Unlocking the Potential of Community Pharmacy

1. Nottinghamshire & DerbyshireGP / Pharmacy Transformation ProgrammeUnlocking the Potential of Community PharmacyCathy QuinnPharmacist LeadNewark & Sherwood and Mansfield & Ashfield CCGsNottinghamshire LPC Annual General Meeting - 15 September 2016

2. Policy & National Context ‘’We can capitalise on the untapped potential, and convenience, that greater utilisation of the skills and expertise of the pharmacy workforce can offer.” Transforming urgent and emergency care services in England - Urgent and Emergency Care Review End of Phase 1 Report’, 13 Nov 2013 ‘’We are committed to ensuring we maximise the part community pharmacy can play in delivering a sustainable long term solution’’ Simon Stevens, Oct 2014 , Five Year Forward View

3. Background Business case to explore ‘untapped potential’ of Community pharmacist independent prescribers in supporting GPs (July 2014) NHS England local office funded 18 month project Hosted and managed by Newark & Sherwood CCG Initially 4 sites across both Derbyshire & Nottinghamshire Extended to 6 sites

4. Project Aims & Objectives • Improve Primary Care access • Release GP time • Improve patient experience • Improve Health outcomes • Medicines optimisation • Quality & Safety • Better use of healthcare system

5. GP / Pharmacy Transformation Pilot Sites

6. Project Overview and Progress • First site went live July 2015 • Implementation over 9 months, final site started April 2016 • Pharmacists undertaking clinical reviews: • Medication reviews including care homes (56%) • Long term disease management reviews (asthma, CHD, CKD and hypertension) (29%) • Urgent care (7%) • Other (8%) • ‘Other’ includes medication queries, discharge information, travel queries, anticoagulant review

7. Emerging Outcomes • At end August 2016: • 6400 consultations – face-to-face and telephone • Estimated 1,250 hours of GP time saved • Favourable cost per consultation - £21.00 to £38.00 • Evidence of significant clinical interventions • Medicines changed in 59% of cases • Safety and quality improvements • side-effects18%, blood tests 15%, self-care advice 23% • 8.5% potential reduction in secondary care referrals • Excellent patient feedback

8. Next Steps and Sustainability • Project is delivering positive outcomes but still to reach its full potential • Due to end November 2016, but each site will remain live for at least one year • Project now runs alongside National Clinical Pharmacists in GP practice pilot • Business case being explored to extend pilot and expand model for Community Pharmacist Independent Prescribers in General Practice • Sustainability will require coherent planning and workforce development

9. Benefits of Programme • Community Pharmacy Independent Prescribers • Medicines expertise in multi-disciplinary team • Contractor model • Reduced employment risk • Corporate indemnity • Dedicated GP mentorship • Project management • Bespoke training • Local independent evaluation • Potential to transfer work to Community Pharmacy

10. What do patients think? • “Very good. It should be done for everyone as it points you in the right direction.” • “The pharmacist was very helpful. He answered the questions I asked and explained himself well. I felt really at ease with him.” “She is lovely, fantastic, I learnt all about my tablets which I didn’t know before” “This is the first time I have been able to properly discuss my medications with an expert”. “She went over everything you can ask her questions if you don’t understand and you don’t feel like you are on the clock…” “I have not always been able to understand all of the information I have been given before about my health.”

11. Discussion • Any questions? • Further information at: www.newarkandsherwood.nhs.uk/file_download/1753/gppt_2.pdf