Pharmacy UTI Service
The service is commissioned via PSNE who will shortly be sending out a new contract for all PSNE Pharmacy Services.
Within this new contract will be the ability to sign up to provide the UTI PGD service.
Once you have contracted with PSNE you will be able to log in to Pharmoutcomes and fill in the 'readiness to provide' module for the UTI PGD service. This will trigger a set up payment as well enabling the Service consultation Module for you to use.
The service includes an element of research to support the case for community pharmacy antibiotic supplies via PGD. Details of the service and its renumeration is provided within the service spec.
Pharmacies Currently Operating
Should your pharmacy not be able to provide the service you must sign post to another that can.
Service Flow Chart
SIGN Guidance No 160
Sign Up Process
- Ensure you pharmacy has signed the new PSNE contract for Pharmacy Services.
Details can be found here. (Most will sign up via Pharmoutcomes but multiples will have been contacted via their head office).
- Download the Service Spec, PGD and resources above.
- Ensure you have all the consumables you need (e.g. dipsticks and sample pots).
- Ensure all relevant staff are briefed and PGD's are signed by the pharmacist.
- Visit Pharmoutcomes and fill in the UTI Nitrofurantoin PGD Sign Up Module. This module will required for you to give assurances that you are ready to provide. It will also trigger the set up payment.
- Once both the contract and the UTI PGD Sign up form are received by PSNE.
They will be reviewed and the UTI PGD module switched on for you to start the service .
email we will post useful FAQs in order to share learning
Below are some frequently asked questions. Click on the question to get access to the answer
How does my pharmacy sign up?
See sign up section above
My pharmacy is not in Newcastle or Gateshead. Why can I use the Newcastle Gateshead CCG PGD?
NENC ICS has commissioned an ICS wide pilot UTI service that utilises a PGD created by Newcastle Gateshead CCG which has been adopted and authorised by the other CCGs across NENC. Therefore, Pharmacists across NENC ICS can use the Newcastle Gateshead PGD to make Nitrofurantoin supplies within other CCGs.
Where do we get sample bottles for the service?
You can normally obtain sample pots from your wholesalers. Usually wholesalers who supply pharmacy sundries will often carry sample pots. Please enquire with your wholesalers.
What do I do with the urine sample and the dipstick after use? Should I have to have any special bin for biological waste or something like that?
This will be up to you as a contractor, some contractors have clinical waste bins as used for Flu etc other are handing the sample back to the patient to dispose of. This should be included in the pharmacy SOP for the service.
How do I get clinical waste picked up?
You will need to contract with a waste provider. You can start by contacting your NHS Doop Waste provider to see if they can provide you a new service for Clinical Waste. There are various companies out there who can pick up clinical waste. You can contact different providers to see if you can get a service that suits your pharmacy. Companies such as SRCL (Stericycle), PHS, Initial are some of the companies however an online search will find several more.
Will the service be just for those who are resident in the region, or can we offer to visitors?
Yes, the service is open to any patient no matter of postcode across England.
If we refer onwards to primary care do we need to do the 3 and 7 day call?
Yes, this ensures that the patient has been followed up
What happens if the patient does not answer the phone on day 3 and or 7, so effectively you cannot complete the service?
Pharmacists need to ensure the patient is contacted at least 3 times. If you are unable to contact the patient, complete the 3 and 7 day section and add an explanation to why you are unable to contact them. This will be picked up and reviewed for future development of the service.
Will NHS 111 be aware of this? I work for OOH and we prescribe for many patients with UTIs who could be treated under this PGD
Yes, NHS 111 North East and North West will be aware and will be referring. They may not be able to filter patients so pharmacists may need to refer on to GP/OOH, if the patient have exclusion criteria
Is PCN lead going to advertise to our local surgeries ?
The service will be advertised via the ICB communications. Your LPC/PCN lead will also be in discussions locally
Will I have to print the notification if the patients GP is not linked within the system.
Yes, this is similar to any of the services. The GP will need to be aware that the patient has received advice and/or treatment.
If Pt has one symptom and we start PO the template , if on day 3 they have worsening of symptoms , you said to start a fresh consultation . What happens to first consultation , ? Do we end up with 2 running consultations - how many payments do we get ?
If a patient develops symptoms and positive for nitrates at day 3 Yes you can start a new consultation. Complete the 1st consultation by adding the appropriate notes at day 3 and 7 for the first consultation as you will be in contact with the patient any way. You will receive two consultation fees.
PGD lists more serious symptoms i.e shivers, back pain etc. as exclusion criteria. I understand that patient presenting with such will need referral but can I still give them nitrofurantoin while they are waiting to be seen?
No, these are exclusions so you cannot use the PGD for supply. Patients should be referred to their GP, urgent treatment centre (UTC) or Out of Hours.
The service flow chart suggests that I put the consultation on PharmOutcomes and claim the service fee even if only one symptom is present. The PGD states that having only one symptom or two symptoms and negative stick test is an exclusion criterion. Can you please clarify?
Yes, you can claim for the service fee if only one system or two symptoms and a negative dipstick test, as advice and support will be given. You are being paid for your consultation with the patient and the subsequent follow-up telephone calls which are still required.
Does it mean that the PGD excludes people with only one symptom from getting Nitrofurantoin under the service but not from the service itself and therefore I claim for the consultation regardless of outcome and even if there is only one symptom?
Whilst the PGD excludes patients with only one symptom from receiving nitrofurantoin, they are not excluded from the service. You will give advice, support and safety netting information as part of the service and complete the follow-up telephone calls. You can therefore claim the consultation fee.
If the nitrites won't show up until being in the bladder for 4 hours, is it best to send the patient away and ask them to come back the next day after doing a morning capture? Otherwise if we do the sample there and then when they have first walked in to the pharmacy, we are likely to get a false negative? This will delay giving the potential treatment but might prevent a false negative. What practice is best to do?
An early morning sample is best but anyone who has had a UTI will know, it can be difficult to retain urine in the bladder for 4 hours. If the patient is negative for nitrites, advice and safety netting can be given. If the symptoms increase they can return and be tested again and re-enter the service. Ensure the relevant leaflets and urine sample bottles are given to each patient.
Lots of cautions before supply eg diabetes, hypertension - how many of these patients will have had kidney function test in last 4 weeks at GP?
Probably not many but this will be the same as if they attended a GP/UTC/OHH service.
Would it be advisable to ask a patient to produce a sample before coming for the consultation as a patient going for an appointment with suspected UTI is asked to take a sample with them
Yes, this would be advisable.
Who are the best people to supply sample bottles? The only type I would be able to supply are the care brand.
- Lots of suppliers available. This would be the contractor’s choice. EMT supplies them if you use them for your bags and bottles but other suppliers are available.