1. Background PM Challenge Fund Local General Practice EPiC
Choice of pharmacy
Workstreams

2. Vision of the service
Pharmacists will have a key role to play supporting general practice to manage the routine, non urgent case mix and those people who struggle to access primary care in working hours.
Pharmacists will offer an enhanced service underpinned by access to the patient’s medical record, PGDs, training and a robust clinical governance framework.
There will be more opportunities for people to access this enhanced service.
Ultimately by redirecting a proportion of routine case mix to Pharmacists it will contribute to increased capacity within general practice to see more complex or frail patients.

3. Vision for Pharmacy
Incorporate Pharmacy as part of the first line primary care team
Provide appointments for patients in a familiar and accessible environment
Use Pharmacists to their full potential, up-skilling and supporting them to work in an extended role
Work with Pharmacists to optimise use of medicines in the city and reduce medicine waste

4. 3 Levels of Service EPiC Pharmacies Level 1
Access to medical records. Pharmacist trained to use them and answer medication queries
Level 2
Trained Pharmacist working with PGD’s. 3-4 trained Pharmacist per module
Level 3
Independent Prescriber provides clinical consultations

5. Costs 2014-15 Normal working hours
M-F
Module 1 (34wks)
Module 2 (34wks)
Module 3 (26wks)
Module 4 (26wks)
No. Appts/day 15 15 15 15
No. appts/wk 75 75 75 75
Total no.appts
2550
2550
1950
1950
£6.25/appt
£15,938
£15,938
£12,187
£12,187
Total Cost
£56,248

6. Costs 2014-15 Extended hours Sat/Sun Module 1 (34wks) Module 2 (34wks)
No. Appts/day 5 5 5 5
No. appts/wk 10 10 10 10
Total no.appts
340
340
260
£6.25/appt
£2,125
£2,125
£1,625
£1,625
Total Cost
£7,500
Evenings
M-F
No.appts/day 2 2 2 2
No appts/wk 10 10 10 10
Total no appts
340
340
260
260

7. IMT solutions IM&T requirements for Pharmacies are:
Access to a booking system with appointments made in real time;
Access to the full patient record to support clinical decision making
Two way feedback mechanism between GP and Pharmacist to be put in place.
Progress to date:
All Pharmacies have N3 and SMART cards.
Pilot to Load System1 onto a Pharmacy system was successful but connectivity centrally was not achieved probably because of firewall issues.
Ongoing challenges with EMIS, especially in relation to a two way interaction between the GP and the Pharmacy system.

8. Training
Pharmacy training plan needs to be developed for Fast Starters to include:
IM&T:
Booking system,
Accessing the medical record,
EPiC metrics
Clinical:
PGDs
PGD tracking system
Relationship building with GPs
Learning from first wave will then inform on going training needs for the Fast Starters as well as the Early Adopters.

9. Outstanding issues
IM&T: Work to resolve existing issues of connectivity with System1 as well as with EMIS.
Finalise and sign off PGDs for inclusion with go live Fast Starters
Develop training plan for Pharmacists in Fast Starters group and implement
Develop Communications for all parties in Fast Starters group and implement. Consider team building session.
Financial: Finalise and agree payment schedule for EPiC Pharmacists both in and out of hours.
Agree method of re-imbursement for medication supplied by EPIC Pharmacies
Get final agreement to participate from Pharmacies and prepare and agree rotas of clinical appointments