Common use of Escalation Process Clause in Contracts

Escalation Process. 9.1. There will be times when the pharmacist will need additional advice or will need to escalate the patient to a higher acuity care location (e.g. back to their GP or an Urgent Treatment Centre or A&E). 9.2. Option A) Refer the patient for an urgent in-hours appointment (Monday to Friday 8:00-18:30): To escalate a patient during the day, pharmacists should support a patient to make an urgent in-hours appointment with their GP. After agreeing this with the patient, the pharmacist should contact the patient’s GP to secure this appointment. The pharmacist may wish to print a copy of the consultation for the patient to take with them to the consultation with their GP. As part of the GP CPCS programme, it is anticipated that GP practices will make appointments available for when the pharmacist decides that the patient needs to be seen by their GP. 9.3. Option B) 9.4. If it is known that a patient has attended CPCS more than twice within any month with the same symptoms and there is no indication for urgent referral, the pharmacist should consider referring the patient to their GP. 6 ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇/government/publications/records-management-code-of-practice-for-health-and-social- care 9.5. In all circumstances, if the patient presents with symptoms outside the scope of CPCS the patient should be managed in line with the best clinical judgement of the pharmacist (See Annex E for scope of symptom groups). 9.6. If the pharmacist suspects that the service is being used inappropriately by patients or carers, they should alert the local NHS England pharmacy commissioning team at the earliest opportunity. 9.7. The pharmacist should use their clinical judgement to decide the urgency, route and need for referral. 9.8. When referring patients to a GP, pharmacists should not set any patient expectations of any specific treatment/outcome.

Escalation Process. 9.1. There will be times when the pharmacist will need additional advice or will need to escalate the patient to a higher acuity care location (e.g. back to their GP or an Urgent Treatment Centre or A&E). 9.2. Option A) Refer the patient for an urgent in-hours appointment (Monday to Friday 8:00-18:30): To escalate a patient during the day, pharmacists should support a patient to make an urgent in-hours appointment with their GP. After agreeing this with the patient, the pharmacist should contact the patient’s GP to secure this appointment. The pharmacist may wish to print a copy of the consultation for the patient to take with them to the consultation with their GP. As part of the GP CPCS programme, it is anticipated that GP practices will make appointments available for when the pharmacist decides that the patient needs to be seen by their GP. 9.3. Option B) 9.4. If it is known that a patient has attended CPCS more than twice within any month with the same symptoms and there is no indication for urgent referral, the pharmacist should consider referring the patient to their GP. 6 ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇/government/publications/records-management-code-of-practice-for-health-and-social- care 9.5. In all circumstances, if the patient presents with symptoms outside the scope of CPCS the patient should be managed in line with the best clinical judgement of the pharmacist (See Annex E for scope of symptom groups). 6 ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇/government/publications/records-management-code-of-practice-for-health-and-social- care 9.6. If the pharmacist suspects that the service is being used inappropriately by patients or carers, they should alert the local NHS England pharmacy commissioning team at the earliest opportunity. 9.7. The pharmacist should use their clinical judgement to decide the urgency, route and need for referral. 9.8. When referring patients to a GP, pharmacists should not set any patient expectations of any specific treatment/outcome.

Escalation Process. 9.1. There will be times when the pharmacist will need additional advice or will need to escalate the patient to a higher acuity care location (e.g. back to their GP or an Urgent Treatment Centre or A&E). 9.2. Option A) Refer the patient for an urgent in-hours appointment (Monday to Friday 8:00-18:30): To escalate a patient during the day, pharmacists should support a patient to make an urgent in-hours appointment with their GP. After agreeing this with the patient, the pharmacist should contact the patient’s patient‟s GP to secure this appointment. The pharmacist may wish to print a copy of the consultation for the patient to take with them to the consultation with their GP. As part of the GP CPCS programme, it is anticipated that GP practices will make appointments available for when the pharmacist decides that the patient needs to be seen by their GP. 9.3. Option B) 9.4. If it is known that a patient has attended CPCS more than twice within any month with the same symptoms and there is no indication for urgent referral, the pharmacist should consider referring the patient to their GP. 6 ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇/government/publications/records-management-code-of-practice-for-health-and-social- care 9.5. In all circumstances, if the patient presents with symptoms outside the scope of CPCS the patient should be managed in line with the best clinical judgement of the pharmacist (See Annex E for scope of symptom groups). 9.6. If the pharmacist suspects that the service is being used inappropriately by patients or carers, they should alert the local NHS England AND nhs improvement pharmacy commissioning team at the earliest opportunity. 9.7. The pharmacist should use their clinical judgement to decide the urgency, route and need for referral. 9.8. When referring patients to a GP, pharmacists should not set any patient expectations of any specific treatment/outcome.

Escalation Process. 9.1. There will be times when the pharmacist will need additional advice or will need to escalate the patient to a higher acuity care location (e.g. back to their GP or an Urgent Treatment Centre or A&E). 9.2. Option A) Refer the patient for an urgent in-hours appointment (Monday to Friday 8:00-18:30): To escalate a patient during the day, pharmacists should support a patient to make an urgent in-hours appointment with their GP. After agreeing this with the patient, the pharmacist should contact the patient’s patient‟s GP to secure this appointment. The pharmacist may wish to print a copy of the consultation for the patient to take with them to the consultation with their GP. As part of the GP CPCS DMIRS programme, it is anticipated that GP practices will make appointments available for when the pharmacist decides that the patient needs to be seen by their GP. 9.3. Option B) 9.4. If it is known that a patient has attended CPCS DMIRS more than twice within any month with the same symptoms and there is no indication for urgent referral, the pharmacist should consider referring the patient to their GP. 6 ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇/government/publications/records-management-code-of-practice-for-health-and-social- care 9.5. In all circumstances, if the patient presents with symptoms outside the scope of CPCS DMIRS the patient should be managed in line with the best clinical judgement of the pharmacist (See Annex E for scope of symptom groups). 9.6. If the pharmacist suspects that the service is being used inappropriately by patients or carers, they should alert the local NHS England pharmacy commissioning team at the earliest opportunity. 9.7. The pharmacist should use their clinical judgement to decide the urgency, route and need for referral. 9.8. When referring patients to a GP, pharmacists should not set any patient expectations of any specific treatment/outcome.

Escalation Process. 9.1. There will be times when the pharmacist will need additional advice or will need to escalate the patient to a higher acuity care location (e.g. back to their GP or an Urgent Treatment Centre or A&E). 9.2. Option A) Refer the patient for an urgent in-hours appointment (Monday to Friday 8:00-18:30): To escalate a patient during the day, pharmacists should support a patient to make an urgent in-hours appointment with their GP. After agreeing this with the patient, the pharmacist should contact the patient’s patient‟s GP to secure this appointment. The pharmacist may wish to print a copy of the consultation for the patient to take with them to the consultation with their GP. As part of the GP CPCS programme, it is anticipated that GP practices will make appointments available for when the pharmacist decides that the patient needs to be seen by their GP. 9.3. Option B) 9.4. If it is known that a patient has attended CPCS more than twice within any month with the same symptoms and there is no indication for urgent referral, the pharmacist should consider referring the patient to their GP. 6 ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇/government/publications/records-management-code-of-practice-for-health-and-social- care 9.5. In all circumstances, if the patient presents with symptoms outside the scope of CPCS the patient should be managed in line with the best clinical judgement of the pharmacist (See Annex E for scope of symptom groups). 9.6. If the pharmacist suspects that the service is being used inappropriately by patients or carers, they should alert the local NHS England pharmacy commissioning team at the earliest opportunity. 9.7. The pharmacist should use their clinical judgement to decide the urgency, route and need for referral. 9.8. When referring patients to a GP, pharmacists should not set any patient expectations of any specific treatment/outcome.

Escalation Process. 9.1. There will be times when the pharmacist will need additional advice or will need to escalate the patient to a higher acuity care location (e.g. back to their GP or an Urgent Treatment Centre or A&E). 9.2. Option A) Refer the patient for an urgent in-hours appointment (Monday to Friday 8:00-18:30): To escalate a patient during the day, pharmacists should support a patient to make an urgent in-hours appointment with their GP. After agreeing this with the patient, the pharmacist should contact the patient’s GP to secure this appointment. The pharmacist may wish to print a copy of the consultation for the patient to take with them to the consultation with their GP. As part of the GP CPCS programme, it is anticipated that GP practices will make appointments available for when the pharmacist decides that the patient needs to be seen by their GP. 9.3. Option B)) Refer patient to A&E or call 999: If the patient presents after referral from GP with severe symptoms indicating the need for an immediate emergency consultation, the pharmacist should refer the patient to attend A&E immediately or call an ambulance. The pharmacist must report any such cases to the local NHS England DMIRS commissioning team: ▇▇▇ ▇▇▇▇▇▇▇▇ 9.4. If it is known that a patient has attended CPCS more than twice within any month with the same symptoms and there is no indication for urgent referral, the pharmacist should consider referring the patient to their GP. 6 ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇/government/publications/records-management-code-of-practice-for-health-and-social- care 9.5. In all circumstances, if the patient presents with symptoms outside the scope of CPCS the patient should be managed in line with the best clinical judgement of the pharmacist (See Annex E for scope of symptom groups). 9.6. If the pharmacist suspects that the service is being used inappropriately by patients or carers, they should alert the local NHS England pharmacy commissioning team at the earliest opportunity. 9.7. The pharmacist should use their clinical judgement to decide the urgency, route and need for referral. 9.8. When referring patients to a GP, pharmacists should not set any patient expectations of any specific treatment/outcome.