Prime Ministers Challenge Fund “Together for the health of Halton ” Community Pharmacy and General Practice joint event 10 th September 2015 HALTON, ST HELENS & KNOWSLEY LOCAL PHARMACEUTICAL COMMITTEE
Jan 02, 2016
Prime Ministers Challenge Fund“Together for the health of Halton”
Community Pharmacy and General Practice joint event
10th September 2015
HALTON, ST HELENS & KNOWSLEYLOCAL PHARMACEUTICAL COMMITTEE
Running order
• Welcome • Overview of the PMCF • The pharmacy scheme – the vision and aims• View from the LPC• Specifics of the scheme• Plenary
• Opportunity for Q&A throughout
Overview of the PMCF
Rob FosterPMCF Programme Lead
HALTON, ST HELENS & KNOWSLEYLOCAL PHARMACEUTICAL COMMITTEE
Overview of the PMCF
• National initiative• Aims are to:– improve access to general practice;– develop a more integrated approach to providing
general practice and wider out-of-hospital services; – develop more innovative ways for people to access
and relate to general practice. • Non recurrent money• Delivery in 2015/16
Overview of the PMCF
• Building on Halton General Practice Strategy• “Together for the health of Halton”• 8 schemes totalling £1.548m• 5 patient facing schemes – blend of:– Improving access;– Alternative access;– Reducing demand
• Pharmacy input/influence in a number of areas
Overview of the PMCF
• GP/Practice leads for all schemes• Focus and consideration on sustainability– Impact and evaluation critical
• Joint working• Using money where possible as an investment to achieve
longer term benefits• All schemes are pilots – opportunity to develop and test
approaches and gain evidence of update, benefits and impact
• Opportunity to gain patient and public feedback• Consider future investment…and funding
PMCF and pharmacy – CCG perspective
Dr Claire FordeCCG Clinical Prescribing Lead
HALTON, ST HELENS & KNOWSLEYLOCAL PHARMACEUTICAL COMMITTEE
PMCF and Pharmacy - CCG Perspective
Why did we include community pharmacy projects in the PMCF bid?• Very accessible clinical resource • Underutilised clinical skills• Can help improve access within GP practices • Links to self-care agenda• Already commission services which we need
to build on
But also…
• Pharmacists can massively contribute to improving the health of our patients
• Need to improve engagement and relationships• Desire to work collaboratively to develop services• Recognise community pharmacy as an essential
part of the primary care team• Feel more involved with the CCG• Ultimately a common goal – a healthier population
Our Vision
• This is just the start – it will develop further over time (probably years)
• Openness and transparency• Collaboration to ensure we commission effectively• Build trust and confidence• Build a common future vision – together• Improved joint working with our GP practices to
improve clinical outcomes for our patients• Improved communication and engagement
View from the LPC
Kath Gulson – Chair Bertha Brown – Chief Officer
HALTON, ST HELENS & KNOWSLEYLOCAL PHARMACEUTICAL COMMITTEE
Opportunity for GPs and Community Pharmacists to work
more closely together
• Improve patient choice• Improve patient access• Build better relationships with other
healthcare professionals
Joint approach
• PMCF project lead• GP lead• CCG medicines management lead• LPC chief officer• LPC chair
Journey So Far
• Rob came to LPC meeting March 2015• Meeting to discuss options• Recruitment• Tonight
Benefits of providing services in pharmacy
• Reduce pressure on GP services• Improved access with extended opening times• Reach those people who rarely set foot in GP
surgery• People with long term conditions speak to
pharmacy once a month when ordering or collecting repeat prescriptions
• Increased choice for patients
Pharmacy is easy to access
• Range of pharmacies• No appointment • Extended hours• Nationally 84% people visit a pharmacy every
year• Nationally 96% of people can access a
pharmacy within 20mins by walking or using public transport
Proposed services
Respiratory• asthma in schoolchildren• COPD respiratory reviews in adults
Blood Pressure Measurement• To include AF detection• Identify people with undiagnosed hypertension• Referral to pharmacy for routine BP measurement
Improvements to Care at the Chemist
Opportunities for pharmacies
• Services pharmacy wants to deliver• Fair remuneration• An opportunity to influence and shape the
development of those services• To make a real difference to the patient• Good data collection and evaluation of services
will provide a good evidence base to prove the value of the service locally and influence future commissioning
ChallengesThings to think about
• Time management – appointment/ad hoc • Use of team and training• Consultation room• Support those delivering the service
Not currently available to all pharmacies
Data Collection
Electronic reporting via PharmOutcomes• Real time information for the CCG• Help evolve the project• Demonstrate outcomes• Provide evidence for project evaluation• Support prompt payment for pharmacies
GP PMCF projects
E consultations
Referral to pharmacy is part of e-consultation1. For self care2. For services such as care at the chemist
The schemes
Lucy ReidMedicines Management Lead
NHS Halton CCG
HALTON, ST HELENS & KNOWSLEYLOCAL PHARMACEUTICAL COMMITTEE
PMCF Pharmacy Projects – Project Development Group
• Lead Pharmacist NHS Halton CCG – Lucy Reid• CCG GP Clinical lead for Medicines
Management• LPC – Bertha Brown/Kath Gulson• 2 Project Managers– Lisa Allman – Senior Pharmacist– Gareth Rustage – Senior Technician
• CCG GP Clinical Lead for IM&T
What are they?Respiratorya) Schools Asthma Education projectb) COPD Support ServiceMonitoring/Screeningc) Blood Pressure Testingd) AF ScreeningSelf-caree) Minor Ailments Service Education
Key Principles for All Schemes
• Fair remuneration• Training to be provided• Awareness raising/patient materials – joint approach with
CCG• Engagement with local GP practices – joint approach with
CCG• IT support to improve communication with GPs re:
outcomes of interventions• Things will develop over time!• Robust evaluation and ongoing feedback vital • Recording via PharmOutcome
1a) Schools Asthma ProjectAims
• To provide a pharmacy-led education session in schools that will contribute to a measurable improvements in inhaler technique, adherence, and associated health outcomes
• To assess, and if necessary improve, inhaler technique for each child or young person (CYP) during a school-based pharmacy-led workshop
• To show an improvement in quality of life – in terms of symptoms, activity limitation and emotional function – at follow-up
• To assess, and increase if necessary, the self- and/or parent-reported adherence of CYP to their asthma therapy
• To increase the confidence of CYP, parents and teachers in the use of inhalers
• To provide improved asthma awareness for all CYP• To ensure clear communication with schools, parents, GPs and CYP
The Sessions• Fun and interactive• Targeting children in years 4-5 (8-10 year-old
students) and years 9-10 cohort (13-15 year-old students)
• Mix of primary and secondary schools• Up to 4 pharmacies to deliver this project • Initial session approx. 1 hour (depending on age
group and advice from schools)• Follow up session/meeting with the school approx.
8 weeks later• Could focus on only those with asthma or all
children in that class/year group
1b) COPD Support ServiceAims– To support patients with diagnosed COPD to get the most from
their respiratory medicines through improved understanding, adherence and technique.
– To improve quality of life and confidence to get involved in additional activities as a result of feeling better.
– To reduce exacerbations and reduce avoidable admissions for COPD patients.
– To support the optimal use of rescue packs (antibiotics and steroids)
– To support the development of patient COPD self-management plans alongside local GPs and practice nurses.
The scheme- Pharmacist reviews within the community pharmacy
setting - Will be required to perform a specific number of reviews
over 6-9 months per pharmacy- Follow-up reviews needs to be included - Approx. 6 pharmacies to deliver this pilot- Assessment of Inhaler technique required- Development of patient resources – jointly with CCG/LPC- Actively review and manage rescue packs in conjunction
with the GP- Communicate back to GP outcome of review so can be
recorded in notes
2a) BP Testing• More pharmacies can potentially get involved• Routine monitoring of BP for patients on specific medications
or conditions• Improved access to routine BP testing for patients – evenings
and weekends, wont need to take time off work• Referrals from GPs – if patient chooses (saves GP/PN time)• Communication direct back to GP to record in patient notes• Accreditation for pharmacists to ensure confidence in service• Support management of patients on oral contraceptives? • Support management of stable hypertensive patients• Equipment funded by PMCF scheme
2b) AF screening• Small number of pharmacies to be involved• Links to pilots possibly being done in GP practice• CCG priority to improve diagnosis of AF• Improved access for patients – evenings and weekends• Accreditation for pharmacists to ensure confidence in service• Equipment funded by PMCF scheme
Self Care
Minor Ailments Service – Pharmacist Education- CPPE education (Assessment and
Management of urgent cases)- Shadowing UCC staff- Specific therapeutic area sessions from A&E or
UCC clinicians- Face to face group sessions rather than e-
learning