Transcript Managing Medicines Use by PBC Groups in West Herts

Managing Medicines Use
by
PBC Groups in West
Hertfordshire
Dr Alison Davies
Presentation to Cover………
• Why is this important
• What are the key aims
• How are these addressed
• What achievements to date
• Going forward….
Why is this important
• Medicines are a central component of health care (Audit
Commission (AC) 2001)
– but their use is not always optimised ………………………..
• Adverse events cost the NHS about £500m a year (AC
2001)
• Only half of the people with chronic diseases take their
•
medicines as recommended… (AC 2001)
Unused and wasted medicines cost the NHS at least
£100m a year (NAO, 2007). In West Herts it is estimated to
exceed £3m/year
• In 2006-07, the NHS drugs bill was 14% of the overall
NHS spend with primary care spend alone being 11%.
– primary care prescribing spend for West Herts PBCs was also
11% of total
• Medicines are chemicals – whilst they have benefits,
they also can cause harm. Linking medicines management to
clinical governance is imperative to manage such risks
What are the key aims
• To work in collaboration with secondary care
and other primary care prescribers
• To ensure effective and cost-effective use of
medicines and integrate these in care-pathways
and service re-design specifications
• For patients with LTC – to prevent admissions
and complications with appropriate medicine
use
• To promote patient safety and public health of
patients by appropriate use medicines and
audits
• To ensure implementation of good practice in
use of medicines
How are these addressed
• Joint committees between 10 / 20 care –
WHJPG & HMMC
• Consider whole evidence-base and
practical application in recommendations
• Communication & education to change
behaviour
• Inclusion of drug treatment guidelines in
service re-design specifications
• Systems and processes to monitor, remind
and review use of medicines
Achievements to date
• Good working relationship with secondary care
on evidence-based guidelines and drug choices –
COPD, Diabetes etc.
• West Herts spend per capita is lowest in EoE
and in the lowest quartile nationally
• Achieved EoE statin and PPI target well before
other areas
• Patients safety issues addressed by audit and
education at practice level
• Patient engagement with Waste Campaign in
2007.
Going forward…….
• Need a robust process for integrated education
• Engagement of patients at individual level and public at
other levels around decisions on medicine use
• Sound governance processes to manage:
– Influence of pharmaceutical industry
– Commissioning and provision role
• Development of a pharmacy strategy to maximise the
contribution community pharmacists can make to
optimise patient care
• Strategic and operational clinical pharmacy input at all
levels:
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–
–
–
Service re-design and care-pathway development
Commissioning & contracting
Education and performance review
Practice and patient support
In Conclusion
• West Herts PBC Groups have been very
successful in managing cost-effective
prescribing
• Involves support of clinical pharmacists
• Further areas of development necessary to
ensure
– Integration of community pharmacy
– Educate all professionals – same messages
– Empower patients in decisions and engage
with public