Transcript Presentation heading

Area Team update – Local Professional Network
Samantha Travis, Clinical Leadership Adviser
Derbyshire / Nottinghamshire
Area Team
Derbyshire / Nottinghamshire
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Population just under 2 million patients
10 CCGs
4 local authorities
433 community pharmacies
Area team functions
• 2 key functions
• Direct commissioning – GPs / Pharmacies/
Optometrists and dentists
• CCG Assurance
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Key contacts – Pharmacy Contract (Notts)
• Liz Gundel Ph: 01138 255461
• Kerrie Woods Ph: 01138 255456
• Mark Yates Ph: 01138 255466
• Jayne Bouch Ph: 01138 255447
• Richard Hobbs Ph: 01138 255472
• Chris Kerry Ph: 01138 255427 (enhanced services only)
All contracting queries relating to contract monitoring / essential / advanced
services and roster / emergency supply / Pharmacy First & Palliative care
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My role
• Clinical Leadership Adviser – lead for establishing
and developing 3 local professional networks
• Clinical pharmacist advice to Area Team
• Controlled drugs Accountable Officer
• Email all controlled drugs queries / errors/
discrepancies to [email protected]
• Ph: 01138 255474
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Local professional networks – pharmacy functions
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Hosted by Area Teams since 1st April 2014
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Support local authorities on the development of the Pharmaceutical Needs Assessment
which NHS England will use in commissioning pharmaceutical services
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Support the development of programmes of work to promote self-care and improve long
term conditions management
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Work with CCGs to develop and implement the primary care strategy
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Work with patients and other health care professionals to develop a comprehensive
programme of work aimed at ensuring medicines optimisation
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Share learning from medication incidents and Serious Incidents Requiring Investigation
(SIRIs)
Provide leadership to ensure robust commissioning of all locally enhanced services
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Local Professional Network – What have we done so far?
• Established network – includes 2 LPCs, CCGs,
local authority representatives, Acute Trust Chief
pharmacists, contracts managers, Academia, LPF
member, patient reps
• Meets every 6 weeks – guest speakers
• LPN executive – 3 LPN Chairs, Medical Director
and Director of Commissioning
• Opportunity to review progress and to discuss
challenges / barriers
• Developed work plan – signed off by the Medical
Director
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LPN hosted events / training
• Training for pharmacists (CCG funded)
- Dementia Friends (CPPE)
- Health coaching
- Diabetes
- Mental health
- Leadership
Call to Action – 5 events – hosted and facilitated by LPN
members and primary care contracting team members
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Community Pharmacy Strategy
• Strategy written in January 2014
• Useful tool when talking to LPCs, CCGs / LA
about pharmacy
• Key themes threaded through area teams wider
primary care strategy
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Community Pharmacy Strategy themes
• Promoting the wider role of community pharmacy
to the public, GPs
• Joint working with GPs & CCGs
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Medicines optimisation
Medicines safety initiatives
Public health & community pharmacy
Urgent & out of hours care
• Call to Action – Community Pharmacy
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Promoting the wider role
Local ‘Think Pharmacy Campaign’ for
winter ailments - December
pharmacytopublic,
GPs
• National campaign ‘The earlier, The better’ from Jan 2014
• Aims to increase public understanding of and confidence in
community pharmacy services.
• Increase the number of people accessing self-care information and
advice on NHS Choices when they have a minor ailment.
• Increase the number of people accessing community pharmacy
services when they have a minor ailment.
• Target audience over 45s, over 60s via their friends, family and
carers and carers 45-64 years
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Urgent & emergency care
The Urgent and Emergency Care Review
recognised that;
‘Community pharmacies are an under-used resource: many
are now open 100 hours a week with a qualified pharmacist
on hand to advise on minor illness, medication queries and
other problems. We can capitalise on the untapped potential,
and convenience, that greater utilisation of the pharmacy
workforce can offer.’
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Urgent & emergency care
• Area team commissioning Pharmacy First / Palliative Care
Drug Stockist and Roster from April 2014
• Commissioned emergency supply of medicines service for 2
weeks over Christmas / New Year 13/14.
• 200 calls/day at weekends / Bank Holidays from patients
who have run out of repeat medicines (DHU)
• Very popular with OOH services and CCGs – AT has
commissioned in OOH period for whole of 2014/15.
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Medicines Optimisation
• Pharmacists generally considered as experts
on medicines – Liberating the NHS 2010
• LPN looking at various initiatives – secondary
/ primary care
• Opportunity to work jointly with CCGs to scope
and explore the possibilities to provide medicines
optimisation and ensure patients get the best
outcomes from their medicines
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Medicines Optimisation
• Patient centred approach.
• Focuses on gaining the most benefit for patients
from their medicines. It is all about making
patients part of the decision in relation to their
medicines.
• Understanding the patient’s goals and aspirations,
which may be different from the outcomes the
NHS would like to see, listening to their concerns
and beliefs about medicines
• Stopping or reducing medicines as well as starting
new ones.
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Medicines Optimisation – the problem
• 30 – 50% of patients do not take their medicines as
intended by the prescriber
• 6.5% of hospital admissions are due to adverse drug
reactions, 70% of these are avoidable.
• 70% of care home residents have a problem with their
medicines at any one time
• 22% of the population now take more than 5 medicines and
5.8% are on ten or more medications a day, rising to 16.3%
in those over 65 years of age.
• Waste medicines in England cost approximately £300
million annually
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Medicines Optimisation workstream
1. Asthma / COPD inhaler technique business case
2. Developing a case for a service to help polypharmacy
patients to get best outcomes from their medicines
3. EPS – Notts - one third GP practices are live. Working
with Healthwatch to agree some key messages for
patients who are reporting confusion with the service (non
recurrent AT funding)
4. Care homes – reviewing services with 5 Notts CCGs
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Public health role of community pharmacy
• Community pharmacy can play an important role in improving the health of
the population in England.
• PHE has recently expressed keenness to explore:
• The role of the HLP
• Health marketing
• NHS Health Checks
• Blood pressure checks
• Vaccination
• Smoking Cessation
and have highlighted community pharmacy’s excellent track record in
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delivering these services
Public health role of community pharmacy
• Healthy Living Pharmacy – excellent evaluation
from elsewhere
• First step is to train Healthy Living Champions
• Funding obtained from Notts LETB to train 85
pharmacy staff members
• Distance learning package – accredited by the
Royal Faculty of Public Health
• 80+ in training currently across Notts
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Primary care transformation
 GP services are at capacity – opportunity for pharmacists?
• Management of minor ailments (local audit 45% of those presenting at GP
surgery could have been managed by other HCP)
• May be opportunities for pharmacists to take on some of the case
management of patients with long term conditions
• Independent prescribing – challenging in the past for community
pharmacists to use skills – business case submitted to realise this potential
• Currently working up a pilot with a local CCG to explore how we could use
trained community pharmacists to work alongside GP practices using
prescribing skills- business case submitted to realise this poten
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Work streams – Medicines safety
• Established medicines safety work stream – 2
Acute Trusts, community providers, CCGs
• Hoping to expand to include 4 Trusts
• Help for Harry – discharge MURs / NMS
• Common assessment process for patients
requiring compliance aids
• Agreeing common messages for patients around
medicines
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Call to Action
• 110 pharmacists and stakeholders gave us their
views on future of pharmacy
• Strong call for national service specifications for
enhanced services
• National campaigns promoting pharmacy
• Improved technology needed – patient records
• Output from NHSE expected Autumn
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Coming soon………
• Working with School of Pharmacy– University of
Nottingham working up an audit / survey of
patients visiting community pharmacies to look atr
the range and quality of self care advice given to
patients and patients perception of the service
offered
• Forming links with HEEM
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Pharmacy First
Samantha Travis, Clinical Leadership Adviser
Derbyshire / Nottinghamshire
Area Team
Pharmacy First - refresher
• Still commissioned if you were signed up and active last
year!
• Accreditation requirements – CPPE Minor Ailments pack
• Actively promote the service to anyone registered with a GP
in Notts who is exempt from prescription charges
• Resource materials available tonight – will be updated over
next few months
• Working with CCG to see if we can fund pharmacies who
aren’t signed up
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Pharmacy First - Ailments
• Pharmacists can currently provide advice and treatment for the following
ailments on the Pharmacy First scheme:
• Head Lice
Vaginal Thrush
• Sore Throat
Constipation
• Toothache
Insect Bites & Stings
• Fever
Warts & Verrucas
• Earache
Fever
• Bacterial Conjunctivitis
Athlete’s Foot
• Diarrhoea
Haemorrhoids
• Threadworm
Hayfever
Patients can also be referred to their GP if necessary.
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Pharmacy First
• Follow specification
• Refer patients with red flag symptoms / contraindications
• Provide only formulary products
• Recent audit of GP appointments – 40% could have been
dealt with by a pharmacist – important urgent care role
• Need to build on the scheme – its not perfect - but must
start by ensuring eligible patients are signed up in those
pharmacies offering the service
• Contact me if you need specifications etc
• Point of contact for those not signed up who would like to
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What are we trying to achieve?
• To encourage patients to use the pharmacy, when
appropriate for advice and treatment of minor ailments.
• To increase the capacity of the available GP appointment
schedules to provide a better service to patients with more
severe or urgent conditions.
• To give patients more choice in how they access health
services
• To expand the role of the Community Pharmacist and
enhance relationships between health professionals
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Contact
• Samantha Travis, LPN Chair / CDAO, Derbys /
Notts Area team
• [email protected]
• Ph: 01138 255474
• Thanks for listening!
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