The NHS Chronic Medication Service at your local pharmacy

The NHS Chronic Medication Service At Your Local Pharmacy - A Service For People With A Long-Term Condition

• The Chronic Medication Service (CMS) is an NHS service for patients with a long-term condition. It is available at pharmacies across Scotland.
  A long-term condition is a health problem that is likely to last longer than a year and needs ongoing medical care, like high blood pressure or diabetes.
• This leaflet is for anyone who has a long-term condition.
• It tells you:
  • what the service is
  • how you can register for the service
  • what happens when you have registered for the service.
  • The service is voluntary. If you have a long-term condition, you can choose whether you want to register for it.

What will the service do for me?

• The service will help you manage the medicines you take for your condition.
• Your pharmacist is an expert in medicines and will talk to you regularly to help you get the most benefit from them.
• When you speak to your pharmacist you will be able to discuss any concerns you have about your medicines.
• Your doctor will continue to provide your medical care.
• There are three parts to the service:
  • Reviewing your use of medicines: if you register for the service, your pharmacist will look at how you use your medicines. They will then discuss with you any problems you may have with your medicines and whether you should get a CMS care plan.
  • CMS care plan: this plan helps your pharmacist give you more regular care and advice about your medicines. They will give you a copy of your care plan and may also speak to your doctor about it.
  • Serial prescriptions: you may be able to get serial prescriptions from your doctor so you can get some medicines on a long-term, repeat prescription. This is different from having a normal repeat prescription. For more about serial prescriptions see below.

• You can register for this service if:
  • you get regular prescriptions to treat a long-term condition, and
  • you are registered with a doctor's surgery in Scotland.
• You can't register for the service if:
  • you are a temporary resident in Scotland, or
  • your main or usual home is a care home.

Using the service

How do I register for the service?

• If you decide to register for the service, you will need to choose a pharmacy where you would like to do this.
• It's a good idea to register with the pharmacy you normally go to for your medicines as your pharmacist will know what medicines you take.
• You can register at any time - you don't need to make an appointment.
• Sometimes, your doctor may advise you to register for this service.
• When you register, your pharmacist will ask you for some information, including your name, address and date of birth.
• You will have to fill in a registration form. The registration form will ask whether:
  • you agree for your doctor and pharmacist to share some information about your medicines
  • you want to register for the service, and
  • you are registered with a doctor's surgery in Scotland and have a long-term condition.
• All staff working with or for the NHS have a legal duty to keep information about you confidential.
• You will need to sign the completed form. Your pharmacist will sign and date it too.
• Your pharmacist will tell your doctor that you have registered for the service at their pharmacy.

I am already registered for the service with a pharmacy but I want to register with a different one. Can I do this?

• Yes, but you can only register for the service with one pharmacy at a time.
• When you register with the new pharmacy, you will no longer be registered at the old pharmacy.

I don't want to use the service any more. Can I cancel my registration?

• Yes, you can withdraw from the service at any time.
• You must tell your pharmacist that you want to withdraw. They will ask you to sign a withdrawal form.
• Your pharmacist will tell your doctor that you are no longer registered for the service at their pharmacy.

If you register for the service, you will still be able to see your doctor regularly.

Reviewing your use of medicines

• When you have registered for the service, your pharmacist will look at how you use your medicines.
• Your pharmacist will ask you about the medicines you
• take for your condition and any problems you have with them.
• Your pharmacist may do this when you register, when you next need one of your medicines, or at another time that suits you.
• Your pharmacist will then work with you to decide if a CMS care plan would help you with your medicines.

The CMS care plan

What is a CMS care plan?

• If your pharmacist thinks a CMS care plan would help you with your medicines, they will:
  • ask you about any problems you have with your medicines
  • talk to you about what you would like to do about the problems and what you should both do, and
  • review and update the care plan with you.
• Your CMS care plan will include:
  • information about any problems you may have with your medicines, for example unpleasant side-effects, difficulty swallowing tablets or remembering when to take them
  • what your pharmacist would like to do to help with your problems, for example make it easier for you to take your medicines
  • what your pharmacist and you think you both need to do to help with the problems and who should do it - for example, speak to your doctor about changing your tablets to easy-to-swallow capsules or a liquid, and
  • a record of when the problems have been solved or if something else needs to happen.
• Your pharmacist will work on your CMS care plan with you. They may share some information from the care plan with your doctor. Your doctor will decide, with you, about any changes to your medicines.
• CMS care plans are held safely and securely on a computer.
• Only a pharmacist can look at your care plan.
• Your pharmacist will give you a paper copy of your CMS care plan.
• Your pharmacist will give you their name and contact details so you can contact them if you have a question or worry about your care plan.

What happens when I have a CMS care plan?

• Your pharmacist will review your CMS care plan regularly with you.
• They will usually look at your care plan when you collect a prescription.
• Sometimes, your pharmacist may ask to speak with you about your care plan.
• They will always talk to you in private.
• Your pharmacist will check your care plan to make sure it is helping you deal with any problems you have with your medicines.
• Your pharmacist will update your care plan when your health care needs change. Your doctor will decide any changes.
• To find out more about CMS care plans, talk to your pharmacist.

Serial prescriptions

What is a serial prescription?

• A serial prescription is a prescription for medicines you need to treat your long-term condition.
• It looks like a normal prescription but lasts for 24 or 56 weeks.
• With a serial prescription, you can get medicines directly from the pharmacy where you are registered. You won't need to see the doctor.

• You can get a serial prescription if:
  • the doctor decides it is the right type of prescription for you and the condition you have.

• If your doctor gives you a serial prescription, you must take it to the pharmacy where you have registered for the service.
• Your doctor will decide how often you should collect the medicines on your serial prescription, for example every four or eight weeks.
• Your pharmacist will keep your serial prescription in the pharmacy. They should have your prescription ready for you when you need it, so you don't have to wait in the pharmacy.
• You will be able to collect medicines from your serial prescription within a few days of when you need them, as you do now.
• You can also collect your prescription early, or get more than usual, for example because you are going on holiday. If you need to do this, you should tell your pharmacist so they can prepare what you need.
• Each time you collect your prescription, your pharmacist will tell your doctor.
• Your doctor can stop your serial prescription. If this happens, your doctor will tell you and your pharmacist. Your pharmacist cannot give you medicines that are no longer on your serial prescription.
• At the end of 24 or 56 weeks, your pharmacist will ask you to sign the serial prescription form.
• They will then tell your doctor there are no medicines left on your serial prescription. Your pharmacist may ask your doctor for a new serial prescription, or give you a re-order form to take to your doctor's surgery.
• Your doctor may prepare a new serial prescription.
• Before doing so, they may ask to see you.
• Your doctor may decide that some of your medicines are not suitable for a serial prescription. For example, you may only need them occasionally - not all the time. If so, your doctor will continue to give them to you on a normal prescription.
• If the doctor gives you a prescription for a medicine that is not on your serial prescription, you can collect it from any pharmacy.
• You don't need to get it from the pharmacy you are registered with for the service.
• But it is helpful for you and your pharmacist if you can get all your prescriptions from the same pharmacy.
• If you move to another doctor's surgery, you should let the old surgery know so they can cancel your serial prescription.

Even if you are not eligible for a serial prescription, you can benefit from the service. You can still use other parts of the service, such as the care plan.

If I have a serial prescription, can I still go to my doctor if I need to?

• Yes, you can make an appointment to see your doctor whenever you like.
• Your pharmacist may also tell you that you need to see the doctor, for example if your condition gets worse.

Can I go to other pharmacies once I have registered for the service?

• Yes. You will need to go to the pharmacy you have registered with to use the service. But you can go to any pharmacy to buy medicines or to collect other prescriptions.

What if I'm unhappy about the service I have received from the pharmacy?

• If you can, first talk to your pharmacist so they can try to sort out your complaint immediately.
• If you can't do this, or if you have already spoken to your pharmacist and are still unhappy, you can make a complaint. The leaflet Giving feedback or making a complaint about the NHS explains how to do this. You can get this leaflet from most places where you get NHS care, by phoning the NHS inform Helpline on 0800 22 44 88 or on the internet (www.hris.org.uk).

How to find out more

For more information about anything in this leaflet, contact:

• your local pharmacy
• your doctor or a member of NHS staff involved in your care
• the NHS inform Helpline on 0800 22 44 88 (calls from a landline are free), or
• the Patient Advice & Support Service (PASS) at your local citizens advice bureau (find your nearest bureau on the internet at www.cas.org.uk or in your local phone book).

Email ask@hris.org.uk to ask for this information in another language or format.

This information is available on the Scottish Government website (www.scotland.gov.uk) and on the Health Rights Information Scotland website (www.hris.org.uk).