Transcript Joint GHP/UKCPA IT Interest Group Seminar Wednesday 4 June

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
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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’
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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/ClinicalAdvisory-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
Specialist
Commissioning
Local Commissioning
NICE
Non-NICE
• What about CDF?
• What about Patient Access Schemes?
Value Based Pricing
• Aim:
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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 (pharmacoeconomic 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.
Pharmacy Specialist Services
Service
Medicines Information Regional MI Centres
Medicines Assurance
Pharmaceutical Quality
Assurance
Medicines Procurement
Medicines Safety
Leadership and
coordination
Medicines Use & Safety
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
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Homecare
Support for patients taking medicines
Medication safety
Medication waste
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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
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Maximising cost-effectiveness
Controlling medicines spend
Managing high cost medicines
Reducing waste
• No avoidable harm
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Reducing medication related incidents
Managing risks and governance
Meeting CQC outcome 9 / NHSLA standards
Reducing readmissions
• Better patient care
– Medicines optimisation