The Organisation Data Service (ODS) code of the premises at which pharmaceutical services may be provided

The name under which a pharmacy contractor, appliance contractor, or local pharmaceutical services contractor trades

The name given to a geographical statutory organisation by NHS England that is a smaller division of a region

Integrated Care Board (ICB) Code

Do you want to claim for the Prevention domain? Answers: yes / no Mandatory

Can you confirm that you will have added your anonymised TARGET treating your infection leaflets review data to the data collection tool on MYS by the end of 31 March 2024? Answers: yes / no (N/A where question was not asked) Mandatory

Can you confirm that you will have completed the TARGET antibiotic checklist review by the end of 31 March 2024? Answers: yes / no (N/A where question was not asked) Mandatory

By the end of 31 March 2024, will all patient-facing staff working at the pharmacy on the day of the declaration, and who provide health advice, have become Antibiotic Guardians and have an awareness of the local antibiotic formulary? Answers: yes / no (N/A where question was not asked) Mandatory

Do you declare that you will have completed your practice review of the TARGET treating your infection leaflets between 1 September 2023 and the end of 31 March 2024? Answers: yes / no (N/A where question was not asked) Mandatory

With regards to the TARGET antibiotic checklist review, will the patient's prescriber have been notified where concerns were identified? Answers: yes / no (N/A where question was not asked) Mandatory

Do you declare that where concerns are identified when completing your practice review of the TARGET treating your infection leaflets, the patient's GP practice will be promptly notified? Answers: yes / no (N/A where question was not asked) Mandatory

Between 1 April 2021 and the end of 31 March 2024, will all non-registered pharmacy staff working at the pharmacy on the day of the declaration have satisfactorily completed the Infection Prevention and Control Level 1 e-learning and assessment? Answers: yes / no (N/A where question was not asked) Mandatory

Between 1 April 2021 and the end of 31 March 2024, will all registered pharmacy professionals working at the pharmacy on the day of the declaration have satisfactorily completed the Infection Prevention and Control Level 2 e-learning and assessment? Answers: yes / no (N/A where question was not asked) Mandatory

Do you declare that by the end of 31 March 2024, you will have at premises level and available for inspection, a new or updated AMS action plan on how you would promote AMS in your day-to-day practice? Answers: yes / no (N/A where question was not asked) Mandatory

Can you confirm that you will have added your anonymised antibiotic checklist review data to the MYS data collection tool by the end of 31 March 2024? Answers: yes / no (N/A where question was not asked) Mandatory

Between 1 April 2021 and the end of 31 March 2024, will all patient-facing pharmacy staff working at the pharmacy providing advice on medicines or healthcare on the day of declaration have satisfactorily completed the Antimicrobial Stewardship for Community Pharmacy e-learning and e-assessment? Answers: yes / no (N/A where question was not asked) Mandatory

By the end of 31 March 2024, will all patient-facing staff working at your pharmacy providing advice on medicines or healthcare on the day of the declaration have been trained on the reasons why unwanted and expired antibiotics should be returned to the pharmacy for safe disposal, and the adverse effects on the environment and antimicrobial resistance when antibiotics are disposed of in domestic waste? Answers: yes / no (N/A where question was not asked) Mandatory