1. 2011 & 2012 PCPA and RPS Research Topline Results

2. RPS and PCPA Research – end of 2011 1,2 Medicines Management teams facing instability and a potential lack of investment further to NHS changes

3. RPS research 2011 1 50% of Medicines Management Teams had contracted in the past 12 months as a result of reorganisation 87% stated that Clinical Commissioning Groups (CCGs) were either talking to or planning to talk to the Medicines Management Team about prescribing and medicines management support but:  only 9% felt that the CCGs would be investing more in Primary Care Medicines Management Teams  47% felt they would be investing less  further 44% unsure what the future outlook would be

4. PCPA research 2011 2 Similar results to RPS research: large number of Medicines Management Teams suffering from low morale and instability as a result of recent NHS changes:  51% were not confident of GP commissioning groups in their locality funding the current Medicines Management Service once budgets were fully developed Medicines Management Teams were providing a variety of roles:  hands on support  audit and prescribing advice  commissioning of services involving medicines  providing oversight and governance, strategic overview and medicines optimisation Top priorities for Medicines Management Teams included:  implementation of QIPP  monitoring and controlling of prescribing costs (particularly in relation to new high cost drugs and wastage)

5. Follow up RPS research 2012 3,4 found that little has changed 62.3% of Commissioners and 40.4% of Providers reporting that they had lost whole time equivalent staff (WTE) picture slightly brighter amongst 10.1% of Commissioners and 23.4% of Providers who had gained WTE staff

6. Follow up RPS research 2012 3,4 Of those Commissioners either currently or soon to be employed by a Commissioning Support Service (CSS) organisation there was more optimism :  92% saying their local CCG was either currently actively engaging about prescribing and Medicines Management support for the future or planning to engage Amongst Providers however outlook was less clear:  only 52.4% saying that the CCGs were either talking or planning to talk to Primary Care Medicines Management teams

7. Follow up RPS research 2012 3,4 Both Providers and Commissioners were found to still be unoptimistic about future investment in Primary Care Medicines Management teams:  only 10.6% of Providers and 8.9% of Commissioners thinking CCGs will invest more  the rest felt investment would be reduced or were unsure about the future Despite this 50% of Providers and 48.6% of Commissioners either agreed or strongly agreed that they felt positive about the future of Medicines Management/Optimisation:  only 26.3% of Providers and 27.6% of Commissioners disagreeing or strongly disagreeing

8. Follow up RPS research 2012 3,4 Both Commissioners and Providers identified the following as top priorities for Medicines Management/Optimisation in primary care:  QIPP and efficiency savings  improving quality and safety for patients  maintaining the continuity of the services they provide They felt the following would be key to helping them deliver effective Medicines Management/Optimisation services:  networking opportunities  sharing of good practice  training

9. References 1. Prescribing Advice and Medicines Management Support – Providers. Research carried out by the Royal Pharmaceutical Society. Data on file. 2011 2. NHS Changes and How They are Affecting You. A Primary Care Pharmacists Association Survey. Data on file. October 2011. 3. Prescribing Advice and Medicines Management Support – Providers. 2011 compared to 2012 Survey Results. Research carried out by the Royal Pharmaceutical Society. Data on file. 2012 4. Prescribing Advice and Medicines Management Support – Commisioners. 2011 compared to 2012 Survey Results. Research carried out by the Royal Pharmaceutical Society. Data on file. 2012

10. JANUARY 2013 Primary Care Medicines Optimisation Workshop

11. OUTLINE A group of 12 practising primary care medicines management leads from a wide geographical spread in CCGs across England discussed the various challenges facing primary care organisations in delivering the NHS medicines optimisation agenda They identified the difficulties associated with NHS reorganisation and highlighted potential solutions and areas for development  NB: the comments and observations reflect the views of the attendees; they do not represent the views of the BMJ, PCPA or the organisations for which they work

12. CURRENT ISSUES FACING MEDICINES MANAGEMENT IN PRIMARY CARE? Organisational changes within the NHS are fragmenting teams creating a loss of continuity, leadership and a number of governance challenges The breadth and depth of medicines management functions are not understood at organisational level Local organisational structures are not standardised – a number of different models are becoming apparent There is a concern that the historical justification for medicines management services based on “switch” savings will not justify on- going services focussed on optimisation/quality of medicines use as savings not necessarily possible in the short term Staff redundancies are creating a loss of knowledge, continuity and expertise A lack of professional leadership for primary care medicines management is apparent

13. SUPPORT REQUIRED MOVING FORWARD? Improved/redeveloped networks National professional leadership Source of independent information on evidence on medicines use, hot topics etc.; reducing rework and helping to prioritise clinical activity Training around softer management skills – leadership, marketing etc. Improved training for primary care prescribers Improved understanding and knowledge of how to make best use of available IT systems Reporting based on wider patient information to support quality agenda More meaningful quality indicators Improved monitoring tools to support quality improvement Appraisal as to how to deliver services including community pharmacy services Focus on high risk areas to maximise resource benefits