Community Pharmacy: local healthcare. Gill Hall Service Development Office South Staffs LPC

Size: px

Start display at page:

Download "Community Pharmacy: local healthcare. Gill Hall Service Development Office South Staffs LPC"

Gyles Byrd
5 years ago
Views:

1 Community Pharmacy: local healthcare Gill Hall Service Development Office South Staffs LPC

2 Pharmacy and the NHS Pharmacies are independent contractors Each pharmacy enters into a contract with the NHS Market entry test linked to PNA and JSNA Three tiers of pharmacy service - Essential services all pharmacies provide - Advanced services all pharmacies can provide - Locally commissioned services - commissioner may choose geography - pharmacy can apply to offer service

Pharmacy stats Over 11,500 pharmacies in England situated in high-street locations, in supermarkets and in residential neighbourhoods Independents (1-5 pharmacies) 38% Multiples (6+

3 Pharmacy stats Over 11,500 pharmacies in England situated in high-street locations, in supermarkets and in residential neighbourhoods Independents (1-5 pharmacies) 38% Multiples (6+ pharmacies) 62% 134 pharmacies in South Staffs LPC Area 36 pharmacies in South East Staffs CCG area 12 pharmacies in Seisdon Most pharmacies have at least one private consultation area

4 Use of Community Pharmacies 99% of the population even those living in the most deprived areas can get to a pharmacy within 20 minutes by car and 96% by walking or using public transport An estimated 1.6 million visits take place in England every day. Approximately 1.2 million of these are for health-related reasons Women, those aged over 35 and those with a long term health condition or disability are frequent users

5 Pharmacy First Services Common Ailments UTI Impetigo Emergency Supply

6 NHS Pharmacy First Common Ailments Service Aims to reduce the following: Patients attending GP surgery to get Rx for a free simple medicine Taking up GP appointment better used for others with more serious condition Avoid patients attending OOH or A&E for simple conditions Pharmacy opening hours mean long availability Free up GP, OOH appointments and A&E availability Cost implications OOH and A&E attendances charged back to CCG Simple service cost effective

7 NHS Pharmacy First Common Ailments Service Service was first commissioned in Stoke Now commissioned by NHSE and all 8 CCGs in Staffordshire and Shropshire Available only to those exempt from prescription charges Can t collect in advance of illness Not intended to swap OTC sale to free supply Those not able to access free meds still get advice and can purchase medication

8 NHS Pharmacy First Common Ailments Service Patients can self-refer or be referred from GP practice, NHS111, word of mouth etc Under 16s need to have parent/guardian to sign Patient usually needs to attend in person New terms of service allow prof judgement BUT usually patient has to attend

9 NHS Pharmacy First Common Ailments Service Can t ask for a medication by name GP or practice team can t refer as go and ask for drug x. Need to refer them in to ask for advice for their health issue If see GP they will probably get a prescription, in exceptional circumstances GP can refer to get medicine BUT have to have full pharmacy consultation

10 NHS Pharmacy First Common Ailments Service When not to supply Ask by medicine by name No supply to staff/immediate family members Using instead of ordering a repeat prescription Lost first lot of medicine supplied under scheme

11 NHS Pharmacy First Common Ailments Service List of conditions covered by service Individual can only access up to 2 or 4 times per year Live recording of all supplies using an on-line system Pharmacies can see all that patients supplies Pharmacy to report suspected fraudulent use

12 NHS Pharmacy First Common Ailments Service Bites and Stings Chickenpox Colds/Flu-like symptoms/nasal Congestion Cold Sores Conjunctivitis (acute bacterial) Constipation (acute) Cough Cystitis Dermatitis/Dry Skin/Allergic Skin Rash Diarrhoea (Acute) Earache Fever management Fungal skin infections Hay Fever (seasonal allergic rhinitis) Haemorrhoids Headache/Migraine Heartburn/Indigestion Infant colic Mouth Ulcers Nappy rash Oral Thrush Scabies Sore Throat Sprains and Strains Teething Threadworms Vaginal Thrush Warts and verrucas

13 NHS Pharmacy First UTI and Impetigo PGD Service Commissioned by NHSE and all 8 CCGs in Staffordshire and Shropshire Available only to those who meet inclusion criteria pharmacist must see patient UTI females 16 to 74 years of age Impetigo in all ages Service Charges: If exempt from prescription charges free If pay for prescriptions pay NHS levy

14 NHS Pharmacy First UTI and Impetigo Service Available from accredited pharmacies Delivered by accredited pharmacist Supply strictly controlled by a Patient Group Directive (PGD) Supply antibiotics to suitable patient GP practice informed via PharmOutcomes Highly effective where GP practice refer patients in Can help free up GP appointments Can help avoid walk-in centre, OOH and A&E attendances

15 NHS Pharmacy First Emergency Supply Service Available from many pharmacies Available during all opening hours of pharmacy Originally only after 6pm, weekends, bank holidays Can supply even when practice is open if no chance of FP10 Pharmacy can supply up to 14 days medication Quantity will depend on drug requested and pharmacist s professional judgement CDs not allowed Patient pays NHS levy for each item / signs exemption GP practice informed via PharmOutcomes PharmOutcomes message is NOT prescription request

16 Patient Facing Website

17 Patient Facing Website

18 Patient Facing Website

19 Patient Facing Website

20 Patient Facing Website

21 Patient Facing Website

22 New Patient Facing Website

24 Electronic Prescription Service EPS Tracker GP and pharmacy can see where script is in system Downloadable even if practice is closed Reduces lost prescriptions Very successful in areas already using it Need to manage patient expectations Pharmacy has to download prescription (hundreds can arrive at once!) Pharmacy still has to get the medicine ready

25 Repeat Dispensing (Batch prescriptions) Electronic repeat (batch) dispensing Only use for stable patients GP stays in control Sets treatment duration, frequency of script etc If set up correctly - allows early supply to cover holidays etc Items can be cancelled at practice if necessary Practice can see what has been issued Pharmacy MUST ask are all items needed today has anything changed with you Authorisation stays centrally on electronic system patient can switch pharmacy eg if move house

26 Medicine Use Review (MUR) Medicines MOT? Face to face with patient in consultation room Find out what the patient knows about their medication Find out if the patient is taking their medicines as prescribed (or at all)

27 NHS Medicine Use Review (MUR) Try to identify if patient has any problems with their medicines or possible side effects Report to patient s GP where necessary Each pharmacy can do 400 NHS MURs / year 70% to be delivered to patients in target groups

28 NHS MUR service target groups High risk medicines NSAIDs Anticoagulants Antiplatelets Diuretics Respiratory disease Asthma COPD Cardiovascular disease Must be on at least four regular medicines Post-discharge from hospital Help prevent re-admission Project with Queens, CCG, LPN and LPC

29 What sort of problems come to light during an NHS MUR? Name of the medicine? What they are for? When to take their medicines? How to take their medicines? How long to take medicine for? Stopped taking them? Suffering from side effects of medicines? How to order medicines? Problems may be due to language issues or lack of understanding? Practical issues such as getting into medicine containers?

30 Helping to find a solution Opening containers Request non CRC tops Tablets in foil not bottles? Remembering when to take a medicine Link to daily activity i.e. getting up, having breakfast Store medicines in a place that acts as a reminder i.e. beside the kettle Make a reminder chart / Use a tick box system Vision problems Language Issues English not first language Difficulty reading Cultural Issues Fasting during Ramadan?

31 NHS New Medicine Service (NMS) It s all about helping patients to get the most from their newly prescribed medicine 25% meds for Long Term Conditions not taken as prescribed Around 15% patients take few, if any, doses of new medicine Problems with new meds: Appear rapidly Widespread Large numbers of patients on long-term meds quickly become nonadherent

32 NHS NMS outline service spec Three stage process 1. Patient engagement (day 0) 2. Intervention (approx. day 14) 3. Follow up (approx. day 28) Follows the prescribing of a new medicine for: Asthma or COPD Diabetes (Type 2) Antiplatelet / Anticoagulant therapy Hypertension

33 The NMS story so far 94% of pharmacies providing the service Provided to 2million+ patients so far Initial research showed An extra 10% patients taking medicines as prescribed as result of NMS An increase in the number of medication problems identified and dealt with

34 Questions & Discussion More information on community pharmacy services at Contact Gill Hall at:

Supporting Self Care Choose Pharmacy Common Ailments Service GP Practice Guide

Supporting Self Care Choose Pharmacy Common Ailments Service GP Practice Guide Contents Section 1: Introduction Section 2: Service Information Section 3: Conditions to be Treated Section 4: Referrals &