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The Pharmacy White Paper: Pharmacy in England Building on strengths, delivering the future

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Delivering personalised, integrated and convenient care, that is of high quality; ... Tacking health inequalities. So what does it say? ... – PowerPoint PPT presentation

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Title: The Pharmacy White Paper: Pharmacy in England Building on strengths, delivering the future


1
The Pharmacy White PaperPharmacy in
EnglandBuilding on strengths, delivering the
future
2
Hands up if you have
  • Read it all
  • Read part of it
  • Read the PSNC briefing

3
The basics
  • Published on 3rd April 2008
  • 141 pages long
  • 56 action points
  • Community pharmacy focussed
  • Matches PSNC policy on service development
  • Very positive...
  • ...but a Green tinged White Paper

4
Historical context
  • Completes action promised in Our health, our
    care, our say to develop pharmacy contract in
    line with White Paper aspirations
  • Galbraith Review
  • All Party Pharmacy Group report
  • NHS Next Stage/Darzi Review
  • Primary and Community Care Strategy
  • Promoting health, not just treatment
  • Delivering personalised, integrated and
    convenient care, that is of high quality and
  • Tacking health inequalities.

5
So what does it say?
  • The Governments stated aim for community
    pharmacy is to see
  • a shift in emphasis from dispensing prescriptions
    to providing clinical services
  • a wider range of services available through
    pharmacies, exploiting their convenient locations
    and extended opening times and
  • greater use of the clinical skills of pharmacists
    and the talents of other pharmacy staff

6
Pharmacies will...
  • become healthy living centres promoting health
    and well-being and helping people to take better
    care of themselves
  • be able to supply certain common medicines and be
    the first port of call for people with minor
    ailments saving every GP up to the equivalent
    of one hour per day or up to 57 million GP
    consultations a year and
  • provide support for people with long-term
    conditions, especially those starting out on a
    new course of treatment.

7
Chapter 1 - Background
  • Outlines the major role that pharmacists,
    pharmacy technicians and other pharmacy staff
    currently play
  • Sets out pharmacys strengths and achievements
  • Identifies further potential for pharmacy to
    contribute to high quality patient care and
    improve the populations health and wellbeing

8
Chapter 2 The context for change
  • Highlights the major health and social challenges
    faced by the country
  • It highlights some key changes, including focus
    on better commissioning of services
  • Annex 1 identifies how and where pharmacy can
    contribute by providing additional services and
    support in tackling some of the most pressing
    challenges
  • Commits to improving commissioning of pharmacy
    services (WCC) ?

9
Chapter 3 Expanding access and choice through
more help with medicines
  • How pharmacists and their staff are helping to
    improve access to medicines and to promote their
    safe and effective use
  • MUR services to be prioritised to meet health
    needs ?
  • MUR funding to reward health outcomes ?
  • Work on embedding repeat dispensing ?

10
Chapter 3 Expanding access and choice through
more help with medicines
  • Research on why people dont take medicines ?
  • Strengthening commissioning of adherence support
    services
  • Extending emergency supply to 28 days ??
  • Allow dispensing doctors to sell OTCs ??
  • How can the contract support care at the 1/2
    care interface
  • Virtual health community clinical pharmacy
    teams

11
Chapter 4 More pharmacy services supporting
healthy living and better care
  • A vision for service development to deliver more
    choice and more modern, effective and world-class
    pharmaceutical services
  • Pharmacies being repositioned, recognised and
    valued by all as healthy living and
    health-promoting centres with public
    perceptions of the potential contribution being
    transformed
  • Expanded access to clinical services
  • Providing more support for people with LTCs

12
Chapter 4 More pharmacy services supporting
healthy living and better care
  • CFH work on IT systems to record interventions
  • Pharmacy staff as NHS Health Trainers ?
  • Incorporate MAS into the national contract
  • Sexual health
  • Chlamydia screening ?
  • Oral contraception supply ?

13
Chapter 4 More pharmacy services supporting
healthy living and better care
  • Vascular risk assessment ?
  • Supporting people with LTCs new service
    proposal
  • Referral networks for cancer
  • 2 Pharmacy Czars ?
  • Jonathan Mason, Head of Prescribing and Pharmacy
    at City and Hackney Teaching Primary Care Trust
  • Martin Stephens, Divisional Clinical Director,
    Diagnostics and Therapy and Associate Medical
    Director, Clinical Effectiveness, Southampton
    University Hospitals NHS Trust

14
Chapter 5 Communications and relationships
  • Government communications plan
  • Working group to facilitate Pharmacy/GP
    communication ?

15
Chapter 6 Research and innovation in practice
  • Proposals for research and developing the
    evidence base
  • Develop a clearer framework for the evaluation of
    pharmacy services (expert panel)
  • Identifies six principal research domains
  • patient and public perceptions and satisfaction
  • impact on care and outcomes (including clinical
    and cost effectiveness, safety and peoples
    understanding of their medicines)
  • quality of service provision
  • value for money
  • impact on workload and flow and
  • pharmacy staff attitudes

16
Chapter 6 Research and innovation in practice
  • Care record access - undertake further work with
    an early adopter PCT to consider the benefits,
    governance and practical arrangements of
    community pharmacists having access to the SCR ?

17
Chapter 7 The pharmacy profession
  • Action to develop the GPhC ?
  • Skill mix/Responsible Pharmacist ?
  • Review of the undergraduate curriculum
  • Merger of pre-reg with undergraduate course?

18
Chapter 8 Structural enablers and levers
  • Galbraith review - two options
  • complete devolution of contracting
    responsibilities to PCT or
  • the concept of any willing provider
  • Governments response
  • Strengthen PCTs commissioning as part of the
    World Class Commissioning (WCC) Programme
  • Recognises that pharmacy contractors are not
    being adequately rewarded for their investment in
    services
  • To stimulate investment in services, there should
    be greater security of income streams but these
    must offer value for money and good health
    outcomes.

19
Chapter 8 Structural enablers and levers
  • Commissioning must foster a shift away from pure
    dispensing and towards rewarding clinically
    focussed pharmaceutical services which will
    secure promotion of health, wellbeing and
    independence
  • Pharmacies that fully embrace the new direction
    of change and that invest in staff and
    infrastructure to support high quality services
    will be better rewarded

20
Chapter 8 Structural enablers and levers
  • Review and strengthening of structure of and data
    requirements for PNAs to ensure they are an
    effective and robust commissioning tool ?
  • Commissioners should engage community pharmacists
    in needs assessments and PBC ??
  • Development of Directed Enhanced Services (DES)

21
Chapter 8 Structural enablers and levers
  • Quality of services - immediate improvements in
    three areas
  • setting more robust standards for Essential and
    Advanced services and harmonising accreditation
    for similar kinds of Enhanced services
  • introduce financial incentives and penalties and
  • introduce more effective sanctions to address
    poor performance
  • Develop a set of pragmatic, easily measurable
    metrics or indicators that will serve to
    demonstrate the quality and outcomes of pharmacy
    service provision

22
Chapter 8 Structural enablers and levers
  • 100 hour pharmacies 4 options
  • introduce a distance restriction of 1.6 2km for
    new applicants
  • require applicants to justify to the PCT the need
    for a 100 hour pharmacy (a lower test than the
    necessary or desirable test)
  • contract through LPS, which allows a broader
    range of services and
  • strengthen requirements for the specific services
    that a 100 hour pharmacy must provide, for
    example a link to minor ailments and out of hours
    services

23
Chapter 8 Structural enablers and levers
  • Dispensing Doctors single regulatory test
  • alternative eligibility criteria, which could be
    based on the distance from the surgery to the
    nearest pharmacy
  • a surgery would be entitled to dispense for all
    its patients

24
DH consultation
  • Published 27th August 2008
  • CoE changes
  • new system based on PCTs assessments of local
    needs
  • to commission services which promote choice and
    competition in the delivery of clinical care and
  • ensures high standards, quality and good patient
    outcomes for the investment made

25
DH consultation
  • Proposals to enable PCTs to take effective action
    on quality grounds where contractors are not
    achieving acceptable performance standards
  • 100hrs exemption LPS route
  • supplementary lists for individual pharmacists
    and compliance with the Safeguarding Vulnerable
    Groups Act 2006

26
DH consultation
  • Possible reform of rural arrangements
  • A single regulatory entry system for pharmacies
    and dispensing doctors, i.e. DD applications
    considered under the reformed CoE test
  • OTC sales by DDs
  • DACs

27
More information www.psnc.org.uk
Pharmacists dont forget that you have been
undertaking CPD today!Record it in your RPSGB
Plan Record file or on-line at
www.uptodate.org.uk
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