NHS Fife Pharmacy 30:Layout 1 - Community Pharmacy

Remember the 999F5 Code!
Please remember that Nicotine is one of the items under the public health service being captured on the urgent
supply forms CP(US). Traditionally data captured on these forms is linked to the GP practice; however the items
under the Public Health Service (Nicotine, Levonorgestrel and Azithromycin), are not to go against GP practices.
To this end, ISD has set up a ‘dummy’ code for each health board so that data can be captured and reported on.
The code for NHS Fife is 999F5. This should be applied to all relevant CP(US) forms with immediate effect. The
code should be used by all community pharmacy colleagues, including locum and relief pharmacists.
Nicorette Invisi Patch® - a New 16-
hour Transdermal Nicotine Patch
Earlier this year, Nicorette Invisi Patch® was launched.
This 16-hour transdermal nicotine patch comes in three
different strengths, 25mg, 15mg and 10mg. The Invisi
Patch® is semi-transparent and smaller than the original
Nicorette® patches. See below the recommended
dosage regimen for the Invisi Patch®:
Dose Regimen
Duration
Nicorette Invisi
Step 1
First 8 weeks
Patch® 25mg
Nicorette Invisi
Step 2
Next 2 weeks
Patch®15mg
Nicorette Invisi
Step 3
Last 2 weeks
Patch® 10mg
It is intended that the Invisi Patch® is worn through the
waking hours (approximately 16 hours) being applied
on waking and removed at bedtime. Those who
experience excessive side effects with the 25mg Invisi
Patch® which does not resolve within a few days should
change to the 15mg Invisi Patch®. This should be
continued for the remainder of the 8 weeks and then
stepped down.
For full prescribing information on Nicorette Invisi
Patch® products see www.emc.medicines.org.uk/ for
the summary of product characteristics.
The original Nicorette ® patches (15mg, 10mg and
5mg) remain available. Clients started on the Invisi
Patch® should be continued on this version as the Invisi
Patch® is not interchangeable with the original
Nicorette® Patches.
VOUCHER SCHEME USERS - Until such times as the
vouchers can be reprinted please write clearly on the
voucher “Nicorette Invisi Patch® “, where the client
should be dispensed the Invisi Patch®.
4 If you require this newsletter in alternative formats, please telephone 01383 565375.

HEAT TARGETS • VOUCHER SCHEME • COMPETITION WINNER • TOBACCO ISSUES CONFERENCE
ISSUE 30
Fife Pharmacy News
JUNE/JULY 2009
Note from the Editor
Welcome to the latest edition of Fife Pharmacy News! In this issue, we’ve decided to focus on the importance of the stop smoking service
within Fife, and the huge role that pharmacy services plays in supporting those who choose to stop . I hope you’ll find this special edition
an interesting and informative read!
Fiona Forsyth, Communications Officer
Fife’s HEAT Targets –
How is it going?
BACKGROUND
The Scottish Cabinet Secretary for Health and Wellbeing is
responsible for all Scotland’s Health Boards. To help NHS Scotland
deliver key objectives as determined by the Cabinet Secretary, all
health boards are monitored against a set of objectives and measures
called HEAT Targets. These are divided into four areas; Health
Improvement, Efficiency and Governance, Access to Services and
Treatment. Smoking Cessation is part of the Health Improvement
category, where the key objective, through stop smoking services is
to reduce adult (16+) smoking rates from 26.5% (2004) to 22%
(2010). In Fife, the target is to support 8% of the smoking
population in successfully quitting (one month post quit).
PHARMACY’S ROLE
The Public Health Service element of the Pharmacy Contract aims to
ensure as many smokers as possible are offered support to stop
smoking through a Community Pharmacy Smoking Cessation
Service. Smoking affects the health of everyone and despite the
2008 ban on smoking in public places, there are still moderately high
levels of smoking throughout Fife.
WHERE ARE WE?
Over the last eight years there has been a reduction in smoking rates.
In Scotland, this has reduced from nearly 25% to 20%.
Collaboration between Community Pharmacy, Primary Care
Development Pharmacists, Fife’s Smoking Cessation Service and
associated specialist workers means we are able to identify ways to
resolve issues and provide the appropriate support. This aids in the
improvement of both activity levels and data capture and keeps us
moving in the right direction to help achieve the targets.
STOP SMOKING – NHS STATISTICS
This is the third annual release of statistics from the national smoking
cessation monitoring in Scotland, covering the 2008 calendar year.
Information is taken from the agreed national minimum dataset for
smoking cessation services (developed by PATH, part of ASH
Scotland), following consultation with services and others and is
based on 'quit attempts' made during the year.
WHO’S GIVING UP?
(Scotland)
• 4.8% of the smoking population made a quit attempt
• 60% of quit attempts were by females and 40% males
• 80% of quit attempts were from people living in urban
areas and 12% rural areas
• 1733 quit attempts were made by pregnant women
• 70% of quit attempts involved the use of NRT
WHERE ARE WE GIVING UP?
Quit attempts made in Pharmacy Services and in Non- Pharmacy
NHS Cessation Services (2008)
NHS Board Pharmacy Non-pharmacy
Fife 18% 92%
HOW ARE WE GIVING UP?
Percentage of quit attempts made by pharmacotherapy (2008)
NHS Board NRT Varenicline Bupropion
Fife 58% 34% 0%
Scotland 70% 17% 0%
If you would like to submit an article or make any suggestions to Fife Pharmacy News, please contact :
Fiona Forsyth, Communications Officer, NHS Fife, Pharmacy Services
Pentland House, Lynebank Hospital, Halbeath Road, Dunfermline, Fife, KY11 4UW
Tel: 01383 565375

No Butts! –
John’s the Winner
One lucky winner has been
chosen from the recent
competition to name the new Fife
Pharmacy Smoking Cessation
Service. The competition
attracted a good number of
entries from Pharmacy staff
throughout Fife.
The panel of judges from Fife’s
Smoking Cessation Service and
Fife Pharmacy decided that “No
Butts – Ask your Pharmacist!”
was the most appropriate name for the service.
Many suggestions were received and in the end the winner, John
Thompson, Pharmacy Manager from Lindsay and Gilmour
Pharmacy in Inverkeithing was chosen for his creative and
informative entry. John received a voucher for a meal for two for
his efforts.
To explain the reasoning behind the name, John said, “I put lots
of thought into my entry and tried to use some psychology too!
Stopping smoking can be really difficult so hopefully, our service
will help people to be less afraid to ask their local pharmacy for
help and advice to stop smoking.”
Combination NRT –
The Benefits
Nicotine replacement therapy (NRT) medications are well known
to provide effective treatment for tobacco dependence.
However, there is now strengthening evidence which
demonstrates that to further improve the value of NRT it is
possible to combine one medication providing passive nicotine
delivery (e.g. transdermal patch) with another medication that
allows nicotine delivery at the patient’s discretion (e.g. gum,
inhaler).
Combining NRT medications not only fulfills the smoker’s
requirement for an effective, slow delivery method which helps
achieve a constant concentration of nicotine, but also reacts to
breakthrough cravings and withdrawal symptoms by providing a
fast acting preparation which can be taken on demand for
immediate relief.
Combination NRT therefore, has huge potential to provide
effective treatment for tobacco dependence in difficult to
manage patients.
And a New Logo too!
In addition to our
new name, “No Butts
– Ask your
Pharmacist!” We also
have a new logo for
our service. Look out
for it in the coming
months to help
highlight the
Pharmacy service.
Fife Tobacco Issues Conference
Pittencreiff Park in Dunfermline was the venue for Fife’s Tobacco Issues
Conference on 27 May 2009. Promoting Excellence through Alliance was the
theme where various organisations with an interest in reducing tobacco use
came together. This year’s conference was held in an attempt to influence the
development of local activities involving parents, schools and the local
community in education programmes for young people, promotion of smoke
free homes, reducing under age tobacco sales and further developing stop
smoking support.
Dr Mike Roworth, Public Health Consultant, NHS Fife opened the conference
which began with an
informative look at the national
picture from Mary Cuthbert,
Tobacco Control Division –
Scottish Government. Smoking
Cessation Support within
Scottish workplaces was
presented by Nina Torbett from
the Centre for Healthy Working
Lives, and Heather Sloan from
the Renfrewshire CHP Health
Improvement Team gave an
insightful presentation on
methods and approaches to
encourage engagement.
Pupils from Kirkland High School at the Fife Pharmacy
stand attending the conference
The conference also included information on local enforcement issues, given
by Geoff Bates, Fife Council Trading Standards as well as an overview of
Alliance Working from Janet Wilson, the Local Alliance Officer from ASH
Scotland.
Workshop sessions took place during the event; Smoke Free Homes and Zones
led by Kay Samson, Tobacco Issues Co-ordinator and Julie Lennox from FMR
Research, as well as Current Local Provision: Successes and Challenges, led by
Mike Roworth, Andrea Smith, Development Pharmacist and the Quit 4 Life
Community Midwives. Prevention and Young People, led by Emma Cepok
and Brian Pringle from ASH Scotland, Engagement; the 3Rs (Reach,
Recruitment, Retention) with Belinda Morgan from Board's PFPI Team and,
Stop Smoking in the Workplace led by Nina Torbett from the Centre for
Healthy Working Lives, supported by Katie Provan.
Delegates came together from a diverse list of organisations including; NHS
Fife, Fife Council, Richmond
Fellowship, Kirkland High School,
Coal Industry Social Welfare
Organisation and CVS Fife.
The Speakers at the conference: Mary Cuthbert (Tobacco
Control Division – Scottish Government), Nina Torbett
(Centre for Healthy Working Lives), Heather Sloan
(Renfrewshire CHP Health Improvement Team), Janet Wilson
(ASH Scotland), Dr Mike Roworth (Public Health Consultant,
NHS Fife), Geoff Bates (Fife Council Trading Standards) and
Kay Samson (Tobacco Issues Co-ordinator, NHS Fife)
Throughout the day, poster
presentations were on display
highlighting valuable
information and the various
services (including Fife
Pharmacy) dedicated to
providing stop smoking
support. Feedback from the
conference has been very
positive.
2

Fife Pharmacy Voucher Scheme
Community Midwife’s
Perspective
Quit 4 Life is a specialist midwife led service which offers support
and advice to pregnant smokers. The midwives who provide this
service, Pamela Galloway and Helen Lowrie have undertaken
specialist training and provide one to one support in clients’ own
homes throughout Fife. Fife Pharmacy News met with Pamela
Galloway, who supports North East Fife and the Kirkcaldy and
Levenmouth areas, to find out how the Fife Voucher scheme helps
in this challenging role.
Pregnant women can
be referred to the
service by GP’s, Health
Visitors, Midwives,
Dentists, Pharmacists
or any other health
professional. Women
can also self refer. On
average, the service
receives between 40
and 50 referrals each
month, the majority
of these come from community and clinic midwives.
Approximately 2% of referrals are received from GPs, with a further
2% from Health Visitors.
Vouchers are designed for healthcare workers who are unable to
prescribe medicines, and by using the Fife the voucher scheme,
Pamela feels that the service has been streamlined. After an initial
consultation, clients can take the voucher straight to their local
pharmacy to receive the most appropriate NRT product quickly and
efficiently. Pamela explains, “Many pregnant women who smoke
feel self-conscious and are afraid they will be judged. Using the
voucher provides a fast and easy way for them to obtain NRT”.
The voucher scheme means that both Pamela and Helen have
responsibility for prescribing NRT. This saves time and helps to
ease the pressures on GPs and community pharmacy staff.
Vouchers speed up the client journey as clients can go straight to
the pharmacy, with no need for a visit to their GP.
Pamela Galloway and Helen Lowrie, Community Midwives
Pamela says, “Our service also provides a way to help other
smokers living within the pregnant women’s household. It’s a
useful way of signposting partners and relatives to gain help and
potentially stop smoking too!”.
… And on to
Community Pharmacy
After the voucher has been completed by the Smoking Cessation
Midwives, it is usually taken to the client’s local community
pharmacy. Fife Pharmacy News caught up with the team at
McIntyre’s Pharmacy in Glenrothes to track the final part of the
voucher’s progress.
The voucher scheme differs from the community pharmacy
smoking cessation programme in that it allows the pharmacy to
dispense NRT products safe in the knowledge that the recipient has
already received the support, advice and encouragement required
to help them stop smoking. Should any problems occur or if the
client’s requirements are not straightforward, the voucher always
includes a reference point and contact telephone number staff can
call for assistance. Vouchers come to the pharmacy via a variety of
routes such as GP surgeries and local smoking cessation schemes as
well as from the Community Midwife service.
Bernadette Brown,
Locum Pharmacist with
McIntyres says, “This is
an excellent scheme in
which community
pharmacies are part of
the bigger picture”.
These sentiments are
echoed by Susan
Dallas and Wendy
Mitchell, Pharmacy
Technicians who lead
the pharmacy’s smoking cessation service. “The vouchers offer
flexibility, choice and ease of use and allow us to help even more
people to stop smoking”, explains Wendy.
The team at McIntyre’s Pharmacy, Glenrothes
Listen Up! …… Local Radio to help Fife Stop Smoking
Fife Pharmacy has teamed up with Fife’s leading commercial radio network, Kingdom FM to launch a
unique local radio campaign, encouraging people to find out what’s on offer from their local community
pharmacy.
The campaign will run across Fife and reach approximately 42,000 listeners each week over a twelveweek
period from mid August 2009.
The campaign will include four areas of community pharmacy services;
Minor Ailment Service, Healthy Living, General medicines information as well as Stop Smoking Advice.
Each area will be highlighted by a short but informative series of statements, broadcast throughout the
day for the campaign duration. Hopefully the stop smoking message will encourage more listeners to
use their local pharmacy to gain the advice and support they need to help them stop smoking!
3