Pharmacy White Paper Listening Event

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Pharmacy White Paper Listening Event

• Thursday 1st May 2008
• Holiday Inn Regents Park, London

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Introduction Welcome

• Dr Keith Ridge
• Chief Pharmaceutical Officer
• Department of Health

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Pharmacy White Paper Listening Events
Dr Keith Ridge Chief Pharmaceutical
Officer Department of Health 1st May 2008
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Press coverage
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Todays programme

• Keynote address Rt Hon Dawn Primarolo, MP,
  MS(PH)
• Overview for the workshops
• Workshop sessions
• Lunch
• NHS Employers Pharmacy White Paper
  Opportunities fotr the NHS, benefits for patients
• Workshop sessions
• Key headline feedback
• QA to panel
• Close at 4.15pm

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• Enjoy the day!

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Pharmacy White Paper Listening Event

• Thursday 1st May 2008
• Holiday Inn Regents Park, London

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Rt Hon Dawn Primarolo MPMinister of State for
Public Health
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Voting Session
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• When instructed, press the number button(s) that
  correspond with your selected answer
• Check your response in the display screen on the
  keypad
• There is no enter key required
• If you want to change your response, use the c
  key to clear and enter your new answer

KEYPADS ARE ONLY ACTIVE TO VOTE WHILE THE PROMPT
IS ON SCREEN
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• Use your keypad to write and send text messages
  (like writing a text message on a mobile phone)
• The c key will backspace/delete letters
• The 0 key is used for a space character
• When you have finished, press the large button to
  submit

ENTER UP TO 127 CHARACTERS - THERE IS NO
PREDICTIVE TEXTING
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Workshop Overview

• Jeannette Howe Peter Dunlevy

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Pharmacy White Paper Overview for the Workshops
Jeannette Howe Head of Pharmacy, Department of
Health Listening Exchange Events May 2008
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White Paper and other documents

• Published 3 April 2008
• Written Ministerial Statement to Parliament
• Press notice with supportive quotes
• Anne Galbraiths report Review of NHS
  pharmaceutical contractual arrangements
  published alongside
• Public perceptions via quantitative and
  qualitative research Community Pharmacy Use
  published on DH website
• Update of research literature, 2004 07,
  published on PharmacyHealthLink website 1 April
• Impact Assessments for 4 proposals on DH website

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Aims of the White Paper

• To set out practical, achievable programmes for
  the development of NHS pharmaceutical services.
• To mesh with the overall strategic direction for
  a fair, personalised, safe and effective NHS,
  tackling health inequalities and supporting
  healthy choices
• Showing the opportunities for pharmacy to provide
  an extended range of services
• Shifting the emphasis from dispensing to clinical
  services, utilising pharmacys skills more fully
  and
• Rewarding quality and better health and service
  outcomes for those who embrace the new contract.
• The focus is on community pharmacy services, but
  the White Paper also covers hospital pharmacies,
  dispensing doctors and appliance contractors.

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Pharmacy White Paper Chapter by Chapter

• Chapter 1 - Background
• Pharmacys role to date
• Considerable strengths on which this White Paper
  builds
• Identifies further potential for pharmacy to
  contribute
• Chapter 2 - Context
• Major health and social challenges
• NHS reform programme
• Focus on commissioning for health and well-being
• Making better use of available resources
• Need to harness new technologies
• Annex 1 - how and where pharmacy can contribute
  to the major health challenges ahead

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Chapter 3 Expanding access to medicines with
more help

• Medicines Use Reviews (MURs) - better target
  health priorities and reward health outcomes
• Greater push on repeat dispensing
• Improving the use of medicines and reducing waste
• Increasing access to medicines, including in an
  emergency and to OTC medicines in rural areas
• Pharmacists critical role in promoting safe use
  of medicines - reducing inappropriate admissions,
  ensuring integrated care
• Local health community clinical pharmacy teams

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Chapter 4 - Future service development in
pharmacies

• As centres promoting healthy living and health
  literacy, supporting self-care
• Exploiting pharmacys ready availability in more
  deprived areas to expand access to healthcare
• Offering people more choice with pharmacies being
  able to prescribe for and deal with minor
  ailments on the NHS, as first port of call,
  complementing, not replacing, role of GPs
• Providing support for people with long-term
  conditions - especially those newly prescribed a
  medicine
• Offering vascular and other screening
• Providing immunisation
• Two new pharmacist clinical directors to support
  this

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Chapter 5 Communications

• Sets out what we know about current public views
  and expectations
• Proposals to develop a communications programme
  to support delivery and to improve public
  awareness and understanding
• More research will underpin this

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Community Pharmacy Use - summary of quantitative
market research

• 84 visit pharmacy a least once a year
• 78 for health related reasons
• Adults in England visit on average 14 times a
  year
• Around 1 in 10 get health advice, but few use
  pharmacy for urgent advice
• Mainly used for prescriptions and OTC medicines
• Currently very low use of other health related
  services in pharmacies, eg health screening
• Women, those aged over 35 and those with a long
  term health condition or disability (LTC) are
  frequent users
• Majority use same pharmacy all the time. Those
  with LTC or disabilities or live in rural areas
  are more likely to visit same pharmacy

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Community Pharmacy Use - summary of qualitative
market research

• Unusual consistency of views across all
  ages/gender
• The term pharmacy is well understood
• Apparent decline in pharmacy use rooted in the
  increased availability of alternative outlets for
  medicines, not rejection of the
  pharmacy/pharmacist role per se.
• A visit to e.g. a supermarket pharmacy not
  necessarily viewed as a pharmacy visit.
• Considerable use already of pharmacists for
  advice and guidance, OTC medicines and in some
  cases tests - driven by ease of access and
  opening times
• Much more interest in making greater use of
  pharmacist for advice, minor ailments and OTC
  supplies, routine tests.
• Repeat prescribing would be widely welcomed

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Chapter 5 Relationships

• Fostering closer professional relationships
• Achieving a shared understanding of how
  respective clinical roles can help deliver more
  personalised and effective care
• A working group led by NHS Employers to formulate
  actions

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Chapter 6 Research and innovation in practice

• Proposals to stimulate more research and
  innovation
• Developing a sound evidence base for delivery
• An expert panel to advise on research priorities
• Pharmacists support for medicines RD
• Access to evidence based medicines information
• Medicines manufactured for safe medication
  practice
• Utilising information technology
• Electronic prescription service
• Access to Summary Care Record

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Chapter 7 The pharmacy profession

• Regulated as other clinical professions to
  safeguard the public and support strategic
  development of high quality practice
• Establishment of the General Pharmaceutical
  Council
• Development of strong professional leadership
• Changes in ET to underpin clinical practice
• Advanced practice as prescribers, pharmacists
  with special interests, consultant pharmacists
• Development of pharmacy technicians
• Legislative changes to support deployment of
  pharmacists clinical skills and better use whole
  pharmacy workforce, as well as new technology
• Strengthen workforce planning
• Professional standards for appliance contractors

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Chapter 8 Structural enablers and levers

• Greenest part of the White Paper
• Commissioning for excellence
• Continuous service improvements in quality and
  outcomes through evidence-based commissioning to
  meet local needs using PNAs
• Revising contractual arrangements (e.g. DES)
• Payments to reward investment in the new clinical
  direction more secure income and value for
  money
• Demonstrably high quality and safety in services
• Proposals for 100 hour pharmacies, and for market
  entry reforms for dispensing doctors and
  appliance contractors

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Chapter 9 Conclusion and action plan

• Governments programme to support and deliver
  change
• Commitment to work in partnership with all other
  health professionals, the public, and the NHS
• An action plan at Annex 2 sets out 56 separate
  actions and a timetable for progress
• Further consultation on the detail of some
  proposals
• At these Learning Exchange Events
• Later this summer through formal consultation

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Pharmacy White Paper - Summary
A blueprint for pharmacy to
How this will be delivered

• Lead on safer and more effective use of
  medicines
• Make a significant impact in promoting better
  health for all and preventing illness (e.g. more
  screening)
• Provide a clear lead for people to help care for
  themselves as well as supporting those with
  long-term conditions
• Have a central role in integrated partnerships to
  address key health inequalities (e.g. access)
• Make a significant contribution to achieving
  wider NHS goals for greater patient control,
  improved choice and local accountability.

• Alignment with the primary and
• community care strategy, setting
• out a series of structural changes
• needed including
• reforming contractual and market entry
  arrangements
• payment systems which reward quality and
  outcomes
• developing the profession and skills base
• better information on clinical outcomes and cost
  effectiveness
• closer working with other professionals (e.g.
  GPs) and
• ensuring better public understanding and
  awareness of the role of pharmacies

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Break
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Workshop Session 1You have been pre allocated
to a workshop the details are on your delegate
badge
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Lunch is being servedin the foyerPlease be
ready to start the next session at 13.30
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Welcome Back

• Dr Keith Ridge
• Chief Pharmaceutical Officer
• Department of Health

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Opportunities for the NHS benefits for patients

• Felicity Cox
• Senior Associate
• NHS Employers

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The Pharmacy White PaperOpportunities for the
NHS, benefits for patients

• Felicity Cox, NHS Employers

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NHS Employers

• Represents the NHS on workforce issues
• Also involved in negotiating primary care
  contracts e.g. GMS
• We negotiated changes to the arrangements for
  dispensing doctors as part of the 2006 / 07 GMS
  contract
• Will help to shape implementation of the White
  Paper and will lead discussions with
  pharmaceutical, medical and public
  representatives on some key policy proposals

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NHS Employers and community pharmacy

• Community pharmacy team
• Reference group
• Developed a response to Anne Galbraiths review
• Have continued discussions with the DH about NHS
  and community pharmacy
• Further developing relationships with PSNC

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Our Vision

• Community pharmacy should be viewed as an
  important part of primary care capacity and
  capability
• Community pharmacists could be important primary
  care providers
• We should make use of the professions clinical
  capacity
• Pharmacy should be commissioned as part of the
  overall primary care strategy

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What else is happening in the NHS?

• Darzi Our NHS, Our Future
• The Primary and Community Care Strategy
• World Class Commissioning
• IT

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The White PaperSome real wins for the NHS

• Repeat dispensing
• Reducing wastage
• Professional relationships
• Quality
• Patient safety
• Improvements to MURs
• Pharmacy at the heart of the community

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Repeat dispensingSome good practice

• Joint working between GPs and Pharmacists
• PCT support
• Link with other priorities e.g. QOF
• PBC and linking in with prescribing measures
• Practice champions
• Practice training

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Reducing waste

• Communication from and to patients and carers
• Not dispensed scheme to advise GPs of medicines
  not dispensed and to prompt more discussion
  between Pharmacist and patient
• Reducing the use of specials
• Benefits of reducing the supply of medicines not
  needed
• Improved clinical record of medicines being used
• More resources available for patient care
• Reduced risks to patients and professionals

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Reducing WasteAn integrated programme
Not dispensed scheme
Medicines Use Review (MURs)
Repeat dispensing
Medication review by GPs
Publicity campaign Engaging
supporting patients
Local Involvement Networks (LINKS) public
engagement support
Repeat prescribing optimising processes with
practice staff
Dispensing Review of the Use of Medicines by GP
dispensary staff
Reducing use of specials where possible
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The White PaperBuilding the role of Pharmacists

• Reaffirm pharmacists position as experts in
  medicines and ensuring patient safety
• Pharmacy and long-term conditions management
• Pharmaceutical care for older people
• Supporting independent living
• Increased public health role
• Supporting self care

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The White PaperSome work for us!

• Medicines use
• Professional relationships between hospitals and
  community pharmacies and between community
  pharmacy and general practice
• Extending the services provided in community
  pharmacy (including the introduction of minor
  ailments schemes)
• Commissioning issues
• Quality and safety
• Dispensing doctors

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Extending servicesContractual options

• Essential services
• Advanced services
• Directed Enhanced Services (DES)
• Local Enhanced Services (LES)

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Dispensing doctors

• Market entry arrangements considered as part of
  the consultation on elements of control of entry
• The White Paper states that changes to control of
  entry may be linked to allowing dispensing
  practices to sell over-the-counter medicines

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Whats next

• Mandate development
• How we can use the community pharmacy contractual
  framework to deliver the vision of White Paper
• How we can ensure PCTs have the other mechanisms
  and vision to deliver the White Paper

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Contact us

• Sarah Bridger
• sarah.bridger_at_nhsemployers.org
• Taryn Harding
• taryn.harding_at_nhsemployers.org

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Workshop Session 2 You have been pre allocated
to a workshop the details are on your delegate
badge
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Pharmacy White Paper Listening Event

• Thursday 1st May 2008
• Holiday Inn Regents Park, London

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Key HeadlineWorkshop Feedback
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Questions to Panel Interactive Voting Session
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Close and Next Steps

• Dr Keith Ridge
• Chief Pharmaceutical Officer
• Department of Health

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Please leave your badge at the desk for recycling
on your way out
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Pharmacy White Paper Listening Event

• Thursday 1st May 2008
• Holiday Inn Regents Park, London