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NHS CB part 2. Steve Brown Director of Pharmacy University Hospitals Bristol NHS Foundation Trust Associate Director Medicines Management NHS South of England. The NHS Operating Framework. ‘Four inter-related challenges:
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NHS CB part 2 Steve Brown Director of Pharmacy University Hospitals Bristol NHS Foundation Trust Associate Director Medicines Management NHS South of England
The NHS Operating Framework ‘Four inter-related challenges: • the need to maintain our continued strong performance on finance and service quality; • the need to address the difficult changes to service provision required to meet the QIPP challenge in the medium term; • the need to complete the transition to the new delivery system set out in Liberating the NHS; and • the urgent need to ensure that elderly and vulnerable patients receive dignified and compassionate care in every part of the NHS’
Priorities • 2012/13 Operating Framework • Innovation Health and Wealth • NICE implementation • Academic Health Science Networks • Specialist Commissioning • High Cost Drugs • Pharmacy Specialist Services • QIPP
Innovation Health and Wealth ‘delivery agenda for spreading innovation at pace and scale throughout the NHS’ ‘Innovation Scorecard’ – monitoring of NHS compliance with NICE TAGs
Academic Health Science Networks • ‘…the identification, adoption and spread of proven innovations and best practice, to improve the quality and productivity of healthcare, resulting in better patient outcomes and population health’ • Research participation • Translating research and learning into practice • Education and training • Service improvement • Information • Wealth creation
Specialist Commissioning • 10 teams nationally linked to 10 of 27 LATs • Specialist Services National Definition Set (SSNDS) • Nationally commissioned services (CAG report) http://www.dh.gov.uk/health/files/2012/09/Clinical-Advisory-Group-for-Prescribed-Services.pdf • SC teams to lead on specific clinical areas • IF / SEC; CF / Y&H • Which drugs? • More national contracts (HPN)?
High cost / PbR excluded drugs • Commissioning • What about CDF? • What about Patient Access Schemes?
Value Based Pricing • Aim: • Improved access -> improved outcomes • Stimulates innovation • Improves new medicines assessment • Includes broader assessment of clinical effectiveness, societal benefits, burden of illness and unmet need
VBP • assessment of health impacts, taking into account health and social care related costs and benefits associated with a medicine (pharmaco-economic evaluation) • take account of costs and benefits related to wider societal factors, such as a medicine’s impact on patients’ ability to work, and impacts on families. • Objective is to use society’s valuation of treatments & their impacts, e.g. society may put greater priority on health gains for patients with severe conditions lacking effective treatments • weightings for Burden of Illness and Therapeutic Innovation and Improvement. • Medicines which target areas of high unmet need & deliver a step change in benefits for patients likely to achieve higher (maximum) prices.
Specialist Pharmacy Services 6.35 Specialist pharmacy services, which are those provided across many health organisations to ensure access to pharmaceutical expertise in a range of disciplines, have an important role to play in catalysing innovation and ensuring its uptake … support all commissioning processes and enable providers of NHS services to deliver high quality care. There is an important interface between specialist pharmacy services and pharmacy education and training in terms of workforce planning and development.
QIPP for the acute sector • Don’t forget the Q • Safety • Effectiveness • Patient Experience • Innovation • IHW • Prevention • Public health • Safety • Productivity
QIPP • Productivity – interwoven with medicines optimisation • Secondary Care Procurement • Medicines usage data / Define • Homecare • Support for patients taking medicines • Medication safety • Medication waste • Secondary care wastage • Patient involvement • Supporting medicines in primary care • Care homes and end of life
The NHS Operating Framework ‘Four inter-related challenges: • the need to maintain our continued strong performance on finance and service quality; • the need to address the difficult changes to service provision required to meet the QIPP challenge in the medium term; • the need to complete the transition to the new delivery system set out in Liberating the NHS; and • the urgent need to ensure that elderly and vulnerable patients receive dignified and compassionate care in every part of the NHS’
Focus on delivering: • Best return on medicines investment • Maximising cost-effectiveness • Controlling medicines spend • Managing high cost medicines • Reducing waste • No avoidable harm • Reducing medication related incidents • Managing risks and governance • Meeting CQC outcome 9 / NHSLA standards • Reducing readmissions • Better patient care • Medicines optimisation