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HOSPITAL PHARMACY TRANSFORMATION PROJECT
Andrew Davies, Professional Lead for Hospital Pharmacy, NHS Improvement @HospChiefPharm
Aamer Safdar, Principal Pharmacist Lead for Education and Development, Guy’s Hospital,
London @asafdar1
Session Plan (60 mins)
• Welcome and introductions (10 mins)
• Introduction and background (15 mins)
• Developing the pharmacy workforce (15 mins)
• Discussion (20 mins)
Welcome and Introductions
• HelloMyNameIs…
• What do I do?
• Where do I do it?
• Why do I do it?
Introduction to HPTP
Hospital Pharmacy Transformation
Programme HPTP
80% pharmacist time on clinical activity
Electronic prescribing and medicines
administration
High Cost Drugs coding
Drug savings
Drug Procurement - CMU
Supply chain
Specialised Pharmacy Service,
Procurement, NHS Manufactured
Medicines Catalogue
Carter Recommendations
6
Hospital pharmacy transformation creates
headroom for medicines optimisation
2015/16 - 45% of time 2015/16 - 55% of time
Transformation
7
Pharmacy Staff & Medicines Cost per WAU
Enablers
STP CollaborationHPTP Plan Implementation NHS Digital; dm+d, EPMA, FMD, Secondary Uses, Clinical Communication
Medicines Optimisation
(£7.6billion)
Clinical Use
- Eliminate Waste
- Medicines Review
- RightCare
Top 10 Medicines List
•Biosimilars
•Switching
Total Medicines Expenditure
• Including PBR; and
•non-PBR
Coding of High Cost Drugs
Infrastructure, Cost and Supply Optimisation
e-Trading:
•e-Ordering
•e-Trading
Aseptic Units & manufactured medicines
e-Prescribing
Commercial Medicines Unit
HoPMOp – Key Work to Deliver Recommendations
DHNHS England
•Spec Com
CQC HEE
NHSI
•GIRFT
•Model Hospital
Key Stakeholders &
Interdependent
Programmes
Job Planning and KPIs
ESR & e-Rostering
Increase to 50% No. of active
prescribers
Sunday ward presence >5
hours
80% Pharmacists
Clinical Activity
Workforce Optimisation
Hospital Pharmacy (£0.7billion)
Pharmacy Workforce OptimisationGoal to release pharmacist time from non-clinical duties to support the following clinical activities & best utilise Pharmacy Technicians skills driving overall workforce efficiencies:
Increase number of pharmacists as independent prescribers (+ potential Pharmacy Technicians using PGD’s)
Pharmacy input to inpatient drug rounds
Pharmacy team presence in Emergency Departments
Pharmacist-led outpatient clinics
Releasing time from other professional groups
Medicines reconciliation to reduce polypharmacy and deliver patient-centred care
Medicines reviews using STOPP/START tool
De-prescribing
Anti-microbial stewardship to ensure antibiotic usage is in line with clinical best-practice
Focus on Medicines Optimisation/ Best practice in prescribing
Faster dispensing of discharge medications
Prescribing discharge medication
Developing improved pathways between hospital & community services
Homecare chemotherapy and IV antibiotics
Reducing patients’ stay in hospital
£5 saving in patient care costs for each £1 spent on clinical pharmacy input
Regional Pharmacy
Deans HEE
Chief Pharmaceutical
Officer for England
Regional Pharmacy Lead (London)
Regional Pharmacy Lead (Mids & East)
Regional Pharmacy Lead (North)
Regional Pharmacy Lead (South)
Deputy Chief Pharmaceutical Officer (NHS E)
Deputy Chief Pharmaceutical Officer (NHS I)
Regional Medicine
Optimisation
Committee
London
Regional Medicine
Optimisation
Committee Mids &
East
Regional Medicine
Optimisation
Committee North
Regional Medicine
Optimisation
Committee South
NHS Trusts and FTs and primary care providers
Supported by
Specialist Pharmacy
Service
North Regional
Pharmacy Dean
Mids & East Regional
Pharmacy Dean
London Regional
Pharmacy Dean
South Regional
Pharmacy Dean
+ wider Medicines
Leadership Team
working across NHSE &
NHSI
Key
NHS E funded
NHS I funded
SPS funded (NHS E)
HEE funded
Professional
accountability
Regional oversight
networks
ALB – regional medicines optimisation
and pharmacy infrastructure
Developing the Pharmacy Workforce• Pharmacy Assistants
• Apprenticeships
• Ward based roles
• Community pharmacy based roles
• Pharmacy Technicians• Ward based patient facing roles
• Advanced roles
• Pharmacists • Ward based patient facing roles
• Independent prescribing
Our workforce
• Following patient pathways
• Right person undertaking the right activity with the right skills underpinned by the right training and support
• System wide educational infrastructure
Our challenges
• Hearts and minds
• Money
• Collaboration
• Culture
• Team Pharmacy
Our workforce
• SCARF
• Sustainable
• Capable
• Adaptable
• Responsive
• Flexible
Implementing the plan
• It takes a teamwork plan how to get to the top of a mountain
• Once the plan is in place, the implementation can be like a marathon… it can take a long time!
Discussion
• Talk to the person next to you and identify your top 3 key issues
Thank you for listening
• What will you do differently having attended this workshop?
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