Specialist knowledge for CHS pharmacy staff

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Chapter: Hospital pharmacy : Community health services

Below are some of the areas where CHS pharmacy staff need specialist knowledge and expertise.

Specialist knowledge for CHS pharmacy staff


Below are some of the areas where CHS pharmacy staff need specialist knowledge and expertise.


Vaccines and immunisation


The UK has a childhood immunisation schedule to protect infants and children from illnesses that can cause morbidity and mortality. The range and timing of vaccines are subject to regular revision as new vaccines become available: a recent example is the addition of human papilloma-virus vaccine to the schedule in 2008. There are other regular vaccination campaigns such as against seasonal flu as well as additional campaigns in response to public health concerns. The latter is well illustrated by the flu pandemic response in 2009. Immunisation against infectious disease is set out in what is known as the Green Book. Updates to the Green Book can only be found online.


Vaccine supplies for GPs are provided via a national contract. Deliveries using refrigerated lorries may be direct to GP practices (where most childhood immunisations are given) and to community clinics and health centres (for the school nursing service) or to nominated distribution centres. It is essential that the ‘cold chain’ is maintained and monitored, from supplier to clinic fridge, up to the point of administration, with an audit trail covering each stage. Advice on appropriate and verified cool boxes and monitoring of temperatures is an essential part of the pharmacy team’s involvement.


Sexual health services


The reduction of unwanted pregnancies and sexually transmitted diseases is an important part of the UK government’s sexual health strategies. Family planning clinics provide free birth control advice and contraceptives to any person needing them. Sexual health services, for example, diagnosis and treatment of Chlamydia, are increasingly being provided in community set-tings; of course, this includes the important role of community pharmacists, but goes beyond the remit of this text.


The provision of family planning items such as oral contraceptives and other medicines used in sexual health clinics needs to be within an agreed stock list and/or formulary. The appropriate and cost-effective use of medi-cines within these services needs to be monitored. There also needs to be appropriate pharmacy input to ensure that legal requirements such as appro-priate labelling of oral and emergency contraceptives are in place.


Intermediate care, rehabilitation services, admissions avoidance teams, respite care


Many services and care pathways are now designed to keep people out of hospital and/or to promote independence so that they can return home more quickly with support from a multidisciplinary team. Intermediate care is defined as rehabilitation programmes of usually not more than 6 weeks and can be provided in community hospitals, by rehabilitation teams, in ‘step-down’ units and by other nurse-led services. CHS pharmacy staff are involved in providing advice about medicines for an individual, assessing the needs of an individual patient for support to take his or her medicines safely and advice on support for concordance (compliance).


Vulnerable patients may need help with self-administration of their medi-cation, for example using memory aids. They may also require information in a more accessible form such as instructions in simple English (or translated into their spoken language), large print labels or a pictorial reminder. Many will be supported by family and other carers who may also require advice and support. Effective communication is particularly important when patients move across interfaces of care. Pharmacists have a key role in ensuring this is achieved.


Support for people with learning disabilities


Learning disability services are discussed in Chapter 13: services may be provided by CHS staff because people with learning disabilities are now integrated as far as possible within local communities. They often live in group homes and hostels with a multidisciplinary community learning dis-ability team coordinating any specialist healthcare required. Pharmacy staff may contribute to this team along with therapists, specialist nurses and con-sultants. In addition, they may work with organisations providing health and social care to ensure that there are safe systems for the management of medicines in these settings.


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