the training sessions. Feedback received was positive, the training clarified issues such as :- o why such schemes exist? o legal issues o guidance on returns o treatment options available o ignorance around injecting drug users - Biweekly support for supply and check in with their named contact has worked effectively according to feedback given at visits. This has ensured the efficient management of supplies and waste collection. The named contact passes on any queries from pharmacy staff with regards to service users and injecting or drug use practices, they have always received prompt responses from our trained and experienced staff. The named contact also prompts pharmacies to ensure data submissions are completed. - Visits are scheduled twice yearly, the aim being to meet staff, assess further training needs and identify best practice. - Feedback from service user 'secret shopper' was excellent, they stated they were treated respectfully, given privacy and felt very comfortable and happy with the service received (in area where no previous Pharmacy provision). - The staff team involved in the running of this scheme consists of management, administration and drug workers. They meet quarterly to discuss, review and schedule visits, training and general management of the scheme. - A stakeholder survey will be completed again at the mid point interval of the current scheme agreement.Key learning points
- Pharmacy staff involved in the delivery of Needle and Syringe schemes should have access to structured training designed to meet the needs and concerns they may hold. The training needs to be interactive, informative and up to date with guidance and legislation. Training should be repeated and offered to all staff in the pharmacy. - Named contacts and meetings that contact improves the potential of the pharmacy staff feeling comfortable and confident about contacting us with any queries or concerns. - Visits improve communication and allow us to assess the manner and environment within which the service user will be served. - A staff team with various skills and expertise ensures we can provide the highest level of support, advice, supply and management of the scheme. - Staff turnover at Pharmacies can be quite high in our experience, therefore the delivery of training is an ongoing necessity and impacts greatly on our staff resources. However to ensure the ongoing adherence to NICE guidance this is a factor we have to manage efficiently, which is why we have a team of six staff members involved to rotate visits and training. - When it is identified that a pharmacy service is not adhering to guidance, it is necessary to review their ongoing participation on the scheme. Initially efforts would be made to address the issues arising, giving extra training or meeting with staff to discuss problems. Ultimately it should be made clear to pharmacies that there are expectations as to the standards required for ongoing participation in the scheme.
This submission won the 2009 Shared Learning Award.
View the supporting material
|Job Title:||Service Manager|
|Address:||Suite 5 Bermar House, Rumour Hill Business Estate, Rumour Hill Road|
|Phone:||01543 504 813|
|Fax:||01543 571 596|
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This page was last updated: 28 September 2009