MUR and NMS Respiratory Toolkit .

1. MUR and NMS Respiratory Toolkit. Somerset LPC

2. Why is asthma being targeted for MUR’s and NMS ? • 5.4 million people in the UK are currently receiving treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12). • Asthma prevalence is thought to have plateaued since the late 1990s, although the UK still has some of the highest rates in Europe and on average 3 people a day die from asthma. • In 2014 (the most recent data available) 1216 people died from asthma. • The NHS spends around 1 billion a year treating and caring for people with asthma. • Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases, including chronic bronchitis, emphysema and chronic obstructive airways disease. • It affects an estimated 3 million people in the UK.

3. Why focus on Asthma and COPD for MUR’s and NMS ? • To access Quality payments the contractor must be offering MUR’s or NMS or be registered for NHS Urgent Medicines Supply. • Over 90% of pharmacies provide Mur’s and NMS. • Results of a Independent academic evaluation (2014) gave a positive reinforcement for the service with improved patient outcomes and reduced cost for the NHS.

4. Benefits of MUR’s / NMS • improve medicines adherence • increase patient engagement with their condition and medicines, which will support them in making decisions about their treatment and self management • reduce medicines wastage • reduce hospital admissions due to adverse events associated with medicines • increase reporting of medicine adverse reactions by pharmacists and patients • positive patient assessments • provide evidence base on the effectiveness of the service • enable the development of outcome and/or quality measures for community pharmacy • For MUR’s limited to 400 per year can generate £11200. • NMS is unlimited range £20 - £28 per intervention. Somerset LPC

5. Part of the Quality Payments ! • Asthma patients dispensed more than 6 short acting bronchodilator inhalers without any corticosteroid inhaler within a 6-month period are referred to an appropriate health care professional for an asthma review. • There are two review points for this criterion: •  Friday 28th April 2017; and Friday 24th November 2017. • At each review point, meeting this criterion is worth 10 points (£640), therefore a total of 20 points (£1,280) can be claimed in 2017 for achieving this criterion. Somerset LPC

6. CPPE Support . • The Centre for Pharmacy Postgraduate Education (CPPE) has a distance learning course and e-assessment on asthma,as well as inhaler technique training e-learning and videos, which pharmacists or pharmacy technicians may find useful to complete before incorporating the QP criterion into their daily practice.

7. Asthma BT guidelines. • While you would normally recommend the NICE COPD guideline over the GOLD guideline, the NICE COPD guideline is out of date, having not been updated since 2010. • NICE undertakes a more comprehensive review of the evidence and prepares their guidance in the context of the English/Welsh NHS. • NICE also involves GPs and nurses in developing their guideline. • The next review of the NICE guideline was scheduled to start in May 2016 , so we cannot expect a revised version until late 2017 or early 2018. • Clearly there have been many new treatment options introduced since 2010, which are therefore not covered by NICE currently.

8. Asthma Resources • BTS ( New British Guidelines for the management of asthma) • Formulary ( Inhaler technique videos and checklists) • Asthma UK (Asthma Action Plans) • In-Check Inspiratory Flow Measurement Device • Inhaler technique training videos / CPPE Online • Teva Respiratory Resources

9. Somerset CCG Formulary Chapter 3 – Respiratory system http://formulary.somersetccg.nhs.uk/?page_id=82