New models of care. Rena Amin BPharm, MSc, IPresc, FRPharmS

Transcription

1 New models of care Rena Amin BPharm, MSc, IPresc, FRPharmS

2 About Me NHS Greenwich Clinical Commissioning Group The Woolwich Centre, 35 Wellington Street, Woolwich SE18 6ND Greenwich CCG 2013 Joint Associate Director, Medicines Management, NHS Greenwich CCG Clinical Associate/ Managing Partner, Hartland Way Surgery Fellow of Royal Pharmaceutical Society Member of Royal Pharmaceutical Society s Innovator Forum Deputy Chair, PCPA (Practice Pharmacists Group) Member of the editorial board, Pharmacy Management Journal

3

4 Why now. Models of care

5

6

7 Why is there a crisis?? Decades of underinvestment in primary care

8 Challenges Increasing workload Huge focus on optimisation of long term conditions/ AE attendance avoidance Increasing pressure on budgets Shift of more complex medicines into primary care Increasing litigation Recruitment and retention issues Lack of sustainable workforce development for the medical and nursing professions and solution

9 So what are these new models of care? A&E NHS 111 Care homes Federated role Public health Phase 1 NHS E clinical pharmacists Plus many more.

10

11 NHS England announces additional investment into general practice NHS England has published its General Practice Forward View (GPFV), which includes an additional investment of 2.4bn a year by , taking the total annual investment for primary care to 12bn. It also confirms a 112m investment to create new roles for pharmacists in general practice.

12 What opportunities are there for this role to expand and grow..

13

14 Matrix working = generalist pharmacist? Traditional role Multispecialty role Focussed role

15 Things to consider. Whilst commissioning the services (multidisciplinary commitment) Risk assessment and business planning SLA/audit and results Governance framework Scope of practice Database management Clarify indemnity issues Reporting of SUI CPD /PDP /appraisals/ organisational Ed &T planning

16 Well a lot can be done.. Pharmacist can improve health outcomes Optimisation of LTC Expertise in advanced clinical roles Cardiology, COPD, Asthma Pharmacist can deliver patient centred services Medicines optimisation, QOF Increasing tendency to work together in multi-professional teams Unplanned admissions DES Improve Access in primary care Extended hours and workload implications Growing expectation from patients that they will experience a seamless service Discharge from hospital, intermediate setting

17 My clinical contribution Patient who are supported with shared care Inaccurate diagnosis/ data quality/governance issues Differential diagnosis Complex/resistant to treat patients Medicines optimisation for LTC Proactive case finding Sign posting/referral to MDT Referral for nonpharmacological interventions Support hospital avoidance/emergency attendances

18 Outcomes from a practice based pharmacist role. 1. Access 2. Financial sustainability 3. Improved quality & achievement of KPIs 4. Medicines optimisation 5. Increased patient satisfaction / experience 6. Holistic team approach -> Avoid duplication -share workload 7. Improve communication -> share stress, better morale and work outputs

19 Improving patient care Overall summary Letter from the Chief Inspector of General Practice We carried out an announced comprehensive inspection. Overall the practice is rated as good. We saw one area of outstanding practice The practice had an in-house pharmacist who was trained as a clinical associate; they ran regular medicines review clinics for patients with long term conditions and also reviewed medicines for patients who had unplanned admissions to ensure safe prescribing. We saw evidence of many cases where the pharmacist had challenged the prescription of medicines from secondary care and had changed them as a result. Accountable person Dr Anna Ingram Registered Manager Mrs Rena Amin Registered Manager

20 Links with hospital and community pharmacists Smoking cessation NMS/MURs Influenza vaccination MI queries Supply issues Unlicensed medication Off formulary queries Discharge queries/admission queries Reablement support OTC prescribing/self care agenda Out of hours support with medicines access and deliveries

21 Impact analysis of this new model Pros New role/career progression Challenging/exciting Enhance patient care MDT working Focused (LTC/minor ailments etc.) Tangible Growing opportunities Isolation Cons Lack of direction Threatening environment Lack of job stability Pigeon holed into older traditional roles Conflict of interest Difficulty in accessing professional development

22 In summary Grab the opportunities Pave the way for future generations We are a versatile profession Austerity creates innovation Accept accountability and become autonomous Take action.

23

24 Any questions??