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Pharmacy funding Where are we now and what next Department of Healths view Reaction from the profession Reaction from the press The LPCs plan Agenda INTRODUCTION The role of community pharmacy ID: 599053

community pharmacy health care pharmacy community care health nhs pharmacies medicines proposals patients patient support service psnc services public

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Slide1

Tees LPC

Pharmacy funding

Where are we now and what next?Slide2

Department of Health’s view

Reaction from the profession

Reaction from the pressThe LPC’s plan

AgendaSlide3

INTRODUCTION

The role of community pharmacy

Community pharmacy already plays a vital role in:

- Dispensing medicines

- Advising on medicines use

- Promoting good health and supporting the prevention

agenda

- Supporting people to look after themselves

But it could play an even greater role, as part of more

integrated local care models, in:

- Optimising medicines usage

- Supporting people with long term conditions

- Treating minor illness and injuries

- Taking referrals from other care providers

- Preventing ill health

- Supporting good health

Key facts and figures

1.6 million

visits to community pharmacy every

day, of which 1.2 million are for health reasons

Around

1 billion

medicines dispensed incommunity pharmacy every year

£8 billion spend every year in primary care onNHS medicines

2.5% current yearly rate of prescription growth

Medicines optimisation

Up to half of patients don’t use medicines in theway intended; many are simply thrown away

1 in 7 over 75s are admitted to hospital becauseof incorrect medicines use

70% of people in care homes may be at risk frommedication errors

DH - Leading the nation’s health and care

9Slide4

PHARMACY AT THE HEART OF THE NHS

Pharmacy at the heart of the NHS

The vision is for community pharmacy to be integrated with the wider health and social care system. This will

help relieve pressure on GPs and Accident and Emergency Departments, ensure optimal use of medicines, and

will mean better value and patient outcomes. It will support the promotion of healthy lifestyles and ill health

prevention, as well as contributing to delivering seven day health and care services.

- Pharmacists enabled to practise more clinically - irrespective of setting and including in community pharmacy

- and optimising medicines in a way which puts patients at the centre of decision making, with regular

monitoring and review.

- Clinical pharmacists in GP practices, able to prescribe medicines and working side by side with GPs, supporting

better health and prevention of ill-health.

- Clinical pharmacists working in care homes, working with residents and staff to make the most of medicines.

- Clinical pharmacists helping patients who have urgent problems, at the end of the phone - for example via the

111 service or on the internet.

- Easier for patients to get their prescriptions, for example via the internet where a patient feels this would be

more convenient for them.

- Pharmacists freed up to support patients to make the most of their medicines, promote health and provide

advice to help people live better, harnessing the skills of the wider pharmacy team to support and deliver high

quality patient centred health and care.

The direction of travel around strengthening clinical practice and medicines optimisation is in keeping with what is

expected of hospital pharmacy.

DH -

Leading the nation’s health and care

10Slide5

EFFICIENCY IN COMMMUNITY PHARMACY

NHS funding for community pharmacy

Amount (£ million)

- The NHS has committed £2.8bn

in

2015/16 on remuneration funding

for community pharmacy.

- £2bn in fees and allowances, with

a further £800m distributed

through margin on drug

reimbursement.

1.4% 0.9%

4.3% 4.9%

13.5%

43.5%

31.7%

Practice payments (£633m)

Dispensing fees (£869m)

Directed Medicines Use Reviews and

other advanced services (£86m)

Electronic prescription allowance (£28m)

Repeat dispensing annual payments

(£17m)

Special fees and other allowances (£97m)Establishment payments (£270m)

- The median average pharmacy receives £220,000 a year in NHS fees and allowances (including

margin).

- In the context of the NHS needing to deliver £22 billion in efficiency savings by 2020/21, we haveto examine community pharmacy and the contribution it can make to this challenge.

DH - Leading the nation’s health and care

13Slide6

EFFICIENCY IN COMMUNITY PHARMACY

Efficiency in community pharmacy

14,000

- There are 11,674 pharmacies in England (at

31 March 2015 )

This is an almost 20%

increase since 2003

, when there were 9,748

.

-

The NHS funds this growing estate while

there is low uptake of digital channels

- out

of step with how other public sector services

have developed over the past 10 years .

-

40% of pharmacies are in clusters of 3 or

more meaning that two-fifths of pharmacies

are within 10 minutes walk of 2 or moreother pharmacies, each being supported by

NHS funds.

- Technology is increasingly being used to

assemble prescriptions, in individual

pharmacies, in small hubs by small groups,and by large organisations, but the current

rules mean some forms of technologycannot be accessed by all pharmacies.

12,00010,000

8,0006,000

4,000

2,0000

2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15Number of community pharmacies Average monthly items per pharmacy

Number of pharmacies and average monthly items dispensed in England, 2003-2015

Source: Prescriptions Dispensed in the Community, Statistics for England - 2003-2013 [NS]

DH -

Leading the nation’s health and care

14Slide7

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Remuneration funding for community pharmacy in 2016/17

Spending on health continues to grow, and the Spending Review announced a £10 billion real terms increase in NHS

funding in England between 2014/15 and 2020/21, of which £6 billion will be delivered by the end of 2016/17. In

the Spending Review, the Government also re-affirmed the need for greater efficiency and productivity, and the

need for the the NHS to deliver £22 billion efficiency savings by 2020/21, as set out in the NHS’s own plan, the Five

Year Forward View. Community pharmacy must play its part in delivering those efficiencies.

The Government believes these efficiencies can be made without compromising the quality of services or public

access to them because:

-

there are more pharmacies than are necessary to maintain good patient access

-

most NHS funded pharmacies qualify for a complex range of fees, regardless of the quality of service and levels

of efficiency of that provider

- more efficient dispensing arrangements remain largely unavailable to pharmacy providers

In 2016/17, the total funding commitment for pharmacies under the community pharmacy contractual

framework (essential and advanced services) will be no higher than £2.63bn, compared to £2.8bn in 2015/16.

The Government is consulting on proposals to realise its objective of a more clinically focussed, modern and

efficient pharmacy sector, delivered within the £2.63bn of funding under the Community Pharmacy Contractual

Framework.

DH -

Leading the nation’s health and care

15Slide8

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Proposals for change in community pharmacy

17 December 2015 marked the start of our consultation with the PSNC, other pharmacy bodies and others,

including patient and public representatives, on changes to community pharmacy, achieved within the £2.63bn

funding cap described previously.

Our aim is that these changes will:

- Integrate community pharmacy and pharmacists more closely within the NHS, optimising medicines use

and delivering better services to patients and the public.

- Modernise the system for patients and the public - making the process of ordering prescriptions and

collecting dispensed medicines more convenient for members of the public by ensuring they are offered

a choice in how they receive their prescription.

- Ensure the system is efficient and delivers value for money for the taxpayer.

-

Maintain good public access to pharmacies and pharmacists in England.

The following slides provide more information on our proposals to achieve these objectives on which we would

welcome your views.

DH -

Leading the nation’s health and care

16Slide9

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Bringing pharmacy into the heart of the NHS

Pharmacists’ skills make them invaluable to patients and the public, but too often those skills are not used effectively,

resulting in avoidable hospital admissions, medicines wastage and sub-optimal care. NHS England has taken important steps

to integrate pharmacy into the NHS and the Government would like to make further progress.

We will work closely with the PSNC, other pharmacy bodies and others, including patient and public representatives, on how

best to introduce a Pharmacy Integration Fund (PhIF). This will be the primary means of driving transformation of the

pharmacy sector to embed medicines optimisation and the practice of clinical pharmacy in primary care, bringing clear

benefits to patients and the public.

The proposal for year one will be to focus particularly on the key enablers to achieve integration of community pharmacy. It

will be spent primarily on supporting the deployment of clinical pharmacists in a range of primary care settings, including GP

practices, multi-speciality community providers, urgent care hubs, care homes and NHS 111. We believe this will be

fundamental to fully integrating community pharmacy into the NHS through the creation of clinical and professional links to

community pharmacists, together with referral pathways. In addition, it is envisaged the fund will support a range of

activities, including:

- Developing the delivery of high quality, clinically focussed pharmacy services that are integrated within wider primary

care, including community pharmacy;

- Integration of the seven principles of medicines optimisation into care pathways for long term conditions such as

diabetes, COPD, asthma and hypertension including opportunities for health improvement and wellbeing;

- Developing, collaboratively with Health Education England, the whole pharmacy workforce to make patient facing roles

the norm;

- Supporting the development and implementation of digital technologies for community pharmacy so that it has the

infrastructure to achieve integration with clinical pathways and medicines optimisation for patients;

- Developing clinical pharmacists working in GP practices, care homes and primary care urgent care hubs (e.g. NHS 111);

- Evaluation of innovative clinical pharmacy services, including those already provided by community pharmacies and those developed through the PhIF;

- Working with Public Health England to develop the value proposition for community pharmacy to encourage the

commissioning of local health and wellbeing services by local authorities with a focus on the Healthy Living Pharmacy

model.DH - Leading the nation’s health and care

17Slide10

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Bringing pharmacy into the heart of the NHS (2)

We welcome views on these proposals, and further proposals from the pharmacy sector, and others, including patient

and public representatives, on bringing pharmacy into the heart of the NHS to deliver better quality services to

patients and the public.

What are your views on the introduction of a Pharmacy Integration Fund?

What areas should the Pharmacy Integration Fund be focussed on?

How else could we facilitate further integration of pharmacists and community pharmacy with other parts of the NHS?

DH -

Leading the nation’s health and care

18Slide11

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Modernising the system to maximise choice and convenience for patients and the

public

Online ordering, click and collect and home delivery are all growing significantly in other sectors and online retail

sales grew by 16% in the UK in 2014. However, the uptake of digital ordering, click and collect and home delivery in

community pharmacy remains low. The Office of National Statistics estimate that less than 10% of adults ordered

their medicines online in 2014.

Because of this, the Government wants to ensure that the regulatory framework and payments system facilitates

online, delivery to door and click and collect pharmacy and prescription services.

These services already exist to an extent within the community pharmacy sector. As part of our consultation we want

to consider how we can promote patient choice and convenience when ordering prescriptions, creating a seamless

digital journey for all patients, where the choice of delivery or collection is made upfront.

Specifically we want to consider proposals to:

-

ensure patients are offered the choice of home delivery or collection when ordering their prescription;

-

introduce a new terms of service for distance-selling pharmacies in recognition of the difference in their service

offering, and thus differentiated payment.

To what extent do you believe the current system facilitates online, delivery to door and click and collect pharmacy and

prescription services?

What do you think are the barriers to greater take-up?

How can we ensure patients are offered the choice of home delivery or collection of their prescription?

DH -

Leading the nation’s health and care

19Slide12

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Making efficiencies

The Government wishes to work with the PSNC and pharmacy organisations to deliver a more efficient and innovative system. As part of

this, we want to consider proposals to:

-

Simplify the NHS pharmacy remuneration payment system

. The current system is complex and does not promote efficient and high

quality services. For example the establishment payment - of around £25,000 per year - is received by all pharmacies dispensing

2,500 or more prescriptions a month, a relatively low prescription volume. This incentivises pharmacy business to open more NHS

funded pharmacies, adding costs to the taxpayer. We therefore propose the establishment payment is phased out over a number of

years.

-

Help pharmacies become more efficient and innovative

through, for example, modern dispensing methods. We will separately

consult on changes to medicines legislation to allow the ‘hub and spoke’ dispensing model across different legal entities. This could

allow independent pharmacies to capture the efficiencies stemming from large-scale, automated dispensing, reduced stock holding

and economies of scale in purchasing and delivery of stock to the hubs, freeing up time to concentrate in the spokes on delivering

patient centred services designed to optimise the use of medicines by patients. These efficiencies could help pharmacies lower their

operating costs and enable pharmacists and their teams to provide more clinical services and to improve and support people’s

health.

- Encourage longer prescription durations, where clinically appropriate

. Where there is no clinical need for a 28-day repeat

prescription, this represents inconvenience to the patient and an avoidable cost to the taxpayer. As part of stable long termcondition management, many prescribers already prescribe 90-day repeat prescriptions where it is clinically appropriate. With a

wider range of interested parties, we will be looking at steps to encourage optimising prescription duration, balancing clinical need,patient safety, avoidance of medicine waste and greater convenience for patients.The above are initial proposals. The Government is open to any proposal that will drive efficiency and innovation in community pharmacy.

What are your views of the extent to which the current system promotes efficiency and innovation?

Do you have any ideas or suggestions for efficiency and innovation in community pharmacy?

What are your views of encouraging longer prescription durations and what thoughts do you have of the means by which

this could be done safely and well?DH - Leading the nation’s health and care

20Slide13

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Maintaining public and patient access to pharmacies

Access to pharmacies in England is excellent - 99% of the population can get to a pharmacy within 20 minutes by car and 96% by

walking or public transport. Access is greater in areas of highest deprivation.

The Government is committed to maintaining access to pharmacies and pharmacy services, and is consulting on its proposal for the

introduction of a Pharmacy Access Scheme, based on a national formula by which qualifying pharmacies, according to an index

based on geography and other factors, will be required to make smaller efficiencies than the rest of the sector.

The proposal is for a national formula to be used to identify those pharmacies that are the most geographically important for

patient access, taking into account an isolation criteria based on travel times or distances, and also population size and needs. The

population needs variables that we propose should be included are as follows:

·

Index of Multiple Deprivation (2015)

·

Proportion of population >75 years who are >85 years

·

Proportion of population >70 years claiming disability living allowance

·

Standardised Mortality Ratios (SMR) by middle super output area

·

Generalised fertility rate

·

Age-sex standardised proportion non-white

·

Age-sex standardised proportion tenure social

·

Age-sex standardised limiting long term illness

Once an index of isolation and population needs is determined, we would then need to determine the means by which pharmacies

would qualify, such as a travel time threshold or similar. The index would then be combined with the chosen qualifying criteria to

generate a list of qualifying pharmacies.

What are your views on the principle of having a Pharmacy Access Scheme?What particular factors do you think we should take into account when designing the Pharmacy Access Scheme?

DH - Leading the nation’s health and care

21Slide14

PROPOSALS FOR CHANGE IN COMMUNITY PHARMACY

Further discussion

Do you have other views you would like to feed into the consultation process?

We welcome feedback from these stakeholder briefing sessions. Please respond to this first phase of the

consultation by Friday 12 February 2016, which will allow us to collate all views received during this

initial period and input them into the ongoing discussions with the PSNC. We are expecting individuals to

input to the consultation via the PSNC and other representative bodies.

We will then hold further stakeholder meetings during March in advance of the consultation period

closing on 24 March.

DH -

Leading the nation’s health and care

22Slide15

Reaction from the profession

https://petition.parliament.uk/petitions/116943

Stop cuts to pharmacy funding and support pharmacy services that save NHS money

39,889 

signatures – but slowing down

I am a community pharmacist

! So

far as part of my 9 hour shift today; I have dispensed and given out medication to 367 different people equating to 987 different items,

had a consultation and supplied a patient with emergency contraception,

Counselled 2 people on

the…(Calum

Plenderleith

)Slide16

Reaction from the press

£170m cuts could kill off a QUARTER of our chemists - prompting warning of even more pressure on

A&Es

Many High Street pharmacies in England face closure, says minister

Pharmacists

were meant to be the face of the NHS - but now our jobs are at risk

Sector's shock at Burt's suggestion of 3,000

closures

Up to 3,000 pharmacies could close after government cuts, MPs warn

One in four pharmacies on the high street face closure

DDA to

scruitinse

effect of pharmacy funding cutSlide17

Do nothing?

Do something…

What are our options?Slide18

Online & Social Media

@

ComPhcyTees 242 followers – many not our pharmacy teams Tees LPC 57 ‘likes’ – we need more

http://psnc.org.uk/tees-lpc/

(or Google Tees LPC)

The LPC’s planSlide19

Fill in the petition

https://petition.parliament.uk/petitions/116943 (or Google pharmacy cuts petition)Write to MP’s

Template for pharmacy Template for pharmacy team members

Other material

NPA (for independent pharmacies)

Head Office (for multiple pharmacies)The LPC’s planSlide20

Visit MP’s and other local decision makers

Local press engagement

Speak to the patient groups (Healthwatch) and ask for their supportWhat other ideas have you got?

The LPC’s planSlide21

Three ideas of how we can:

Get our patients’ support

Get other health care professionals’ supportAnyone else and how

Group discussionSlide22

10am 9 February 2016

Proposals for Community Pharmacy review 2016/2017 and negotiation with the

DoHPSNC proposalsSlide23

Community Pharmacy

Review

2016/17A summary of

PSNC’s service

development proposals

to

the

Department

of Health and NHS EnglandSlide24

Introduction

On 17th December

2015

the Department

of Health

(DH)

and NHS England

wrote

a joint open letter to PSNC entitled Community

pharmacy in 2016/17 and beyond. In the

letter the Government announced that funding for community

pharmacy in 2016/17 would be cut by £170m, from £2.8bn to £2.63bn,

which is a reduction of more than 6% in

cash terms.PSNC is

working with the other national community pharmacy organisations and the

Royal Pharmaceutical Society to respond to the Government’s proposals and

to coordinate a campaign against the aspects of the proposals

which will have an adverse impact on patient

services and access to community pharmacies.Further

information on the Government’s proposals and PSNC response can

be found on the PSNC

website.The open letter

stated:There is real potential for far greater use of community pharmacy and

pharmacists: in prevention of ill health; support for healthy living; support for self-care for minor ailments and long term conditions; medication reviews in care homes; and as part of more integrated local care models.

To this end we need a clinically focussed community pharmacy service that is better integrated with primary care. That will help relieve the pressure on GPs and Accident and Emergency Departments, ensure optimal use of medicines, better value and better patient outcomes,

and contribute to delivering seven day health and care services.As DH and NHS England have

no specific proposals on how to develop

a clinically focussed community pharmacy service, PSNC agreed to submit proposals for discussion. This

document summarises the proposals that PSNC has made to DH and NHS England.Slide25

The

context for

PSNC’s proposals

When the

2005 Community

Pharmacy

Contractual

Framework

(CPCF) was introduced, there was an agreement that it would evolve to respond to the needs of patients and the NHS and

to reflect the desire of the profession to build more services around the dispensing

service.While the CPCF has developed with the addition of new clinical services, including the New Medicine Service and the Seasonal Flu Vaccination Service, it has

not yet developed as far as pharmacy contractors and PSNC would wish.

In 2012 PSNC agreed a clear Vision of its aims and aspirations for the community pharmacy service, with community

pharmacy teams helping people to optimise their use of medicines, supporting their health and care for acute and long-term conditions, allowing them

to live independently in their own homes and providing individualised information, advice and assistance to support the public’s health and healthy living. psnc.org.uk/vision

A 2012 survey

of community pharmacy contractors confirmed that the majority of the sector (98%

of respondents) supported this aspiration for

community pharmacy and since then PSNC has been working towards this vision by

seeking to develop the community pharmacy service across

four key domains:

In

2015

PSNC proposed five immediate service developments that NHS England could implement in its Pharmacy 5 Point Forward Plan. Our service

development proposals to DH draw on this plan.psnc.org.uk/5pointplanSlide26

The PSNC

proposalsThese

proposals set out how the

CPCF could develop

in

order

to meet

DH and NHS England’s stated aims of developing a

more clinically focused community

pharmacy service while also meeting the other ‘efficiency and

productivity’ requirements set out in their

letter of 17th December 2015.

They have been presented to DH and NHS England as outline

proposals to prompt further discussions with PSNC. We will undertake further development work

on the proposals, subject to the response they receive from

DH and NHS England.The

proposals are set out in three

phases, in recognition of the need to allow the wider NHS and

community pharmacy to adopt them in a controlled manner that

also allows time for other

enablers, such as IT, to

be put in place.

We recognise that implementing these service development proposals would have substantial implications for DH’s

planned restructuring of funding delivery and this would require detailed consideration.

PSNC is publishing this summary of the service development proposals so that contractors

and their teams are kept abreast of potential development

of the CPCF and have time to consider how they may impact on their

practiceSlide27

Phase 1 –

Community

Pharmacy Care Package

Transfer

from

Repeat

Prescribing

to eRepeat

Dispensing

(eRD

)

and the

development

of a

community

pharmacy

care package for

patientsUse of electronic repeat dispensing

becomes the default prescribing option where

the prescriber wishes to prescribe on a long-term

basisThe

duration of each supply to the patient is determined by the pharmacist and

patient, with guidance from the prescriber, in order to ensure it is based on clinical need and to seek

to avoid unintended wastage of medicinesPatients

are registered with an individual pharmacy to allow a

patient centred/holistic approach to supporting their use of medicines/ management of

LTCsFunding mechanism for the care package must ensure there is no

drive to dispense prescriptions where the patient has no need for themSlide28

Phase 1 –

Community

Pharmacy Care Package

Medicines

optimisation

support

provided

regularly

MUR-type

conversations

with the

patient

may

be

required,

including

at the start of the process,

and NMS-type interventions would be provided as required

Synchronisation of patient’s

medicines undertaken to support adherence and

reduce wastePatient Activation Measure (PAM) and adherence

scores would be used to indicate the impact of pharmacy interventions, including on the patient’s engagement with their health

This will assist the targeting of pharmacy engagement with the patient to

improve adherence and optimise use of their

medicines, allowing the patient to set their own motivational

goalsSlide29

Phase 1 – Inhaler

technique

checks/coaching

Offer

of an inhaler

technique

check and

coaching

session

to

patients

prescribed

inhalers using

eRD

at

least twice a

year

A formal system for

referral back to the prescriber would be implemented

for circumstances where a referral is clinically

necessarySlide30

Phase 1

Prescription Interventions

Pharmacies already

make

interventions

on

prescriptions

These are

communicated

to

the prescriber

but are not

always

clearly

recorded

in

patients’ pharmacy records

Information on the interventions is not

centrally collated and thereforethe

value of these interventions cannot be determined

Under this proposal such interventions would now be clearly recorded using a standard

classification system and the data would be centrally collatedNational and local (CCG) guidance would

be provided to pharmacies on target interventions

Not dispensed interventions would fall within the remit of this proposalSlide31

Phase 1 –

Post-discharge

MURs/medicines reconciliation

Post-discharge

MURs

should

continue

to

be

provided

Numbers

should increase as

communications between hospital

and

community pharmacies

improve

For

some patients a full

MUR may not be required, but a medicines reconciliation

(conducted by support staff) would be

of benefit to all patientsFurther work is required

to determine the optimal approach to supporting patients post-discharge and this may be a candidate for

support from the Pharmacy Integration FundSlide32

Phase 1

Pharmacy First service

Minor Ailments

Advice Service & an

Emergency

Supply

Service

To

effectively

implement such

a service,

review

and

implementation

of

amended

NHS 111

referral pathways would

be required in order to support the

referral of more patients to the

serviceFurther development of IT

infrastructure would also be beneficial to support referrals and messaging between NHS 111

sites and community pharmaciesThis is an area which the Pharmacy Integration Fund

could supportSlide33

Phase 1

Public Health Campaigns

PHE and NHS

England

should

agree

up

to

six

national campaign topics

each

year,

utilising

PHE’s

portfolio

of national

campaignsEach campaign could run within

pharmacies for up to 2

monthsThis approach would

allow PHE to deliver a consistent

campaign message across the whole pharmacy network reaching millions of people at onceSlide34

Phase 2 – Enhanced

community

pharmacycare package for patients

All pharmacies will

need

to have

SCR access

in

place

and

have to provide

the

national flu

vaccination

service

Building on

the development

of

the

care package in phase 1, additional elements would

be provided to patients registered to receive

the serviceThese elements would support the development of a pharmacy care

plan with the aim of optimising the patient’s use of medicines, treatment of their condition and improvement of their patient activation

scoreSlide35

Phase 2 – Enhanced

community

pharmacycare package for patients

Examples would

include assessing

CAT

and ACT

scores

for

patients

with

COPD

and

asthma, frailty

and

falls

assessments

and use

of other screening tools (building on the work of the Community Pharmacy Future

projects)Use of

these tools would allow the assessment of the

impact of the community pharmacy support on the patient

and their conditionAs appropriate an annual MUR-type review may

be undertaken and NMS interventions would be provided when patients commence new therapiesMost of the interventions would

be provided on an ongoing and regular basis, generally as patients present in the pharmacy to

obtain their next supply of medicinesSlide36

Phase 2 –

Healthy

Living Pharmacy or equivalent accreditation

In

order

to

support the

effective

provision

of

public health

campaigns,

pro-active

healthy

living advice and locally commissioned

public health

services,

pharmacies

will work towards achieving an HLP equivalent accreditation

The training of support staff

as health champions will provide them with the skills to effectively support

behaviour change by patients and the public, related to

both healthy living and medicines optimisationA deadline by which

pharmacies must be accredited would be set and an ongoing requirement to ensure that accreditation is

maintainedSlide37

Phase

3

During

this phase the

service

developments proposed

in Phase 1 and 2

would continue

to

be

provided

Pharmacies

would

additionally

provide support to specific groups of patients to manage long

term conditions, e.g. hypertension and asthma, and more advanced support for frail and older people with multiple conditions

This would release further GP practice capacity but it would also require the majority

of community pharmacists to be qualified as independent prescribers (or for the Alberta approach to

prescribing qualification to be adopted)Slide38

Other

service

developments and the future

DH has identified the

provision

of additional clinical pharmacy

support

for care

homes as one area that needs to be

taken forward.PSNC believes community pharmacy can provide some

of the necessary support required by care homes and

patients living within them, but the approach to team

working with general practice would need to be

explored in order to maximise the

value provided to patients and the NHS.This is work that could

initially be explored using funding from the Pharmacy

Integration Fund.Overall,

the outline proposals set out here represent a starting point for

discussions with DH and NHS England. They describe how community pharmacy teams could make

a more significant contribution to patient care.

At

this time of financial strain and increasing demand

we believe they are ideas that DH and NHS England cannot afford

to ignore.Slide39

Business as usual

Current advanced services

Current local enhanced servicesThreat or Opportunity?What next?Slide40

Questions

Remarks

CommentsThank you!Slide41

Thank you