6Speakers Jasmeen Islam Deputy Head of Medicines Management, NWCSU Mark Green GP, St Hilary Brow Group PracticeSarah Boyd-Short Commissioning Support Manager – Contracts & DeliveryNicola Bradley Community Pharmacy Manager for the Wirral Minor Ailments SchemeNick Thayer Community Pharmacist, Well Pharmacies, Eastern CheshireKevin Noble Pinnacle Health Partnership LLP
7Introduction and Background Melanie CarrolContractor support and Service Development PharmacistCommunity Pharmacy Cheshire and Wirral
8How did we get here? West Wirral Minor Ailments Service Opportunities to work togetherUrgent Care Board Paper
9Additional challenges Merger of LPC’sMerger of CCG’sNHS contract
10Working Group CCG Ian Stewart, Sarah Boyd-Short GP Hannah McKay CSU Nicola Bradley, Jasmeen IslamLPC Melanie CarrolLPN Suzanne AustinOthers stakeholders when needed
11Where are we now…… NHS Contract Service Specification Level 1 ProtocolsLevel 2 PGD’s
13Deputy Head of Medicines Management Jasmeen IslamDeputy Head of Medicines ManagementNWCSUMarch 2015Background of my roleTeam workGP ClustersLPN event
14Community Pharmacy Manifesto National DriversFive Year Forward ViewInvesting in building the public’s understanding that pharmacies can help them deal with coughs, colds and other minor ailmentsCommunity Pharmacy Manifesto5 pledgesEncourage patients to think ‘pharmacy first’, and use pharmacy to help relieve pressure on GPs and emergency departmentsCommunity Pharmacy- helping provide better quality and resilient urgent care -NHSEBetter integrate pharmacy into the urgent and emergency care systemself-management of minor ailmentsNeed to embrace the opportunities under the 5yfvResearch from the Royal Pharmaceutical Society27 shows that common ailments cost the NHS an extra £1.1 billion a year when patients are treated at Emergency Departments or GP surgeries rather than at community pharmacies. Treatment results were equally good regardless of whether patients were treated at a pharmacy, Emergency Departments or GP practice. The cost of treating common ailments in community pharmacies was found to be £29.30 per patient. The cost of treating the same problems at Emergency Departments was found to be nearly five times higher at £ per patient and nearly three times higher at GP practices at £82.34 per patient. Overall, the study estimates that 3% of all A&E consultations and 5.5% of GP consultations for common ailments could be managed in community pharmacies. This equates to over 650,000 visits to A&E and over 18 million GP consultations every year that could be diverted with a total annual cost saving of over £1billion.Policy makers agree that within five years healthcare delivery needs to change. Far more care needs to be provided local in primary care and we need a radical upgrade in prevention and public health.
15Example mapping of prescribing: fever & pain in children
17JSNAThere is currently one pharmacy for every 3,402 residents, which compares extremely favourably to the national average of one pharmacy for every 5,000 resident population.
18than the cost of treating the patient in a pharmacy Community pharmacists in England could help save the NHS up to £1bn a year if they were contracted to run a national minor ailments service, according to figures obtained by the Royal Pharmaceutical Society (RPS).We also have new evidence, such as the recent Pharmacy Research UK publication, Community Pharmacy Management of Minor Illness showing that common ailments such as coughs and sore throats cost the NHS an extra £1.1 billion a year when patients are treated in Emergency Departments or GP surgeries rather than at community pharmacies with treatment results being equally good regardless of whether patients were treated at a pharmacy, Emergency Departments or general practice.The cost of treating a patient with a minor ailment in an A&E department isTwice as high3.5 times as high5 times as highthan the cost of treating the patient in a pharmacy
19Statistics…The cost of treating a patient with a minor ailment in an A&E department is five times higher than the cost of treating the patient in a pharmacy Coughs and sore throats cost the NHS an extra £1.1 billion a year when patients are treated in Emergency Departments or GP surgeries(source: RPS) Patient experience is high on the agenda nationally and locallyrather than at community pharmacies with treatment results being equally good regardless of whether patients were treated at a pharmacy, Emergency Departments or general practice.
20Further ContextNigel Mathers, the honorary secretary of the Royal College of General Practitioners:‘“sensible” that community pharmacists, and not over-stretched GPs, should be the first port of call for common ailments.Such a move .. would take pressure off the demand for a GP appointment and leave more time for doctors to deal with more complex consultations’
21Future Travel… National Minor Ailment Service – much discussion… National exploration of co-commissioning of community pharmacy services:potential for future yearsRCGP / RPS collaborationRPS video – Minor Ailments
22NHS Contract – Next Steps Sarah Boyd-ShortCommissioning Support Manager – Contracts & Delivery(ext 1790)
23GOVERNANCE AND REGULATORY Full Legal NameAddressIs this the Principal AddressYES/NOIs this the Registered AddressCompany NumberAuthorised SignatureName and Title [ ] [ ]Tel: [ ]Provider’s Information Governance LeadName [ ]Provider’s Caldicott GuardianProvider’s Senior Information Risk OwnerProvider’s Accountable Emergency OfficerProvider’s Safeguarding and Prevent LeadAddresses for service of NoticesProvider: [ ]Address: [ ] [ ]Provider RepresentativeTitle [ ] [ ]Tel: [ ]
25Service Provision 2 distinct levels: Level 1 Service Renumeration: Patient assessment - accredited pharmacistProvision of P or GSL medicine or applianceAdvice on conditionRenumeration:£4.50 per consultationFormulary tariff for medicines provided
26Service Specification Level 2 ServicePatient assessment - accredited pharmacistProvision of a Prescription Only MedicinePatient Group DirectionSpecified conditionsSpecified CriteriaCommunication to patient’s registered GP to advise treatment providedRenumeration:£8.20 per consultationFormulary tariff for medicines provided
27Level 1 24 Level 1 Treatment Protocols Adapted from those used in: West Cheshire, East Cheshire, Vale Royal, and South CheshireDefinitionInclusion/Exclusion criteriaTreatment ChoiceCounselling and AdviceReferral
28Level 1 Clinical Knowledge Summaries http://cks.nice.org.uk/ Summary of Product CharacteristicsPatient.co.uk
31Level 2 Adapted from those used in: West Cheshire, East Cheshire, Vale Royal, and South CheshireNICE Good Practice Guidance GPG2 (September 2013) https://www.nice.org.uk/guidance/mpg2/resourcesCompetency framework: For health professionals using Patient Group Directions
32Patient Group Directions Patient Group Directions (PGDs) provide a legal framework that allows some registered health professionals to supply and/or administer a specified medicine(s) to a pre‑defined group of patients, without them having to see a prescriber.
33NICE Competency Framework: For health professionals using Patient Group Directions DomainsCompetency areasThe patient consultationKnowledgeOptionsShared decision‑makingSafe and effectiveSafeGovernanceAlways improvingPGDs in contextInformationThe healthcare systemCollaboration
34NICE Competency Framework Each competency area includes:a statement that gives a general overview of what the competency area coversa list of individual competencies, referenced to relevant good practice recommendations, where applicable.
35NICE Competency Framework Individual health professionals need to consider:how they will use the competency frameworkhow each competency applies to their scope of practice and individual responsibilitieswhat evidence can be collected and documented to demonstrate competency e.g. case studies
37Uncomplicated UTI in Women Diagnosis of UTI - Quick Reference Guide for Primary Care https://www.gov.uk/government/publications/urinary-tract-infection-diagnosisCPPE - Antibacterial resistance - a global threat to public health: the role of the pharmacy team
38Uncomplicated UTI in Women Severe or ≥ 3 symptoms of UTI:UrgencyPolyuriaDysuriaFrequencySuprapubic tendernessNO vaginal discharge or irritation
39Delivering the Service Nick ThayerWell PharmacyEastern Cheshire
40Pinnacle Health Partnership LLP PharmOutcomesKevin NoblePinnacle Health Partnership LLP
41Contact Details Sarah Boyd-Short (ext 1790)Nicola BradleyMelanie Carrol