Modernising Community Pharmacy

1
ModernisingCommunity Pharmacy

• A Strategy for Oldham 2005-7
• Ian Short
• Secretary
• Oldham, Tameside Glossop Local
  Pharmaceutical Committee

2
Topics to cover

• Update on the new pharmacy contract
• Current pharmacy services in Oldham
• Recent developments
• Action plans
• Constraints
• Performance management review

3
A Vision for Pharmacy in the new NHS

• An integral part of the NHS
• Planning and delivering local services
• Supporting self-care
• Responding to the diverse needs of patients
  communities
• A source of innovation in delivery of services
• Helping to deliver aspirations in NSFs
• Helping to tackle health inequalities

4
The new contract major themes

• Support for self-care
• Management of long-term conditions (CDM)
• Public Health health promotion plus

5
Similar to nGMS contract

• Essential Services
• Nationally funded
• All pharmacists must provide
• Advanced Services
• Nationally funded
• All pharmacists may provide
• Enhanced Services
• Locally commissioned to meet local need

6
Synergy

• Shifts emphasis from high volume to a quality
  focused, evidence based contract
• Quality framework has big incentives attached
• Enhanced services can help GPs hit QoF targets
• More flexible provision of services
• Opportunity to sub-contract services
• Developing pharmacy human resources and
  modernising infrastructure

7
Essential Services

• Dispensing
• Repeat dispensing
• Signposting
• Support for self-care
• Public health services
• Waste medication disposal
• Clinical governance

8
Advanced Services

• Medicines Use Review
• planned
• Prescription Interventions
• opportunistic

9
Enhanced Services (e.g.)

• Minor ailments
• EHC service
• Concordance services
• Care home and Intermediate Care services
• Home care services domiciliary assessments
• Smoking cessation
• Needle exchange
• Diabetes screening
• Services to schools

• Substance misuse services
• CHD screening
• Palliative care services
• Full Clinical medication review
• Out of Hours service
• Disease specific medicines management
• Head Lice
• Gluten Free food supply service

10
Sensitive Issues

• Money
• National funding partly uses savings on PCT
  drug budgets from reduced generics prices
  (recharged to PCTs)
• Pharmacy Enhanced services will compete for PCT
  funds
• Perceived threats to Traditional Rôles
• Confidentiality
• Rôle based access to medical records (and
  pharmacy dispensing records) will be required

11
Update

• Essential Services
• On track apart from Repeat Dispensing
• Additional Services problematic
• National paperwork unwieldy
• Misunderstood by GPs
• New concept for patients
• Enhanced Services
• Existing services maintained
• Expansion plans in Strategy and awaiting LDP
• Monitoring
• Detail under discussion in steering group
• LPC would prefer PCT staff to do this

12
Strategy

• PCT owned strategy
• Developed in co-operation with LPC
• Dynamic
• Working document
• Links directly to
• Primary Care Services Strategy
• SSDP
• LDP

13
National context

• White Paper Our Health, Our Care, Our Say
• Supporting People with Long Term Conditions
• NHS Plan
• Pharmacy in the Future
• Vision for Pharmacy
• NPfIT
• Practice Based Commissioning
• Pharmacist prescribing

14
Current Services

• 41 community pharmacies in Oldham
• Open retail hours including Sundays
• Rota for Bank Holidays
• Dispense prescriptions
• Provide advice sell medicines for Self-Care
• Pharmacy Needle Exchange
• Supervised Consumption of methadone
• Palliative Care drug access scheme
• Stop Smoking
• Secondary Care services inc Discharge Planning
• Unique care collaborative

15
LIFT

• Pharmacy within LIFT centres
• Integration with other Primary Care services
• Additional choice and convenience for patients
• Pharmacy in community
• Outreach
• Health promotion
• Additional choice and convenience for patients

16
A Model
Communitypharmacy
Communitypharmacy
Integrated Care Centre Pharmacy
Communitypharmacy
Communitypharmacy
Communitypharmacy
17
LIFT - concerns

• The only centre so far completed has failed to
  integrate the pharmacy at all
• LPC has not been included in the detailed
  internal planning of the ICC

18
Needs Assessment

• Minor Ailment Scheme
• Stop Smoking
• Emergency Hormonal Contraception
• Supervised Consumption (extended)
• Pharmacy Needle Exchange
• Anticoagulation monitoring
• Care Home support
• Full clinical medication review

19
Minor Ailments Scheme

• Currently a pilot in 12 pharmacies
• Includes 14 different conditions
• Assessment (Oct 05)
• 1485 patients treated during the first 11 months
• average cost 2.46
• approximately 240 GP hours saved

20
Point of Care Testing

• GMSHA Pilot
• Regular testing in pharmacy for
• Blood glucose
• Cholesterol
• Anti-coagulant status

21
NPfIT

• Community pharmacy access to N3
• Hardware now available
• Connectivity now available
• Smart cards needed
• GP buy in needed
• Electronic prescriptions coming soon?

22
Questions