The national direction of travel involves working across Sustainability and Transformation Partnerships (STP). In 2016, the chief pharmacists across our STP (population 1.5M) came together to represent all areas of Pharmacy.
Our medicines optimisation group has representation from our 3 CCGs, all acute, mental health and community Trusts and the local pharmaceutical committees (LPCs) representing community pharmacies. The medicines optimisation group has now met on a monthly basis for over 2 years and is well established and respected by the STP. This report describes the benefits of working across a wider geographical area, involving all the main stakeholders, including how projects were spread.
We present a selection of eight projects that were helped by having our STP collaborative group, which in total have saved £9.3M/year, and which have raised standards of care, while also improving the quality & safety of care:
a) Increasing uptake of biosimilars saving £4.6M
b) De-prescribing sip feeds and use of alternatives, (supported in one CCG by an incentive scheme asking GP to record weights of patients in GP notes), saving £800K
c) Consulting on and implementing OTC purchase rather than prescribing saving £680K
d) Care home medication reviews, spread of the Vanguard model and introduction of technicians – direct savings £490K; Rio score reduction in hospitalization savings £2.75M
One CCG using technicians estimate annualized savings per technician to be £70K.
The significant quality and safety benefits are harder to quantify and measure but anecdotally there have been significant benefits on both counts and improved processes within care homes. This project is supported by local authorities,patients, carers and our clinical staff.
e) Electronic Medicines Optimisation Pathway – providing discharge information to community Pharmacy at hospital discharge (EMOP). There are direct savings which are not yet quantified, as we are still agreeing the collation method across the STP, there are many quality benefits for patients through community pharmacy interventions. GPs support the additional safety afforded by this work.
f) Open/Look in the Bag – Community Pharmacists, provided with consistent communications resources, have supported a campaign across the STP to make patients aware of dispensed items they may not need. Patients are able to look in the bag and return items no longer required directly to the pharmacy prior to leaving the premises. The number of not dispensed items is monitored against time in order to monitor the effect of this type of campaign aimed at reducing unnecessary medication waste.
g) Workforce planning. This piece of work was started because of difficulties with recruitment especially at grades 7/8a for pharmacists and 4/5 for technicians. We included local and national data collection from various sources, a PESTLE analysis and a local audit of existing posts and vacancies. The work has now been extended into a presentation for PCNs to help them understand why they will need a pharmacist to meet the new work in QoF and to help them with recruitment, if they so wish.
h) National educational support – we were fortunate to be invited to attend some national study days on spread of large projects and managing change. This training has helped the group to engage more effectively with the top team, identify and brief champions and prepare materials which are succinct and can be used at a moment’s notice. This has raised the profile of Pharmacy and Medicines optimisation within the STP patch.
Overall we have collaborated and learned from our mistakes. We hope that sharing this work encourages others to engage across an STP patch for the benefit of patient care.
The national direction of travel involves working across Sustainability and Transformation Partnerships (STP). In 2016, the chief pharmacists across our STP (population 1.5M) came together to represent all areas of Pharmacy. Our medicines optimisation group has representation from our 3 CCGs, all acute, mental health and community Trusts and the local pharmaceutical committees (LPCs) representing community pharmacies. The medicines optimisation group has now met on a monthly basis for over 2 years and is well established and respected by the STP. This report describes the benefits of working across a wider geographical area, involving all the main stakeholders, including how projects were spread.
We present a selection of eight projects that were helped by having our STP collaborative group, which in total have saved £9.3M/year, and which have raised standards of care, while also improving the quality & safety of care:
a) Increasing uptake of biosimilars saving £4.6M
b) De-prescribing sip feeds and use of alternatives, (supported in one CCG by an incentive scheme asking GP to record weights of patients in GP notes), saving £800K
c) Consulting on and implementing OTC purchase rather than prescribing saving £680K
d) Care home medication reviews, spread of the Vanguard model and introduction of technicians – direct savings £490K; Rio score reduction in hospitalization savings £2.75M
One CCG using technicians estimate annualized savings per technician to be £70K.
The significant quality and safety benefits are harder to quantify and measure but anecdotally there have been significant benefits on both counts and improved processes within care homes. This project is supported by local authorities,patients, carers and our clinical staff.
e) Electronic Medicines Optimisation Pathway – providing discharge information to community Pharmacy at hospital discharge (EMOP). There are direct savings which are not yet quantified, as we are still agreeing the collation method across the STP, there are many quality benefits for patients through community pharmacy interventions. GPs support the additional safety afforded by this work.
f) Open/Look in the Bag – Community Pharmacists, provided with consistent communications resources, have supported a campaign across the STP to make patients aware of dispensed items they may not need. Patients are able to look in the bag and return items no longer required directly to the pharmacy prior to leaving the premises. The number of not dispensed items is monitored against time in order to monitor the effect of this type of campaign aimed at reducing unnecessary medication waste.
g) Workforce planning. This piece of work was started because of difficulties with recruitment especially at grades 7/8a for pharmacists and 4/5 for technicians. We included local and national data collection from various sources, a PESTLE analysis and a local audit of existing posts and vacancies. The work has now been extended into a presentation for PCNs to help them understand why they will need a pharmacist to meet the new work in QoF and to help them with recruitment, if they so wish.
h) National educational support – we were fortunate to be invited to attend some national study days on spread of large projects and managing change. This training has helped the group to engage more effectively with the top team, identify and brief champions and prepare materials which are succinct and can be used at a moment’s notice. This has raised the profile of Pharmacy and Medicines optimisation within the STP patch.
Overall we have collaborated and learned from our mistakes. We hope that sharing this work encourages others to engage across an STP patch for the benefit of patient care.
