Think Pharmacy

Sue Sharpe CEO PSNC

Outline of Talk

• • • The Vision for the future community pharmacy The four domains for pharmacy services  Medicines Optimisation  Public Health  Minor Ailments  Supporting Independence The challenges

The Context

• • • • • Pressures on public funds Impact on GP funding in real terms - £400m?

Crisis in urgent care provision Need to develop long term treatment plan, not a sticking plaster What can community pharmacy do to help our NHS survive?

Our Vision

The community pharmacy service will offer support to our communities, helping people to optimise use of medicines to support their health and care for acute and long-term conditions, and providing individualised information, advice and assistance to support the public’s health and healthy living.

The Third Pillar – the

foundations

The Third Pillar –

reducing unnecessary GP appointments for minor ailments

The Third Pillar -

helping care for patients with LTCs + supporting independence

The Third Pillar

- preventing avoidable disease; promoting healthy lifestyles

National and local commissioning of pharmacy

• • •

services

National contract includes dispensing, support for self care, receiving waste medicines, MURs, NMS and (at present) public health campaigns Local supplementary services can meet specific targets to reduce costs for CCGs Strong record of public health service provision by pharmacies

The Four Domains

Medicines optimisation Public Health Minor ailments Supporting independent living

Medicines Optimisation

Local services to supplement MURs and NMS Domiciliary MURs Croydon

Medicines Optimisation

• • • Local services in Greater Manchester: improving inhaler technique Outcomes: reduced spend – lower prescribing of blue inhalers; lower need for additional therapy; synchronising Rxs – lower waste + Improved patient outcomes – use of ACT + CAT assessments

Medicines Optimisation

• • • Respiratory MUR project in South Central (206 pharmacies) 40% of people with asthma showed better asthma control 55% of COPD patients showed an improvement in symptom management Analysis of data on emergency asthma and COPD admissions showed a positive association between the introduction of the project and changes in emergency hospital admissions

Public Health – Pharmacy services

• • • • • • Services for drug misusers: supervised self administration; Needle + Syringe Programmes Sexual Health services: EHC; contraception; safe sex advice Alcohol, obesity, healthy lifestyles advice Smoking cessation Vaccination and screening e.g NHS Health Check Healthy Living Pharmacies

Minor ailments

Working to reduce unnecessary use of GP and A+E services. Potential savings to the NHS – estimates 3 year projections – shift from A+E, Walk-in centres + GP surgeries Shift

Saving

20%

£83m

35%

£210m

50%

£321m

Minor ailments

Figures – estimated

Population P’mouth 211000 Consultations Minor Ailments MA alone 1190000 W Hants 529000 2990000 214000 538000 193000 484000

Top 5 Minor ailments

Back pain Dermatitis Heartburn/ indigestion Nasal Congestion Constipation

Annual consultations

8.4m

6.8m

6.8m

5.3m

4.3m

Supporting Independence

• • • • • Working to support independent living – examples include:

Home delivery of medicines Monitored dose dispensing systems Falls risk screening and advice Supply of aids Identifying emerging problems

The Principal Challenges

• • • • Establishing effective partnership working with GPs and local authorities Identifying where pharmacies can best help manage workload and costs Ensuring agreement on effective and relevant communication Outcomes- based service commissioning – using evidence and monitoring outcomes and impact