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Think Pharmacy Minor Ailments Service March 2015.

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Presentation on theme: "Think Pharmacy Minor Ailments Service March 2015."— Presentation transcript:

1 Think Pharmacy Minor Ailments Service March 2015

2 Welcome

3 Housekeeping

4 Agenda Introduction Background GP Perspective NHS Contract – Next Steps Conditions and Treatments Delivering the Service PharmOutcomes Demonstration Q&A

5 Thanks to our sponsors Lundbeck UK and Teva UK

6 Jasmeen IslamDeputy Head of Medicines Management, NWCSU Mark GreenGP, St Hilary Brow Group Practice Sarah Boyd-ShortCommissioning Support Manager – Contracts & Delivery Nicola BradleyCommunity Pharmacy Manager for the Wirral Minor Ailments Scheme Nick ThayerCommunity Pharmacist, Well Pharmacies, Eastern Cheshire Kevin Noble Pinnacle Health Partnership LLP Speakers

7 Introduction and Background Melanie Carrol Contractor support and Service Development Pharmacist Community Pharmacy Cheshire and Wirral

8 How did we get here? West Wirral Minor Ailments Service Opportunities to work together Urgent Care Board Paper

9 Additional challenges Merger of LPC’s Merger of CCG’s NHS contract

10 Working Group CCG Ian Stewart, Sarah Boyd-Short GP Hannah McKay CSU Nicola Bradley, Jasmeen Islam LPC Melanie Carrol LPN Suzanne Austin Others stakeholders when needed

11 Where are we now…… NHS Contract Service Specification Level 1 Protocols Level 2 PGD’s


13 Jasmeen Islam Deputy Head of Medicines Management NWCSU March 2015

14 National Drivers Five Year Forward View Investing in building the public’s understanding that pharmacies can help them deal with coughs, colds and other minor ailments Community Pharmacy Manifesto 5 pledges Encourage patients to think ‘pharmacy first’, and use pharmacy to help relieve pressure on GPs and emergency departments Community Pharmacy- helping provide better quality and resilient urgent care -NHSE Better integrate pharmacy into the urgent and emergency care system self-management of minor ailments

15 Example mapping of prescribing: fever & pain in children

16 Example mapping of prescribing: hayfever

17 JSNA There 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.

18 The cost of treating a patient with a minor ailment in an A&E department is a)Twice as high b)3.5 times as high c)5 times as high than the cost of treating the patient in a pharmacy

19 Statistics… 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 locally

20 Further Context Nigel 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’

21 Future Travel… National Minor Ailment Service – much discussion… National exploration of co-commissioning of community pharmacy services: potential for future years RCGP / RPS collaboration RPS video – Minor Ailments

22 NHS Contract – Next Steps Sarah Boyd-Short Commissioning Support Manager – Contracts & Delivery (ext 1790)

23 GOVERNANCE AND REGULATORY Full Legal Name Address Is this the Principal AddressYES/NO Is this the Registered AddressYES/NO Company Number Authorised Signature Name and Title [ ] [ ] Tel: [ ] Provider’s Information Governance Lead Name [ ] [ ] Tel: [ ] Provider’s Caldicott Guardian Name [ ] [ ] Tel: [ ] Provider’s Senior Information Risk Owner Name [ ] [ ] Tel: [ ] Provider’s Accountable Emergency Officer Name [ ] [ ] Tel: [ ] Provider’s Safeguarding and Prevent Lead Name [ ] [ ] Tel: [ ] Addresses for service of Notices Provider: [ ] Address: [ ] [ ] Provider RepresentativeTitle [ ] Address: [ ] [ ] Tel: [ ]

24 Conditions and Treatments Nicola Bradley

25 Service Provision 2 distinct levels: Level 1 Service Patient assessment - accredited pharmacist Provision of P or GSL medicine or appliance Advice on condition Renumeration: £4.50 per consultation Formulary tariff for medicines provided

26 Service Specification Level 2 Service Patient assessment - accredited pharmacist Provision of a Prescription Only Medicine Patient Group Direction Specified conditions Specified Criteria Communication to patient’s registered GP to advise treatment provided Renumeration: £8.20 per consultation Formulary tariff for medicines provided

27 Level 1 24 Level 1 Treatment Protocols Adapted from those used in: – West Cheshire, East Cheshire, Vale Royal, and South Cheshire Definition Inclusion/Exclusion criteria Treatment Choice Counselling and Advice Referral

28 Level 1 Clinical Knowledge Summaries Summary of Product Characteristics

29 Level 1 Conditions Acne Vulgaris(mild) Acute Bacterial Conjunctivitis Allergy Athlete’s Foot Cold Sores Constipation Cough Cystitis Dermatitis / Eczema (mild) Diarrhoea Genital Thrush Haemorrhoids Headache, Pain (including Dental Pain) Hay fever (Seasonal Allergic Rhinitis) Head lice Indigestion and Heartburn Mouth Ulcers Nappy rash Nasal Congestion Oral candidiasis Scabies Sore throat Threadworm Warts and verrucae

30 Cough– Simple linctus Cystitis – Lifestyle advice, analgesia Dental Pain–Ibuprofen, Paracetamol Head lice – Bug busting kit Hedrin 4% (Second line) Level 1 Treatment Protocols

31 Level 2 Adapted from those used in: – West Cheshire, East Cheshire, Vale Royal, and South Cheshire NICE Good Practice Guidance GPG2 (September 2013) ources ources Competency framework: For health professionals using Patient Group Directions

32 Patient 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.

33 NICE Competency Framework: For health professionals using Patient Group Directions DomainsCompetency areas The patient consultationKnowledge Options Shared decision ‑ making Safe and effectiveSafe Governance Always improving PGDs in contextInformation The healthcare system Collaboration

34 NICE Competency Framework Each competency area includes: –a statement that gives a general overview of what the competency area covers –a list of individual competencies, referenced to relevant good practice recommendations, where applicable.

35 NICE Competency Framework Individual health professionals need to consider: –how they will use the competency framework –how each competency applies to their scope of practice and individual responsibilities –what evidence can be collected and documented to demonstrate competency e.g. case studies

36 Level 2 PGDs Acute Bacterial Conjunctivitis Fusidic Acid Eye Drops Chloramphenicol Eye drops/ointment Uncomplicated Urinary Tract Infection in Women Trimethoprim 200mg Hay fever (allergic rhinitis)Beconase nasal spray Impetigo Fucidic acid 2% Cream Migraine Sumatriptan 50mg tablets Oral candidiasis in infants <2 yearsNystatin oral suspension

37 Uncomplicated UTI in Women Diagnosis of UTI - Quick Reference Guide for Primary Care infection-diagnosis infection-diagnosis CPPE - Antibacterial resistance - a global threat to public health: the role of the pharmacy team

38 Uncomplicated UTI in Women Severe or ≥ 3 symptoms of UTI: Urgency Polyuria Dysuria Frequency Suprapubic tenderness NO vaginal discharge or irritation

39 Delivering the Service Nick Thayer Well Pharmacy Eastern Cheshire

40 PharmOutcomes Kevin Noble Pinnacle Health Partnership LLP

41 Sarah Boyd-Short (ext 1790) Nicola Bradley Melanie Carrol Contact Details

42 Any Questions?

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