Transcript Prudent Healthcare Prescribing Workshop April 2014 Howard Rowe

Prudent Healthcare
Prescribing Workshop
April 2014
Howard Rowe
Clinical Director:
head of medicines management
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Introduction and Aims
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Aims
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Format
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Set the Scene
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Aims
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Understanding of Prudent Healthcare and
its application to Prescribing
Produce recommendations for Change in
prescribing arrangements
Identify where more work is needed
Capture lessons on "the workshop
process"
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Format
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Presentations
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Understanding Prudent Healthcare and the
underpinning Principles
To test the current arrangements for
Prescribing against those Principles
Patients' perspective
 Clinicians' perspective
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Group Work
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Define "what would good look like?"
Test and Prioritise the Ideas that emerge
Next Steps
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Set the Scene: use of medicines
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14,000 prescribed doses in a lifetime
Age and Use of Medicines
Percentage of adults
who reported
being on regular
prescribed medication
(for a year or more),
by age and sex
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Set the Scene
Use of three or
more prescription
drugs
in the past 30
days
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Set the Scene
65+
10% of Population,
Account for 30% of
Medicines Expenditure in
Primary Care
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Set the Scene
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Use of Medicines: Prescribing Volume
Primary Care
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7.6 million items per annum
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200 million doses per annum or
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550, 000 doses per day
Primary Care: rate of increase
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Volume: Wales 2.62%,
Cwm Taf 1.52
(gold)
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Set the Scene
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Medicines Expenditure
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Primary Care
£56 million per annum
 £220,000 every working day (like today)
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Primary Care: rate of increase
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Spend: Wales 2.05%,
Cwm Taf 1.72% (bronze)
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Set the Scene
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Medicines Expenditure
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Secondary Care
(within Cwm Taf)
£20 million per annum
 £6 million arising from NICE/AWMSG
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2014-2015 need £1m (26%) to £2.5m (42%) for
NICE/AWMSG
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Set the Scene
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Do No Harm
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Prescribing: Lithium
“Grandfather wins £1m drug blunder payout”
(at East Glamorgan Hospital)
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Set the Scene
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Do No Harm
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Dispensing: Peppermint Water
Wednesday, 1 March, 2000, 18:31 GMT
“Chemists fined after baby death”
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Administration: Penicillin Allergy
30th October 2013
“Grandmother, 61, 'died after nurse gave her
penicillin despite SEVEN warnings that
she was allergic to it‘ “
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Set the Scene
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Culture in the Community
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Set the Scene
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Quality: Prescribing Indicators
Ibuprofen And Naproxen as % of NSAIDs - September 2013
Qtr
Efficiency and Productivity Target: Maintain performance
levels within the upper quartile (78.3) or show an
80.00
79.00
Co-Amoxiclav Items % of Antibacterial Items - September 2013
Qtr
Efficiency and Productivity Target: Maintain performance levels
within the lower quartile (2.5) or show a reduction towards the
quartile below
8
7
6
78.00
5
77.00
4
76.00
3
75.00
National-GP
Cwm Taf
Hywel Dda
Cardiff And Vale Uni
Betsi Cadwaladr Uni
Abertawe Bro Morgannwg Uni
Powys Teaching
National-GP
Cwm Taf
Betsi Cadwaladr Uni
Powys Teaching
Hywel Dda
0
Cardiff And Vale Uni
73.00
Aneurin Bevan
1
Abertawe Bro Morgannwg Uni
74.00
Aneurin Bevan
2
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Set the Scene
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Quality
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Realising potential from being Integrated
Health Board

Diclofenac
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