Community Pharmacy

Frequently Asked Questions

Chronic Medication Service

Stage 1 - Patient Registration

Stage 2 - Pharmaceutical Care Planning

Stage 3 - Serial Prescribing and Dispensing

Stage 1 - Patient Registration

Q1: Who is eligible to register for CMS?
A. To be eligible to register for CMS, a patient must be registered with a GP practice in Scotland, have a long-term medical condition such as asthma, diabetes or heart disease and receive regular prescriptions. In addition they must not be a resident in a care home setting or a temporary resident in Scotland.
Q2. So patients in Care Homes are excluded from CMS?
A. Yes. Currently care home patients are excluded. Support for patients with long-term conditions residing in care homes is being considered as a separate service.
Q3. Is it like MAS and only available to patients who are exempt from prescriptions charges?
A. No. Any patient with a long-term condition can register for CMS regardless of their exemption (or paying) status. However, the serial prescribing and dispensing stage of CMS is restricted in the initial year to patients who are exempt from prescription charges on the grounds of their age, maternity and medical exemptions.
Q4. Can a patient register with any community pharmacy for CMS?
A. Yes. A patient who is eligible to register for CMS can register with any community pharmacy in Scotland.
Q5. Can a patient who lives in Scotland but is registered with a GP practice in England register for CMS?
A. No, to be eligible for CMS the patient must be registered with a GP practice in Scotland.
Q6. What information is needed to register a patient for CMS?
A. You need to provide the patient's:
  • name
  • gender
  • address
  • postcode
  • date of birth
  • exemption category
  • Community Health Index (CHI) number.
All of this data should already be held in the patient's PMR record.
Q7. Is there a new form for registering patients for CMS?
A. Yes. Your NHS Board will replace the CP2 forms used for MAS with a new dual form for both CMS and MAS. The left-hand side of the form will remain as the CP2 form and the previously blank right-hand side becomes the new CP3 form used for CMS registrations.
Q8. So I will not have to change paper in my printer for each service?
A. No. Your PMR system will know on which side of the form to print, based on the service you are undertaking at that time - registering a patient for either MAS using the CP2 or CMS using the CP3 or recording the outcome of a MAS consultation on a CP2.
Q9. How do I submit CP3 forms?
A. All CMS CP3 registration and withdrawal forms should be submitted to PSD along with all other prescription forms. They are included in the exempt part of your bi-monthly (or monthly if this is your current practice) submission. They should be bundled separately from other documents, i.e. all your CMS CP3 registration forms and CP3 withdrawal forms together. You should also make sure that the bar-coded form is presented face side up with the barcode on the left-hand side as this helps the scanners read the prescriptions without interruption. Remember the registration has already happened using the electronic registration message but the paper forms still need to be imaged and stored by NSS.
Q10. Who do I contact to get further supplies of the CP2/CP3 forms?
A. Your NHS Board will keep supplies of the forms. They will send you an initial batch and then you re-order from the same contact you previously used for CP2 forms. Remember to order in plenty of time, so that you do not run out of forms before you receive a further supply

Q11. What do you mean by explicit patient consent?

A. Explicit patient consent is required for CMS because it involves different information being shared between healthcare professionals - for example, you will be sending dispensing data back to a GP practice and an end-of-care treatment summary which contains patient related data. Patients must be told about the use of their information and their consent obtained before their information is used in different ways. Patient consent should be informed (i.e. they understand the implications of agreeing to its use) and freely given. Explicit consent means asking a patient to actively express consent - which is best practice.
Q12. Can a patient transfer to another community pharmacy for CMS?
A. Yes. As part of the transfer, the original community pharmacy will be notified of the withdrawal of the patient, as will their GP practice, who will also be notified of the registration at the new community pharmacy.
Q13. As the GP gets notification of CMS registrations, will they now also get notification of MAS registrations?
A. No. MAS is a pharmacy-only service.
Q14. How will I know if a patient is registered for CMS elsewhere?
A. You can request an on-line CMS registration status request to check if a patient is already registered for CMS at another pharmacy. A patient can only be registered with one pharmacy at any one time. If you try and register a patient who is already registered with another pharmacy, then your PMR system will inform you that the patient is already registered elsewhere and you will be prompted to check with the patient that they wish to move their registration. If they do want to move their registration then you can proceed to register them. Their registration will be withdrawn from the original pharmacy and their GP practice notified of the change.
Q15. Does a patient's CMS registration lapse like a MAS registration can?
A. No. CMS registrations do not lapse. Their registration can be withdrawn - for example, if they die or move their registration to another pharmacy - but it will not lapse.

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Stage 2 - Pharmaceutical Care Planning

Q16. How do I access the Pharmacy Care Record?
A. The Pharmacy Care Record (PCR) is a web-based resource that can be accessed via the computer/s in your pharmacy. Your PMR system supplier will make sure your computer/s are configured to do this. You will also be given a user name and password by your NHS Board. You use these to log on to the PCR.
Q17. What happens if I forget my password?
A. You should contact the ePharmacy Helpdesk on 0131 275 6600 and they will reset this for you.
Q18. Do I leave a note of my user name and password for my locums to allow them to log onto PCT in my absence?
A. No. You must keep your user name and password confidential - just like the PIN number for one of your bank cards. Work is being progressed to ensure that all locums are given their own user name and password to allow them to access the PCR. There will also be a process for newly qualified pharmacists and those coming to work in Scotland to request a user name and password.
Q19. Who will provide me with information about how to use the Pharmacy Care Record?
A. Your PMR system supplier provides you with information about how to access the PCR from your PMR system. They will also advise you on how to upload any relevant patient data from your PMR system to PCR. NES Pharmacy is producing a user manual for PCR and this will be sent to each community pharmacy ahead of CMS starting.
Q20. When will I be able to access the PCR?
A. It will be available ahead of CMS starting.
Q21. What do I do if I need help or have to report a problem with it?
A. You should contact the ePharmacy Helpdesk in the first instance on 0131 275 6600 or email at NSS.PSDHelp@nhs.net.
Q22. Will I have to develop a pharmaceutical care plan for every patient that I register for CMS?
A. No. You should identify and prioritise individual patients who may be at risk of suboptimal therapeutic management, suffering side effects or showing signs of poor compliance and develop a pharmaceutical care plan for them in the first instance. This allows you to introduce CMS in a planned way, using your time effectively by initially targeting those patients most in need of your support.
Q23. How will I identify these patients?
A. You must undertake a risk assessment of any patient that you register for CMS within the first three months of registering them for the service. This risk assessment helps you to identify and prioritise those most in need of your support. To assist you with this, the PCR has a risk assessment tool which you can use to develop an overall risk profile for each of the patients you have registered.

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Stage 3 - Serial Prescribing and Dispensing

Q24. Can any patient registered for CMS be given a serial prescription?
A. No. It is not a requirement of CMS that every patient is provided with a serial prescription/s. In addition, in the first year of CMS, only people with age-related, maternity or medical exemptions may be given a serial prescription. This is because serial dispensing relies mainly on electronic claim messages and this means that the regular Counter Fraud Service (CFS) checks cannot be undertaken because there is no patient signature associated with the electronic claim. This position will be reviewed in 2011.
Q25. Who decides on the dispensing intervals for a serial prescription?
A. The patient's GP decides on the dispensing intervals.
Q26. Can controlled drugs be provided on serial prescription for CMS?
A. Only controlled drugs listed in Schedule 5 of the Misuse of Drugs Regulations 2001 can be prescribed on a serial prescription. No other controlled drugs are allowed. In addition, cytotoxic medicines such as methotrexate are not prescribable on a serial prescription.
Q27. Can a GP amend a CMS serial prescriptions as they can with AMS prescriptions?
A. No. A GP can not amend a CMS serial prescription. They can only cancel an item on a serial prescription. Therefore, if a GP wishes to change an item, for example increase or decrease the strength of the medication then they will have to cancel the original CMS item and produce a new prescription. This can be a standard GP10 prescription or a serial prescription depending on the GP's clinical opinion.
Q28. Where do I find the CMS disease specific protocols?
A. The disease specific protocols are available in the PCR and within the Establishing Effective Therapeutic Partnerships Framework
Q29. What happens if a patient requests a dispensing episode slightly earlier or later than the GP has outlined on the serial prescription, for example if the prescription states dispense every 56 days and the patient comes in a week earlier than expected?
A. You can use your professional judgement, within reason, to decide on the appropriateness of any request for a dispensing episode, whether earlier or later. It is not mandatory that you only supply an episode at rigid 56 days intervals. It is worth noting that patients who comply well with medication, frequently order their supplies slightly earlier to ensure that they do not run short. You should monitor regular late requests for poor compliance.
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