Think Pharmacy

Sue SharpeCEO

PSNC

Outline of Talk

• The Vision for the future community pharmacy

• The four domains for pharmacy servicesMedicines OptimisationPublic HealthMinor AilmentsSupporting Independence

• The challenges

Our Vision

The community pharmacy service will offer support to our communities, helping people to optimise use of medicines to support their health and care for acute and long-term conditions, and providing individualised information, advice and assistance to support the public’s health and healthy living.

The Third Pillar

The Third Pillar – reducing unnecessary GP appointments for minor ailments

The Third Pillar - helping care for patients with LTCs + supporting independence

The Third Pillar - preventing avoidable disease; promoting healthy lifestyles

NHS Community Pharmacy Services

2011-12c900m items dispensedCost of medicines c£8bn2.5m MURsAve pharmacy dispensed 6,700 items per monthNHS income typically 85-95% total turnover

National and local commissioning

• National contract includes dispensing, MURs, NMS and at present public health campaigns

• Local supplementary services can meet specific targets to reduce costs for CCGs

• Strong record of public health service provision by pharmacies

The Four Domains

Medicines optimisation

Public Health

Minor ailments

Supporting independent living

Medicines OptimisationLocal services to supplement MURs and NMS

Domiciliary MURs Croydon

Medicines Optimisation

• Local services in Greater Manchester: improving inhaler technique

• Outcomes: reduced spend – lower prescribing of blue inhalers; lower need for additional therapy; synchronising Rxs – lower waste +

• Improved patient outcomes – use of ACT + CAT assessments

Medicines Optimisation

Respiratory MUR project in South Central (206 pharmacies)• 40% of people with asthma showed better asthma

control• 55% of COPD patients showed an improvement in

symptom management• Analysis of data on emergency asthma and COPD

admissions showed a positive association between the introduction of the project and changes in emergency hospital admissions

Public Health – Pharmacy services• Services for drug misusers: supervised self-

administration; Needle + Syringe Programmes• Sexual Health services: EHC; contraception; safe

sex advice• Alcohol, obesity, healthy lifestyles advice• Smoking cessation• Vaccination and screening e.g NHS Health

Check

Minor ailments

Working to reduce unnecessary use of GP and A+E services. Potential savings to the NHS – estimates3 year projections – shift from A+E, Walk-in centres + GP surgeriesShift 20% 35% 50%Saving £83m £210m £321m

Minor ailments

• CCG Rotherham figures – estimatedPopulation Consultations Minor Ailments MA alone24,800 1400000 252000 227000

Top 5 Minor ailments Annual consultationsBack pain 8.4mDermatitis 6.8mHeartburn/ indigestion 6.8mNasal Congestion 5.3mConstipation 4.3m

Supporting Independence

Working to support independent living:• Home delivery of medicines• Monitored dose dispensing systems• Falls risk screening and advice• Supply of aids• Identifying emerging problems

The Principal Challenges

• Establishing partnership working with GPs and local authorities

• Identifying where pharmacies can help manage workload and costs

• Ensuring agreement on effective and relevant communication

• Outcomes- based service commissioning – monitoring outcomes and impact