Define patient populations

[chrisjwood16]

There are different eligibility criteria for the pharmacy services of interest. We will need to account for this in our denominator when calculating rates.

Eligibility for each condition taken from:
https://www.england.nhs.uk/wp-content/uploads/2023/11/PRN00936_ii_Pharmacy-First-Clinical-Pathways-v.1.6.pdf
https://www.england.nhs.uk/wp-content/uploads/2021/11/PRN00173-adv-service-spec-nhs-community-pharmacy-hypertension-case-finding-advanced-service-v2.3.pdf
https://www.england.nhs.uk/long-read/nhs-pharmacy-contraception-service/

Clinical pathways:

Condition	Age Range	Sex	Exclusions
Uncomplicated Urinary Tract Infection	16 to 64 years	Female	Pregnant individuals, urinary catheter, recurrent UTI (2 episodes in last 6 months, or 3 episodes in last 12 months)
Shingles	18 years and over	Any	Pregnant individuals
Impetigo	1 year and over	Any	Bullous impetigo, recurrent impetigo (2 or more episodes in the same year), pregnant individuals under 16 years
Infected Insect Bites	1 year and over	Any	Pregnant individuals under 16 years
Acute Sore Throat	5 years and over	Any	Pregnant individuals under 16 years
Acute Sinusitis	12 years and over	Any	Immunosuppressed individuals, chronic sinusitis (symptoms lasting more than 12 weeks), pregnant individuals under 16 years
Acute Otitis Media	1 to 17 years	Any	Recurrent acute otitis media (3 or more episodes in 6 months or four or more episodes in 12 months), pregnant individuals under 16 years

Hypertension case finding:

Inclusion criteria

• Adults who are 40 years old or over, who do not have a current diagnosis of hypertension.
• Patients, by exception, under the age of 40 who request the service because they have a recognised family history of hypertension may be provided the service at the discretion of pharmacy staff.
  • Patients between 35 and 39 years old who are approached about or request the service may be tested at the discretion of the pharmacy staff.
• Adults, of any age, with or without a prior diagnosis of hypertension, specified by a general practice for the measurement of blood pressure (clinic and ambulatory blood pressure checks). This process should be agreed locally with general practices.

Exclusion criteria

• People under the age of 40 years old, unless at the discretion of the pharmacy staff or unless they have been specified by a general practice for the measurement of blood pressure.
• People who have their blood pressure regularly monitored by a healthcare professional.
• People who require daily blood pressure monitoring for any period of time, e.g. 7-day clinic BP checks as an alternative to ABPM.
• People with a diagnosis of atrial fibrillation or history of irregular heartbeat.

Contraception service:

Inclusion criteria:
Be an individual seeking to be initiated on an OC, or seeking to obtain a further supply of their ongoing OC:

• Combined Oral Contraceptive (COC) – from menarche up to and including 49 years of age; or
• Progestogen Only Pill (POP) – from menarche up to and including 54 years of age.

Exclusion criteria:

• Individuals under 16 years of age and assessed as not competent using Fraser Guidelines
• Individuals 16 years of age and over and assessed as lacking capacity to consent

[chrisjwood16]

Initial focus should be on clinical pathways and the inclusion criteria.
We will need to assess how accurately we can account for the exclusion criteria for the clinical pathways