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Criteria |
Points |
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Asthma/COPD Personalised asthma action plans and promoting spacer device use in children prescribed pressurised metered dose inhalers (pMDIs)
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On the day of the declaration, the pharmacy contractor must have evidence that they have ensured that:
The pharmacy contractor must be able to show that pharmacy staff have referred patients with asthma to an appropriate healthcare professional where this is not the case
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Band 1 = 1.25 Band 2 = 16.67 Band 3 = 20.83 Band 4 = 25.00 Band 5 = 29.17 Band 6 = 33.33 |
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Inhaler technique checks for patients prescribed a new inhaler with asthma or COPD during the COVID-19 pandemic
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On the day of the declaration, the pharmacy contractor must be able to evidence that pharmacy staff have identified patients with asthma or COPD, who were prescribed a new inhaler (i.e. for the first time or changed to a new inhaler device) between 1 April 2020 to 31 August 2021 but did not have their inhaler technique checked due to the COVID-19 pandemic, have since been offered an inhaler technique check as part of the catch-up NMS arrangements.
All pharmacists working at the pharmacy, who are providing inhaler technique checks, as part of the catch-up NMS arrangements, must have satisfactorily completed the CPPE inhaler technique for health professionals: getting it right e-learning or attended a CPPE face-to-face or online inhaler technique workshop and passed the e-assessment (the e-assessment must be completed if you have completed the e-learning or attended the face-to-face/online workshop) before providing inhaler technique checks.
Where appropriate, pharmacists can conduct remote inhaler technique checks, as part of the catch-up NMS arrangements, as described in the following paper: Taskforce for Lung Health position paper on optimising inhaler technique remotely |
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Return of unwanted and used inhalers
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On the day of the declaration, the pharmacy must be able to evidence that they have spoken (a verbal conversation) with all patients, their carer or representatives, for whom they have dispensed an inhaler between 1st September 2021 and 31st January 2022 about the environmental benefits of them returning all unwanted and used inhaler devices to a community pharmacy for safe and environmentally friendly disposal.
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The points allocation for meeting the Respiratory Domain ranges from 1.25 to 33.33 and will be dependent on your total prescription volume for 2020/2021. Each point will be worth between £67.75 and £135.50 and so a contractor can earn between £84.69 and £4516.21
The aims of this quality criterion are for community pharmacy to:
- continue work from previous PQS in reducing morbidity and preventable deaths from asthma through targeted clinical surveillance and evidence-based interventions;
- contribute to optimising inhaler technique and outcomes in patients with asthma or COPD; and
- promote safe and environmentally friendly disposal of all unwanted and used inhaler devices by engaging in discussions with all patients, their carers and/or representatives.
Personalised asthma action plans and promoting spacer device use in children prescribed pressurised metered dose inhalers (pMDIs)
The National Review of Asthma Deaths (NRAD) made several recommendations to improve the care of people with asthma including:
- People with asthma should be provided with a personalised asthma action plan (PAAP) which can help to identify worsening asthma, support corrective action and advise patients and carers of how and when to seek help. Patients with a PAAP were four times less likely to die from an asthma attack but 77% of patients included in the NRAD report had no record of having a PAAP.
In addition, the NICE technology appraisal (NICE TA38) guidance recommends the use of spacer devices in combination with press and breathe pressurised metered dose inhalers (pMDIs) to achieve optimum asthma management in children between the ages of five to 15 years.
When making a declaration for this criterion, the following information must be reported on the MYS application:
- the total number of children aged 5 to 15 that they have referred for a spacer device, where appropriate, in line with NICE TA38; and
- the total number of patients 5 years and above with asthma that they have referred to have a personalised asthma action plan.
Inhaler technique checks for patients prescribed a new inhaler with asthma or COPD during the COVID-19 pandemic
Poor inhaler technique can affect both patients with asthma and COPD and increase hospitalisations.
This quality criterion seeks to ensure patients are supported to get the most from their medicines and minimise preventable exacerbations of asthma and/or COPD. Contractors are advised to use their IPC risk assessment to determine the safest way to conduct inhaler technique checks i.e. whether virtual checks are more appropriate due to local COVID-19 outbreaks.
The requirement of this criterion is for community pharmacies to identify patients who have had a change to their inhaler device or been initiated on a new inhaler device and not received an inhaler technique review. The identified patients should be offered an inhaler technique review as part of the catch-up NMS model (the completed NMS, which include the inhaler technique review, will be claimed for in the usual way).
Contractors must record any intervention or referral made in the patient medication record (PMR) as these may be required for post payment verification purposes.
When making a declaration for this criterion, the following information must be reported on the MYS application:
- the total number of pharmacists working at the pharmacy who have satisfactorily completed the CPPE inhaler technique for health professionals: getting it right training and passed the e-assessment;
- the total number of pharmacists working at the pharmacy who have attended a CPPE face-to-face/online inhaler technique workshop and passed the e-assessment;
- the total number of patients identified as having been prescribed an inhaler for the first time or changed to a new inhaler device between 1 April 2020 and 31 August 2021 who were asked if they have had an inhaler technique check during that time;
- the total number of patients who answered no to the previous question and were offered a catch-up NMS, including an inhaler technique check;
- the total number of patients who were subsequently provided with a face-to-face catch-up NMS, including an inhaler technique check;
- the total number of patients who were subsequently provided with a remote catch-up NMS, including an inhaler technique check; and
- the total number of patients who were referred to their prescriber due to issues identified during a catch-up NMS
The PSNC has produced some useful guidance and templates that have a suggested process to follow, and record sheets and a referral form that can be used for both of the above criteria:
PSNC suggested process for referral
Return of unwanted and used inhalers
The NHS has made a commitment to tackle climate change by reducing its emissions to ‘net zero’. Medicines account for 25% of emissions within the NHS.
If every inhaler-user in the UK returned all their inhalers for one year, this could save 512,330 tonnes of CO2eq – the same as a VW Golf car being driven around the world 88,606 times [1].
The aim of this criterion is to highlight to patients the environmental benefit of all used or unwanted inhalers being returned to a pharmacy to be disposed of safely via the Essential Service (Disposal of Unwanted Medicines) so that they are included in the medicines waste and destroyed by high temperature incineration to safely destroy the residual propellant gases.
When making a declaration for this criterion, the following information must be reported on the MYS application:
- the total number of patient-facing pharmacy staff working at the pharmacy who have been trained on the reasons why used, unwanted and expired inhalers should be returned to the pharmacy for safe disposal and the adverse effects on the environment when inhalers are disposed of in domestic waste; and
- the total number of conversations had with patients and/or their carer or representatives on the safe and environmentally friendly disposal of their inhaler
The PSNC has produced a briefing sheet that can be used when speaking with patients, carers and representatives who have been dispensed an inhaler, about returning all unwanted and used inhaler devices to the pharmacy for safe and environmentally friendly disposal.
The PSNC has produced a briefing sheet that can be used as a training resource to meet the requirement for all patient-facing staff to have been trained for this criterion.
PSNC Briefing Sheet on inhaler disposal
Numark has produced a collection sheet for use in collating all the data collected for this domain.