Specialist Medicines Service

The service aims to support the responsive and effective supply of essential medication for Palliative and End of Life Care (PEoLC) and the treatment of Clostridioides difficile (also known as Clostridium difficile, C. difficile or C. diff). This is a type of bacteria that can cause diarrhoea.

The demand for palliative care treatments and the relevant antibiotics, vancomycin or fidaxomicin, may be urgent and/or unpredictable. The service will operate during all normal opening hours for the community pharmacy and/or any locally commissioned extended hours e.g., Public/Bank holiday rota.

The pharmacy contractor(s) (provider) will stock minimum stock levels of a locally agreed list of drugs and will make a commitment to ensure those users of this service have prompt access to these medicines. The pharmacy will provide information and advice to the user, carer and clinician as required.

Pharmacy teams should refer to the joint Royal Pharmaceutical Society (RPS)/Marie Curie UK Quality Improvement (Daffodil) Standards for support in continual improvement of their palliative and end of life care arrangements. They may also refer to the specialist palliative care advice lines at the local hospices within SNEE.

The pharmacy will maintain stocks of the specified list of medicines required to deliver this service and will dispense these in response to NHS prescriptions presented. The stock levels may be requested where there have been reports of failure to hold minimum stocks.

The pharmacy will be expected to hold the minimum stock level unless there is evidence of drugs being dispensed and awaiting stock replenishment. The pharmacy will be expected to report stock levels on a quarterly basis and will receive remuneration for each report submitted. Providers should seek to maintain adequate stocks of medication in line with local demand and in anticipation of reduced wholesaler deliveries, e.g., weekends, bank holiday periods.