Community Pharmacy – Call to Action

1. Community Pharmacy – Call to Action Derbyshire / Nottinghamshire Area Team

2. ‘Call to Action’ – Community Pharmacy In February 2014 the NHS England Derbyshire and Nottinghamshire Area Team held five ‘Call to Action Community Pharmacy’ events across Derbyshire and Nottinghamshire • The Area Team asked stakeholders four key questions and the consolidated response common themes were as follows:-

3. 1) How can we promote pharmacies and the full service available? • Community pharmacy should be promoted to patients and other NHS staff as highly trained health care professionals who are experts in medicines !! • Pharmacies should be promoted as centres of healthcare and advice. • Joint learning opportunities between pharmacy and GP practice staff would help to encourage better understanding and encourage joint working. • Pharmacy should be promoted as the first point of call in GP practices, OOH service premises and A&E departments. • The accessibility of community pharmacy and the long opening hours should be promoted.

4. 2) How can the way we commission services for community pharmacy maximise the potential for it to support patients to get more from their medicines? • A suite of nationally commissioned service specifications were seen as essential. This would help pharmacies to make a consistent offer to the public and would reduce local variations. • Where there is an evidence base for the benefits and positive outcomes community pharmacy interventions can bring a patient with specific long term conditions i.e. Asthma, COPD, national specifications should be developed and commissioned. • The community pharmacy contract should be more closely aligned to the GMS contract to ensure both professions are contractually obliged to support medicines optimisation services.

5. CONT - 2) How can the way we commission services for community pharmacy maximise the potential for it to support patients to get more from their medicines? • New services should look at ways in which pharmacy skill mix can be used. • National self-care standards and messages should be agreed. • GP practices should refer patients to pharmacy for medication reviews (pharmacists have the knowledge to undertake both compliance and clinical medication reviews).

6. 3) How can we better integrate community pharmacy services into the patient care pathway? • Community pharmacists need to be included whenever patient pathways involving medicines are to be developed if pharmacists aspirations in self care and long term conditions management are to be realised. • GPs diagnose, pharmacists prescribe model has been mooted for years but with little progress. Could a model be piloted nationally as part of the transformation of primary care work? • Community pharmacists saw themselves having a bigger role to play with specific patient groups including; children with complex medical conditions and medicines regimes, frail elderly patients, patients with multiple long term conditions, management of patients taking high risk medicines (including warfarin, lithium and methotrexate). Integration in services involving these patient groups was seen as essential.

7. 4) How can the use of a range of technologies increase the safety of dispensing? • Access to patient medical records is seen as essential for community pharmacy to offer a safe and effective service. • Access to records would support safe community pharmacy services in the out-of-hours period and would support clinical service delivery. • Electronic discharge records sent systematically to community pharmacy and GP practices would help to improve seamless transfer of care, reduce errors in prescribing, dispensing and administration of medicines and minimise re-admissions caused by inappropriate use of medicines.

8. CONT - 4) How can the use of a range of technologies increase the safety of dispensing? • A simple electronic recording system for dispensing errors with minimal fields to complete would encourage incident reporting. Community pharmacies would like feedback and shared learning from common dispensing errors. The lack of feedback from the current system was seen as a deficiency. • Pharmacists want to see the introduction of mobile technologies and applications to support service development and implementation.

9. Next steps…..nationally • NHS England feeding this into a primary care strategic framework to be published in the Autumn • Looking at production of national specifications for enhanced services which would be commissioned locally • Piloting summary care record use in community pharmacies NHS | Presentation to [XXXX Company] | [Type Date]

10. Locally…… • Flu vaccination • Role of pharmacists in asthma / COPD • Polypharmacy • Domiciliary MURS • SCR bid • Independent prescribing NHS | Presentation to [XXXX Company] | [Type Date]