PHARMACISTS WITH SPECIAL INTERESTS PhwSIs THE POLICY CONTEXT

1
PHARMACISTS WITH SPECIAL INTERESTS (PhwSIs)THE
POLICY CONTEXT

• November 2006
• Jeannette Howe
• Head of Pharmacy
• Department of Health

2
Drivers for change

• Public service reform
• Our health, our care, our say White Paper
• System reform
• Practice based commissioning
• New contracts for GPs, dentists etc
• OFT report
• A Vision for Pharmacy
• Choosing health through pharmacy

3
Health Reform Framework
Transaction
Incentives and tariff Information and
benchmarking
Demand side
Supply-side
Choice and Commissioning
New providers and competition
Better Care Better patient experience Better
value for money
System Management Regulation
Targets, Institutions and Regulation
4
White PaperOur health, our care, our sayA new
direction for community services

• More services closer to where people live
• Supporting independence well-being
• Supporting choice giving people a say
• Supporting people with high levels of need
• Sustained realignment of health social care
  system

5
Our health, our care, our sayBetter access to
community services

• Improving urgent access
• Rapid access to sexual health services EHC,
  chlamydia testing
• Improving immunisation services
• Rapid access to mental health services
• Making better use of community pharmacy services

6
Our health, our care, our sayCare closer to home

• Specialist care more locally dermatology, ENT,
  general surgery, orthopaedics, urology,
  gynaecology
• Demonstration sites evaluation
• Shift resource reflect in Local Delivery Plans
  for 2008 planning round
• Accessible community facilities
• Service reconfiguration
• Flexibility to unbundle the tariff for
  diagnostics post-acute care

7
Our health, our care, our sayCare closer to
home

• Currently there are nearly 45 million
  outpatient appointments every year in England.
  Estimates vary by specialty, but for some
  specialties up to half of these could eventually
  be provided in a community setting.

8
Our health, our care, our sayCare closer to home

• Specialist care more locally dermatology, ENT,
  general surgery, orthopaedics, urology,
  gynaecology
• Demonstration sites evaluation
• Shift resource reflect in Local Delivery Plans
  for 2008 planning round
• Accessible community facilities
• Service reconfiguration
• Flexibility to unbundle the tariff for
  diagnostics post-acute care

9
Our health, our care, our sayCare closer to
home

• Spend 27 of NHS budget on primary care
  services, compared with an OCED average of 33

10
Our health, our care, our sayEnsuring reforms
put people in control

• Responsive services new providers, including
  pharmacists wanting to establish or expand
  services
• Effective commissioning national commissioning
  framework, guidance
• Practice based commissioning
• Restructuring and role of PCTs
• Engage public strong local voice, single
  complaints system, better use of surveys

11
Our health, our care, our sayMaking sure change
happens

• High quality information about peoples
  conditions services available
• Assessment of quality accreditation of primary
  care practices and providers revalidation of
  professionals
• Steamlined joined up regulation
• Clinical governance patient safety
• Developing the workforce advanced
  practitioners, PwSIs, joint NHS LA service
  workforce planning

12
A Vision for Pharmacy in theNew NHS

• New community pharmacy contractual framework
• As well as nationally determined essential and
  (advanced) services, we want to facilitate local
  PCT commissioning of (enhanced) services.

13
A Vision for Pharmacy in theNew NHS

• Pharmacists with special interests
• We will consider a scheme to designate
  pharmacists with a special interest so that
  those providing services using particular
  expertise can be appropriately recognised.

14
Current Community Pharmacy Contractual Framework

• Essential Services (all - mandatory)
• Dispensing repeat dispensing, EPS DDA
• Promotion of healthy life styles
• Self care
• Sign-posting to other services
• Disposal of waste medicines
• Clinical governance
• Advanced Services (voluntary)
• Medicines use review (MURs)
• Accredited pharmacist pharmacy

15
Current Community Pharmacy Contractual Framework

• Enhanced/Local Services
• PCT commission to meet local needs
• Some widespread, others not
• Eg Minor ailment schemes
• Supervised methadone/needle exchange
• Anticoagulant monitoring
• Stop smoking schemes
• Clinical medication review
• Disease specific medicines management
• Pharmacist prescribing

16
Pharmacists with SpecialInterests Commissioning
options

• Range of options, including
• Community pharmacy contract - enhanced services
• Primary medical care contracts nGMS (eg
  pharmacist partner), APMS

17
Lord Warner, MS(R) Extractfrom recent speech

• As a Government we are therefore less concerned
  about which contracting routes are used to secure
  high quality primary care services, but that you
  move service delivery forward not to accept what
  has gone before as satisfactory as that might
  be but to seek out continuing enhancement in
  the services patients receive and how they access
  these services.

18
EXPERT PHARMACISTS GET THE GO-AHEAD

• Pharmacists with Special Interests to offer
  care and advice about diabetes, STIs and
  long-term conditions on patients doorsteps.
• Patients with long-term conditions will soon be
  able to manage their diabetes or heart disease
  when they pop to the shops thanks to a new breed
  of expert pharmacists, Health Minister Andy
  Burnham announced today.
• 4 September 2006

19
Pharmacists with SpecialInterests Conclusion

• Address NHS priorities - health improvement and
  long term conditions
• Care closer to home
• Service redesign
• Focus on commissioning PbC
• Utilise pharmacists clinical skills and location
• A timely additional option