1. NHS South Norfolk CCG – Waste and Self-Care what’s the fuss all about?
Françoise Price
Senior Clinical Pharmacist and prescribing adviser

2. SNCCG Context 24 GP practices 35 number of pharmacies
Primary care prescribing FOT £36,177,255
More than 5 million prescriptions dispensed
Spend per ASTROPU £38.52 c.f. national £40.33
QIPP for circa £2m
Waste estimated at £1.2m
Budget QIPP’d i.e. find savings of £1.9m
Current performance looks like £375k savings on this budget
Helped by category M and drug pricing but also focus on cost effective prescribing

3. Waste

4. Not just £s Insulin £384 Cardiovascular £157 Costs: Drugs Disease
Family
Disposal

5. It’s not a new problem- returned by one patient August 2011

6. Hidden costs
Returned medicines cannot be reused We have to destroy them
Drugs
Disease
Family
Disposal

7. What’s the most expensive medicine in the NHS?
It is the one that is never taken!
Remember to ONLY ORDER WHAT YOU NEED and help us to make more of your local NHS resources.
NICE Medicines optimisation facts and figures:
Estimated that between 30% and 50% of medicines prescribed for long‑term conditions are not taken as intended (World Health Organization 2003).
Data from the Health and Social Care Information Centre (HSCIC) shows that between 2003 and 2013 the average number of prescription items per year for any one person in England increased from 13 (in 2003) to 19 (in 2013).

8. What can you do?
Spread the word
Be honest with your healthcare professional with regards to medicines taking
Only order what you need
Help family and friends with their medication ordering

9. Self-Care What do we mean by self-care?
Self care is about everyone taking responsibility for their own health and wellbeing. This includes keeping both the body and mind fit and healthy.
Lifestyle choices – prevention of ill health
Expert patients – long term conditions
Self management of minor or self limiting conditions
Self care is defined by the Department of Health as a part of daily living. It is the care taken by individuals
towards their own health and well-being, and includes the care extended to their children, family, friends
and others in neighbourhoods and local communities. Self care includes the actions people take for
themselves, their children and their families to stay fit and maintain good physical and mental health;
meet social and psychological needs; prevent illness or accidents; care for minor ailments and long-term
conditions; and maintain health and well-being after an acute illness or discharge from hospital.

10. Self Care Nation
92% of people feel it is important to take responsibility for their own health But 34% went to their GP anyway 47% of people would not visit their local pharmacist as first port of call

11. Why? Pharmacists aren’t as qualified as GPs or hospital staff 18%
I have been seeing my GP for many years and do not wish to change
I am entitled to free prescriptions so would never pay for OTC medicine
I am entitled to see my GP when I want
My GP surgery is closer
18%
11%
12% 8%
Pharmacist qualifications
Consultant level
CPD

12. With the NHS facing unprecedented demand from users while also under pressure to manage costs, health professionals believe that even small changes in behaviour could reduce the burden and free up more money for patient care.

13. National Context 57 million GP consultations every year are for
minor ailments that could be self-treated at home.
This takes on average, one hour per day of GP’s
time and costs the NHS £2 billion per year.
• Additionally minor illness and injuries account for
approximately three quarters of A&E attendances
of which 15% have the potential to be treated with self care at home.
Each A&E attendance costs the NHS £112
Key message – cannot afford to go on like this.
Think of films e.g.
Suffragettes – people went to see the pharmacist or his wife Edith Ellyn (Helen Bonham Carter)

14. Local context
Nationally, 99% of people are within 20 minutes travel time of a community pharmacy
NHS SNCCG spent April – November 2016:
Cough mixtures and nasal decongestants £1805 – 864 items
Rubs for aches and pains £123,366 – 25,178 items
Paracetamol £203,081 – 60,208 items
Chloramphenicol eye preparations £7136 – 864 items
Moisturisers £162, 420 – 27,027 items

17. Ask your pharmacist about
1. Low Back Pain 2. Eczema 3. Heartburn and indigestion 4. Fever in children 5. Constipation 6. Headache and migraine 7. Coughs
8. Acne 9. Sprains and strains 10. Sore throat 11. Otitis media 12. Common cold 13. Sinusitis 14. Urine symptoms in men

18. Communication strategy across Norfolk
What we are doing
SNCCG Self Care policy
Communication strategy across Norfolk
Integration with other work streams
Education:
GPs
Pharmacists
People
Resources:
NHS Choices
Self care forum
111
Integration:
Care homes – Homely remedies
Unplanned care
Working with LPC; public health; LMC
Need your help – spread the word

19. Support local campaigns
What can you do?
Lead by example
Spread the word
Raise awareness
Share ideas
Support local campaigns

20. QUESTIONS?