Community pharmacies: promoting health and wellbeing [QS196]

Community pharmacies: promoting health and wellbeing [QS196]
NICE Quality standard 8 August 2020

• This quality standard covers how community pharmacies can support the health and wellbeing of the local population. It describes high-quality care in priority areas for improvement.

 

Community Pharmacy Contractual Framework: Year 2 (2020-21)

Community Pharmacy Contractual Framework five-year deal: year 2 (2020 to 2021)
DHSC, NHS England/Improvement, PSNC 24 February 2020

• Changes to commissioning over 2020/21 include NHS Discharge Medicines Service, Hepatitis C testing service, NHS Community Pharmacist Consultation Service (NHS CPCS) referrals for urgent medicine supply from NHS 111 Online, referral of minor illness from GP surgeries.
• Part of the Community Pharmacy Contractual Framework: 2019 to 2024 - 5-year deal setting out how community pharmacy will support delivery of the NHS Long Term Plan.

Changes to the GP contract in 2020/21 (February 2020)

Changes to the GP contract in 2020/21 (February 2020)
Pharmaceutical Services Negotiating Committee 17 February 020

• This PSNC Briefing provides a summary of the changes to the General Medical Services contract in 2020/21, which are of most relevance to community pharmacy, including LPC officers and members and PCN pharmacy leads.

Multimorbidity and polypharmacy - the evidence

Multimorbidity and polypharmacy [KTT18]
NICE Key Therapeutic Topic updated September 2019

• A summary of the evidence base on multimorbidity and polypharmacy.

Analysis of [pharmacy] inspection reports

Analysis of inspection reports
General Pharmaceutical Council September 2019

• Analysis for the General Pharmaceutical Council to identify the key patterns, trends and themes in pharmacy inspection reports from November 2013 to August 2018 identified seven emergent themes that were associated with good and/or poor performance: governance. These were: a proactive approach; efficient processes; responsiveness; customer and patient focus; added value; and a lack of key knowledge and a failure to learn.

Role of community pharmacies

Role of community pharmacies
House of Commons Library Briefing 30 September 2019

• Briefing for a debate in Westminster Hall on the role of community pharmacies held on 2 October 2019.

NHS England / NHS Improvement Board meeting in common 26 September 2019

NHS England / NHS Improvement Board meeting in common 26 September 2019

Highlights for Arden & GEM CSU by Anne Gray, Knowledge Officer
Arden & GEM CSU

Papers available on NHS England website.

Video will be available here: https://www.england.nhs.uk/about/board/meetings/previous/

Agenda

1. Welcome and Introduction

• Apologies for Absence

• Declarations of Interest

• Minutes and matters arising from the Board Meetings in Common of the Boards of NHS England and NHS Improvement held on 27 June 2019

2. Chairs’ report ( Verbal report - Dido Harding) 

3. Chief Executive’s report (Verbal report - Simon Stevens)

4. EU Exit readiness (Keith Willett)

5. The NHS recommendations to Government and Parliament for an NHS Integrated Care Bill (Ian Dodge)

5a: The NHS’s recommendations to Government and Parliament for an NHS Bill

5b: Annex 1: Implementing the NHS Long Term Plan: Public Engagement on Proposals for Possible Changes to Legislation

6. Digital-First Primary Care consultation outcome (Dr Nikki Kanani, Ed Waller)

7. Clinically-led review of NHS access standards (Steve Powis)

8. Operational, quality and financial performance update (Julian Kelly, Amanda Pritchard)

9. Community pharmacy reform (Ian Dodge)

9a: The Community Pharmacy Contractual Framework for 2019/20 to 2023/24: supporting delivery for the NHS Long Term Plan

10. Public Participation Dashboard (Ruth May)

11. NHS England Mandate Assurance 2018/19 (Ian Dodge)

12. Seal report (Jessica Dahlstrom)

Highlights

Public health service provision by community pharmacies: a systematic map of evidence

Public health service provision by community pharmacies: a systematic map of evidence
EPPI Centre, Institute of Education, June 2019

• This systematic map identifies an expanding and diverse research literature seeking to provide evidence on public health interventions that are provided by community pharmacies in OECD countries.

Pharmacy Manual

Pharmacy Manual
NHS England 30 April 2019

• The Pharmacy Manual forms part of a suite of policies and procedures to support commissioning and contract management of primary care. These policies and procedures support quality and consistency of commissioning and eliminate duplication of effort in the management of the four primary care contractor groups

Productive healthy ageing: interventions for quality of life

Productive healthy ageing: interventions for quality of life
PHE 19 March 2019

• This document lists interventions that can be made by pharmacy teams, to help older people to lead more independent lives and improve their health.
• The document includes interventions based around:
• preventing falls
• dementia
• physical inactivity
• social isolation and loneliness
• malnutrition

Polypharmacy: Getting our medicines right

Polypharmacy: Getting our medicines right
Royal Pharmaceutical Society 1 February 2019

• This guide provides a summary of the scale and complexity of the issue of polypharmacy. It outlines how healthcare professionals, patients and carers can find solutions when polypharmacy causes problems for patients and points to useful resources that can help. 
• The guidance recommends that all healthcare organisations have systems in place to ensure people taking 10 or more medicines can be identified and highlighted as requiring a comprehensive medication review with a pharmacist.

Pharmacist services for non‐hospitalised patients

Pharmacist services for non‐hospitalised patients
Cochrane Database of Systematic Reviews 2018, Issue 9. Art. No.: CD013102. DOI: 10.1002/14651858.CD013102.

• A review of the evidence around services provided by pharmacists to non hopsitalised patients identified 116 studies (n=41,851) from community pharmacies and hospital outpatient clinics.
• Anlaysis found that some services provided by pharmacists can have positive effects on patient health, including improved management of blood pressure and physical function. The pharmacist services did not reduce hospital visits or admissions. 
• Services delivered by pharmacists produced similar effects on patient health compared with services delivered by other healthcare professionals.

The Report of the Short Life Working Group on reducing medication-related harm

The Report of the Short Life Working Group on reducing medication-related harm
DHSC 23 February 2018

• The Short Life Working Group report makes recommendations for a programme of work to tackle medication error and improve medicine safety.
• This includes
• increased use of technological developments to aid patient safety such as the pharmacist-led information technology intervention (PINCER) which identifies patients at risk from hazardous prescribing and supports pharmacists to work with general practices
• better shared decision-making
• improved training and continuing professional development
• development of an online repository, consisting of examples of good medicine safety practice and prescribing safety metrics

Evaluation of Value Proposition projects to support the MCP new model of care in Dudley

Evaluation of Value Proposition Projects
Dudley CCG 2 November 2017

• Evaluation of a series of schemes to support development of the Multi-Speciality Community Provider (MCP) model of care in Dudley. The report describes the need, implementation and effectiveness of each scheme.
• The schemes evaluated as "very effective" were:
• Integrated Plus. This scheme embeds locality link officers in MDTs who link patients in the top 2% of those at high risk of hospital admissions and frequent visits to GPs, with community and voluntary services, addressing non-clinical needs through ‘social prescribing’ support. Savings of around £18,000 were reported as resulting from
• A 24% reduction in visits to the GP.
• A 15% reduction in GP home visits.
• A 15% increase in GP telephone consultations.
• A 4% reduction in A&E attendances, saving around £5,000 (522 patient referrals).
• A 7% reduction in emergency admissions, saving around £80,000 (441 patient referrals).
• Falls and Fracture Prevention Service. The redesign expanded the existing Public Health commissioned service to include clinical input: two additional nurses, a physiotherapist and a part-time falls specialist pharmacist and establishment of the single point of access. Early outcome data shows the reduction in waiting times for acute, consultant led falls services falling from 18 weeks to 12 since April. Anecdotally this reduction was supported by interviewees who talked about consultant ability to see urgent cases.
• Practice Based Pharmacists. An extension of an existing service through development of the pharmacist role and standardised contracts. Evaluation indicates savings in repeat medication prescriptions, reduction of waste, avoided hospital admissions and reduction of GP workload.
• Prescription Ordering Direct Contact Centre to standardise and streamline the management of repeat prescribing across Dudley and reduce waste. Based on an existing service the Dudley service. The evaluation showed a reduction in prescription volume, and reduced pressure in associated GP practices.
• Other schemes were:
• Care Coordinator Service - to provide a link within, and between MDTs, and between primary care and hospital services. 
• Sense.ly Kiosk - a self-service ‘kiosk’ which enables patients to take their own weight and blood pressure measurements prior to a primary care appointment with guidance by a virtual nurse avatar. 
• Sense.ly Patient Services App - combines an electronic triage service with an appointment booking service.
• Care Home Telemedicine Service - supporting care home staff to help prevent admissions to hospital 
• Care Home End of Life Education Programme - training and support for care home staff in caring for older people with end-of-life and palliative care needs.

Community Pharmacy Clinical Services Review

Community Pharmacy Clinical Services
King’s Fund for the Chief Pharmaceutical Officer, December 2016

• This report is based on a review of the evidence, examination of current commissioning models and opportunities for community pharmacy.
• The report identifies the barriers that prevent best use of community pharmacies and workforce, makes recommendations for what clinical services community pharmacies should provide and how the service should be commissioned in future.

The value of community pharmacy

The value of community pharmacy
PwC for Pharmaceutical Services Negotiating Committee,7 September 2016

• An analysis of the value to the NHS, to patients and to wider society of 12 specific services provided by community pharmacy in England in 2015, focusing on public health services; support for self-care; and medicine support services, which include enhancing access to medicines and delivering patient management service.

Community Pharmacy Forward View

Community Pharmacy shares its Forward View: a vision for the future
PSNC and Pharmacy Voice, 30 August 2016

• The Community Pharmacy Forward View focuses on three key roles for the community pharmacy of the future:
• As the facilitator of personalised care for people with long-term conditions;
• As the trusted, convenient first port of call for episodic healthcare advice and treatment; and
• As the neighbourhood health and wellbeing hub.

Community pharmacists - case studies

Good practice examples: Commissioning of community pharmacists  outside of the core contract
Royal Pharmaceutical Society July 2016

• Examples of community pharmacy services.

Role of pharmacists in General Practice

Pharmacists and general practice: A practical and timely part of solving the primary care workload and workforce crisis
NHS Alliance, Royal Pharmaceutical Society, 3 December 2014

• An exploration of the current role of pharmacists working within general practice, why this isn’t more widespread, what the barriers might be, and how they might be overcome.

Guidelines on collaboration with the pharamceutical industry working together

Guidance on collaboration between healthcare professionals and the pharmaceutical industry: Ethics, transparency, partnership
Royal Pharmaceutical Society, 29 March 2012

• The ten things you should know..
• Dos and don'ts for healthcare professionals
• Dos and don'ts for the pharmaceutical industry

• Resources for joint working are included in the ABPI guidance and available on the DH website "Moving beyond sponsorship: Interactive toolkit for joint working between the NHS and the pharmaceutical industry"
• Training resources for healthcare professionals on the ABPI code of practice are available here: