ࡱ>   !"#$%&'(Root Entry F.GkObjectPoolzGkzGkWordDocumentZKA.A|. hhhhhhhhh.....)))()A|.-./@Bo \mno()FG#&'/15@\_`hj  % ' / 7 : ; C E \ ] e g p q y ~  ccU^UUc Uc ^]ܥe- ,ZK(fFFJJJJJ6J6J6J6J&J6JRJ46JJSJJJJJJJJJJJJJJJJTCKZKJJJJJJZKJJJJJJJJJJJJCo-ordinated Pharmacy Services for Drug Users Contractual Aims: Supervised administration of oral methadone (Supervised Administration) Support to users collecting their dispensed prescriptions for methadone and other drugs used in the management of drug misuse (Prescription Support) Syringe and needle exchange scheme for injecting drug users (Injecting Support) Advice on harm reduction measures and the supply of condoms (Health Promotion) Injecting Support and Health Promotion Who will receive the service? Drug users who self refer to the service and agree to abide by the rules of the scheme, which includes an explanation of the degree of confidentiality afforded by this scheme. In addition it is likely that a small number of sex workers will access this scheme to obtain free condoms. Who will provide the service? The aim will be to make the services available from a limited number of pharmacies strategically situated throughout the city. It is expected that this will be a dynamic situation with pharmacies entering and leaving the scheme as situations change. Pharmacies currently participating the scheme funded via Sheffield DAAT(Drug Alcohol Action Team) and administered via Associated Chemists (Wicker) Ltd are: PharmacyPhoneAssociated Chemists (Wicker) Ltd, 6-71 Wicker S3 8HT272 7676G K Greenstreet Ltd, 827 Barnsley Rd, S5 0QF245 6567Boots, 252-254 West Street, S1 1QF272 1554Peak Pharmacy 287 Prince of Wales Road, S2 1FH253 0130Weldricks 150 Crookes , S10 1UH266 1294Moss Pharmacy, Manor Park Centre239 6321Lloyds, Alderson Rd258 4116Lloyds, Exchange Street272 0117Rowlands, Belhouse Road245 6137 All participating pharmacies will be expected to work closely with the exchange scheme run by Turning Point (Sidney Street, S1). In order to recruit pharmacies to Injecting Support in areas where there is a perceived need, it may mean that we will have to negotiate acceptable levels of involvement. This could lead to pharmacies in areas of need offering: Limited supply (say to regulars only) Sale (as opposed to free supply) of injecting equipment Strict exchange - one for one only policy However, at the moment all participants offer the full scheme and we hope to maintain this. In any case, all pharmacies involved, as an absolute minimum, have to supply sharps containers and accept returns and to have a written handout setting out the service that they provide. Drug users would be able to vote with their feet as to whether or not they wished to avail themselves of the lower levels of service. Other points to note : Finance for this scheme is capped at a level that means it will not be possible to recruit every Sheffield Pharmacy! Around 10 to 12 participating pharmacies in key areas is the target. We have had to modify the recording sheets and monthly returns in order to standardise the recording format with that used by Turning Point so as to enable the DAAT to undertake computer analysis of the returns that is necessary. Additional recording forms - these are necessary in order to keep track of the DAATs stock of Injecting Equipment. All forms to be returned to Associated Chemists in a timely manner in order to facilitate data entry, payment and computer analysis of supplies. The service to be provided in a discreet manner as set out in the Guidance Notes in the Appendices. However, those clients who fail to keep to the rules may be refused supply & should then be referred to Turning Point.. The pharmacist will ensure that, where appropriate, users of the service are referred to other services that work with drug users. In particular clients should be referred , where appropriate to services where they can access screening and vaccination (specifically to include Hepatitis B&C & HIV screening). (Health Promotion). There is also the option for direct referral into treatment via Guernsey House. Young persons. The service is aimed at adult drug users . Consequently, this scheme only covers clients over the age of 18. Younger persons seeking supplies must be referred to the Shed Project (91 Division Street, S1 4GE). For extended hours pharmacies there may be occasions, when the risk of not supplying to a young person immediately outweighs the benefits of attending SHED. Where this decision is made the pharmacist should document the reasons and urge the young person to attend SHED as soon as possible The pharmacy will carry information leaflets on harm reduction, injecting techniques and information on self help and support services. (Health Promotion)- provided via Associated Chemists. MONITORING & AUDIT Associated Chemists will receive monthly returns from participating pharmacies. We will collate these and will submit a monthly summary to Sheffield DAAT which will include: Number of syringes, needles and condoms supplied (split by item) Number of transactions via Injecting Support Service Number of transactions which include the supply of condoms. Details of items ordered via the Supplies Authority and stock held (belonging to Sheffield Health) It is a condition of a pharmacys inclusion in any scheme that Sheffield DAAT has a right to check records and stock levels of items purchased by them for use in this scheme. Remuneration for Injecting Support & associated Health Promotion: The annual budget for 2006/7 is 78,000 inc VAT - this covers the professional element with the hardware being provided by Sheffield Health free of charge. Payments to pharmacies for this service will be inclusive of VAT and should be accounted for accordingly. We have again produced at a simple scheme for distributing the available funds. Top slice the available funds to extract a Management Fee to cover the administration, analysis etc. Top slice an amount to cover Element 4 Health Promotion booklets etc and form printing. Monthly Service Provision Fee - 25 per pharmacy per month (assume 10) (This equates to the previous retainer fee at 300 pa.) The balance to be distributed on a monthly basis (4,350) in proportion to activity (ie number of transactions) calculated from the monthly returns. Again the fee per transaction will vary from month to month, depending on total activity. PAYMENT The pharmacy must have a signed agreement with Associated Chemists (Wicker) Ltd to provide the Service. Agreements expire at the end of each financial year, but will be ongoing subject to a 1 month notice. The following returns must be made by the 5th working day of the month covering the previous calendar month. Needle Exchange Recording Form(s) (NR1) Needle Exchange Summary Form (NR2) Needle Exchange Stock Calculation Sheet (NR3) Payment will then be made by the last working day of the month. PROTOCOL Preliminary Information The pharmacist should issue staff with clear directions as to how the scheme will be administered within the pharmacy. It is anticipated that, where possible, the pharmacist will be the person who undertakes the Needle Exchange and provides the Health Promotion message. The pharmacist should ensure that their insurance covers pharmacists, staff and members of the public. Pharmacy staff should consider vaccination against Hepatitis B. Logo The two arrow logo is used to represent the exchange scheme. Participating pharmacies should display this logo on the pharmacy door or window. Registration of Pharmacies A named pharmacist representing the pharmacy contractor must complete the enclosed registration scheme and agree to the rules that apply. Registration of Clients There is no formal registration for users, however, clients must provide their initials, date of birth and postal area of Sheffield where the live (ie first part of post code). Confidentiality Provided clients abide by the rules then all transactions are treated in strict confidence. This should be made clear to all staff involved. Equipment See current order form. Maximum Supply As a guideline it is suggested that a maximum of 12 syringes, 12 needles. 3 condoms, 12 swabs and 3 sharps containers are supplied. Larger quantities are available from Turning Point. With regular users you may feel it appropriate to supply larger quantities on certain occasions. Exchange Procedure An information leaflet should be handed out at the initial transaction and at other appropriate times. Health Promotion Leaflets should be available and be issued where necessary. Paperwork should be completed recording initials, date of birth, area of Sheffield, sex and items supplied. Returned Equipment All returned equipment should be placed directly into the pharmacy sharps bin by the user. For collection & replacement of the pharmacy sharps containers contact Margaret Davies , Contracts & Communications Officer, Sheffield Drug & Alcohol Action Team C/o Town Hall, Pinstone Street, Sheffield S1 2HH, Tel: 0114 273 6810 Full containers should be sealed. If no pharmacy sharps container is available clients should be directed to another participating pharmacy or to Turning Point. Safety Guidelines If used equipment should be found in or around the pharmacy, then w Cover cuts or abrasions with waterproof plasters w Wear protective gloves w Take the sharps container to the discarded equipment. Any liquid spillage should be treated with en-cap powder. After 2 minutes this should be removed with a disposable cloth which should be placed in a bag and put in the Sharps Bin. The area should be swabbed with concentrated bleach (This may bleach the surface). Ensure adequate ventilation when using Bleach. If these Guidelines are followed it is unlikely that any injury will occur. However, if a needle stick injury is sustained the wound should be encouraged to bleed and should be washed thoroughly with soap and cold water. Splashes of blood in the eyes or mouth should be irrigated copiously with water. The affected person should report to the Accident & Emergency Department. Enquiries Phone 272 7676. For enquiries about specific aspects of this scheme please ask for Martin Bennett. For clinical/operational queries - ask for the pharmacist on duty. For administration queries - ask for Jane Harvey or Kathy Wood. 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"s`s`Martin Bennett