CYP Asthma Programme:GP AgreementSpecification of Support Requirements Name of Your GP Surgery: Please Select the Associated PCN: Central Dearne North North-East Penistone South Please confirm the Type of Support Service for Activation: DOAC Protect (SMR-03 and CVD-06) Step 1: Contacting Patients Do You Consent For Patients Within the Selected Cohort to be Contacted Through Eclipse Patient Engagement Interface? Yes Possibly - need more information No Would you Prefer the GP Surgery to Contact the Patients Themselves? Yes No Do You Wish for Patients to be Contacted Through an Alternative Method? Yes No Step 2: Reviewing Patients 1. How would the practice like us to address patients that are overdue a weight check? Ask the patient to attend surgery for a weight check Ask the patient to weigh themselves if possible Ask the patient to be weighed by an alternative method 2. How would the practice like us to address patients that are appearing to need a dose change? Email surgery nominated Key Contact 1 (as listed below) Email surgery nominated Key Contact 2 (as listed below) Contact a specific GP Surgery Nurse/Pharmacist/GP 3. How would the practice like us to address patients that appear able to be switched to Edoxaban? PPF Pharmacist to commence with optimisation. Email surgery nominated Key Contact 1 (as listed below) Email surgery nominated Key Contact 2 (as listed below) Contact a specific GP Surgery Nurse/Pharmacist/GP with patient list of those appearing able to be switched to Edoxaban 4. How would the practice like us to address patients that appear to not have a recorded blood test within the last six months? Ask the patient to attend surgery for blood test Email surgery nominated Key Contact 1 (as listed below) with patient list of those appearing to need a blood test completed Email surgery nominated Key Contact 2 (as listed below) with patient list of those appearing to need a blood test completed No action taken by PPF pharmacists; Wait until patient next has a review at the GP surgery 5. Are you happy for PPF pharmacists to advise patients with overdue blood tests to book in with your practice or do you have an alternative method? Yes No Alternative Method Proposed Start Date: This Month Next Month Within 3 Months Within 6 Months Key Contact 1 - Practice Admin Lead for this Programme First Name Last Name Tel: Email Key Contact 2 - Practice Clinical Lead for this programme First Name Last Name Telephone Email Thank you for completing your surgery application for the Barnsley Hypertension Protect.
