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?