Leading integrated pharmacy and medicines optimisation Guidance for ICSs and STPs on transformation and improvement opportunities to benefit patients through integrated pharmacy and medicines optimisation

September 2020

1 | Contents

Contents

Foreword ........................................................................................ 2

Introduction .................................................................................... 3

Building future clinical pharmacy services ..................................... 5

Annex A: System leadership for pharmacy .................................. 10

Annex B: Priorities for workforce, medicines value and safety ..... 15

Annex C: IPMO transformation plan ............................................ 19

2 | Foreword

Foreword

Alongside the deeply challenging experiences of the COVID-19 pandemic, the NHS

has found a greater need for and openness to teamwork across professional,

organisational and system boundaries. It is striking to hear the many reports of

progress health and social care services have made in bringing about positive

changes to practice, pathways or systems through working as teams in the widest

sense during the last few months.

It is paramount that we keep up the momentum as we move to ‘system by default’

working and ‘lock in’ the beneficial changes that we’ve collectively brought about.

This includes backing local initiative and flexibility; enhanced local system working;

strong clinical leadership; and the rapid scaling of new technology-enabled service

delivery.

In pharmacy, there have been many examples of innovative practice and

collaborative working; something we must all strive to retain. It feels positive that

pharmacy teams have been able to make change happen nationally, regionally and

locally in collaboration with health and social care colleagues.

This guidance is about how to build on this refreshing teamwork more

systematically to help improve and transform pharmacy and medicines optimisation.

Building on the expansion of the pharmacy workforce into primary care networks to

capture the innovation and ensure we use the resources available to us to address

health inequalities and improve health outcomes for people who use medicines and

pharmacy services. Collaborative leadership at system level will be vital in the

months and years ahead as we learn to live with and beyond COVID-19. Pharmacy

leaders, professionals and teams must be particularly attentive to the stark health

inequalities that have been exposed again, in particular with respect to Black, Asian

and minority ethnic people and deprived communities.

Much good work is underway including the approaches to collaborative system

leadership we’ve been exploring with the support of the Pharmacy Integration Fund.

This guidance contains the learning and coincides with the appointment of Regional

Chief Pharmacist colleagues – bringing the full complement to seven – who will

lead this work.

I’m grateful to our pilot sites and teams up and down the country for all they have

done to spearhead this work.

Dr Keith Ridge CBE, Chief Pharmaceutical Officer for England

3 | Introduction

Introduction

1. The NHS Operational Planning and Contracting Guidance 2020/21 sets out a

timetable for every part of the country to move towards becoming an Integrated

Care System (ICS) by April 2021. Local systems are asked to use their system-

wide strategic plans developed in 2019 to deliver the commitments of the NHS

Long Term Plan and achieve a ‘system by default’ approach to delivering care.

2. ICSs will undertake two core roles: system transformation and collective

management of system performance. This document sets out the principles

and approach to the development of a pharmacy and medicines optimisation

transformation plan in each ICS and a system-wide pharmacy professional

leadership model to bring about collective management of system performance.

3. The NHS pharmacy profession’s collaborative, system-wide working established

in response to the COVID-19 pandemic has accelerated the regional and local

framework needed to secure these changes for the future. The deliberate

tripartite working bringing together pharmacy professionals across secondary,

primary and community care has stimulated local innovation recognising that the

urgent need of the population requires valued solutions that are integrated

across health and social care regardless of the setting.

4. Implementing the ambition for integrated care detailed in the NHS Long Term

Plan requires the continued development of an integrated pharmacy workforce

at all levels to maximise the clinical contribution of the third largest workforce

group and ensure the safe use of and best value for money from the more than

£18 billion1 the NHS invests in medicines each year.

5. The pharmacy and medicines optimisation plans will be co-ordinated and

supported by the NHS England and NHS Improvement regional chief

pharmacists and pharmacy leadership teams within the seven English regions to

ensure consistency in the plans and coherence in the use of pan regional

1 https://digital.nhs.uk/data-and-information/publications/statistical/prescribing-costs-in-hospitals-and-the-community/2018-2019

4 | Introduction

resources such as education and training, medicines information services, the

recovery planning in response to COVID-19, and medicines procurement.

5 | Building future clinical pharmacy services

Building future clinical pharmacy services

What are our ambitions for pharmacy and medicines optimisation under the NHS Long Term Plan?

6. Medicines remain the most common therapeutic intervention in the NHS, with

48% of adults having taken a prescription medicine each week.2 As ICSs

develop, it is essential therefore that pharmacy workforce and medicines

optimisation are considered from the outset. The scope and scale of the

challenges mean that we need to transform the way that services are both

developed and delivered. This will require effective planning and strong and

effective local leadership to ensure that services are appropriately resourced, fit-

for-purpose, resilient and sustainable.

7. Post COVID-19, the NHS has been asked to take this opportunity to ‘lock in’

beneficial changes that have been brought about. This includes local initiatives

and flexibility; enhanced local system working; strong clinical leadership; flexible

and remote working where appropriate; and rapid scaling of new technology-

enabled service delivery options such as digital consultations. Patients should

only be required to attend hospital where clinically necessary meaning staff

must continue to work flexibly to see or support patients through remote or

virtual consultations for the foreseeable future. Pharmacy has a key role to play

in safe and effective services, ensuring the public get the best from their

medicines, and in improving the public’s health.

Pharmacy professional workforce

8. Our vision builds on the ambitions of the NHS Long Term Plan and earlier work

delivered through the Five Year Forward View vanguards and new care models

which introduced new roles such as clinical pharmacists in general practice,

pharmacists in integrated urgent care (IUC) pathways and pharmacists and

pharmacy technicians in care homes. Pharmacist prescribers, advanced

2 https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/health-survey-for-england-2016

6 | Building future clinical pharmacy services

practice and consultant pharmacists work autonomously with patients and within

multidisciplinary teams to treat and support patients across health and care

settings. These roles need to be developed at scale across systems. Where

they do exist evidence of their success has been demonstrated by the COVID-

19 response and ensured that these roles have now become firmly established

and are the basis for how services will operate in the ICS and the newly

established primary care networks (PCNs).

9. Pharmacy and medicines optimisation will be critical in supporting the expected

increase in the need for community and mental health services to deal with post

COVID-19 complications and rehabilitation including the increase in long-term

conditions and the need to support patients to be cared for in their own homes.

It will be essential to upskill pharmacy technicians and pharmacists to take on

wider roles to ensure safe medicines practice when there may be stretched

resources and workforce pressures for other healthcare professionals.

10. The pharmacy workforce is the third largest single staff group in the NHS.

Alongside clinical patient-facing roles, this specialist workforce also ensures a

resilient medicine supply chain (including procurement, manufacture and

compounding of aseptic products, quality assurance and medicines information

services) and supports national strategic priorities such as antimicrobial

stewardship and medicines safety.

11. In January 2019, the General Pharmaceutical Council (GPhC) consulted on new

initial education and training (IE&T) outcomes for pharmacists. The proposed

outcomes were broadly accepted and the reforms are now being implemented,

including the provision of greater opportunities for workplace experience in

clinical settings. The NHS needs to introduce a standard foundation training

programme as a priority to support pharmacists in the early stages of their

careers through a structured work-based approach that embeds knowledge,

skills, abilities, values, attitudes and beliefs in their practice. As the new GPhC

IE&T standards are implemented, then it is proposed to orientate IE&T

requirements to provide registered, independent prescribing pharmacists at the

end of the five-year period. As stated in the People Plan, this would include the

replacement of the current pre-registration pharmacist year by a new, one-year

foundation curriculum, which, led by the GPhC, could commence from

September 2021, subject to consultation, if all the relevant organisations work in

partnership to deliver to this timescale.

7 | Building future clinical pharmacy services

12. Pharmacists remain the guardians of safe, effective and legal use of medicines.

The UK has extremely high standards of safety in the production and supply of

medicines with strict legal and regulatory frameworks. Expertise in this area

should not be taken for granted, although the primary function of the pharmacy

workforce will increasingly be the safe and effective use of medicines and

reducing health inequalities. The scope of medicines optimisation is widening

from the historical emphasis on prescribing and medicines supply to holistic,

integrated, person-centred services including deprescribing and personalised

care. The combination of clinical, scientific, operational design, technical and

engineering skills that are unique to the pharmacy professional provide the

strong foundations for ensuring patients will benefit from the many new

innovations in medicines. Annex B sets out key priorities for the pharmacy

professional workforce.

Medicines safety and value

13. The Overprescribing Review into problematic polypharmacy commissioned in

December 2018 by the Secretary of State for Health is expected to report later

this year. The initial rapid evidence review undertaken by the EEPRU

highlighted that: “Taking many medicines is related to having a greater risk of

death. This might be because people who have poorer health take more

medicines and, due to their poorer health, are also at greater risk of death”.

There are specific actions aimed at reducing that risk that require strong

pharmacy professional leadership to implement across systems. Ensuring

medicines safety and optimising use, while delivering good value for money for

the NHS are essential.

14. Similarly, the report published by Public Health England about addiction to

prescribed medicines highlights the harm that some medicines can cause if they

are not initiated, reviewed and used appropriately. The report recommendations

expect clinical pharmacists to play a major part in supporting patients to become

less dependent on these medicines and to make sure they are only initiated

when really needed.

15. Baroness Cumberlege’s Independent Medicines and Medical Devices Safety

Review report First Do No Harm highlights how sodium valproate, an effective

antiepileptic medicine, but with a known high level of teratogenicity, continues to

cause harm to unborn children, leaving them with lifelong disabilities. Clinical

8 | Building future clinical pharmacy services

pharmacists will again play an important role in helping to minimise its use, and

when it is used to make sure it is prescribed and used safely and reviewed

regularly.

16. In key areas specific medicines use is expected to rise, as a result of the

COVID-19 pandemic and as the NHS Long Term Plan commitments for cancer,

respiratory and cardiovascular disease and mental health services are

developed. In other areas, the reduction of antimicrobial prescribing requires

local clinical leadership to bring about change through collaborative

multidisciplinary working as part of the Antimicrobial Resistance National Action

Plan. This will be particularly important while there is no vaccine available for

COVID-19. A renewed emphasis on de-prescribing and avoiding overprescribing

means more structured medication reviews (SMRs) for those patients taking

several medicines for multiple conditions. Sharing information – both personal

and virtual – between care settings before starting, changing or stopping

medicines becomes ever more important.

17. The operating model for the regional medicines optimisation committees

(RMOCs) outlines how the committees work at national and regional level to

help patients get the most from their medicines, while ensuring taxpayers get

the best value from the annual medicines bill. The necessary leadership through

national and regional oversight is aimed at supporting and optimising local

prescribing practice and reduce unwarranted variation. The role of the RMOCs

is to promote collaboration and help reduce duplication on issues related to

medicines across the healthcare system.

18. STP/ICS financial planning will need to take account of how the medicines

budget can be balanced across the system while acknowledging that the legal

responsibilities still sit within secondary and primary care commissioning.

Savings and efficiencies will need to be built into system plans. The COVID-19

pandemic has highlighted the significant pharmaceutical expertise required to

inform future service design and financial modelling to support a secure

medicine supply chain and deliver safe systems. Pharmacy leadership will be

essential as part of the emergency preparedness, response and resilience

arrangements at STP/ICS level to manage medicines supply and pharmacy

services during incidents such as the pandemic and in preparation for EU Exit.

9 | Building future clinical pharmacy services

19. The Medicines Safety Improvement Programme (MedSIP) has established a

number of key initiatives to drive system wide medicines safety and gather

opinion about the most important priorities for: high risk drugs; high risk parts of

the medicines use process as set out by the short life working group on

medication errors and to protect patients with the highest vulnerabilities.

20. System-wide metrics will be an essential tool to facilitate collective management

of system performance. A move towards measuring health outcomes needs to

be built into pathways and addressing prescribing priorities for funding. The

system priorities for delivering medicines safety and value are set out in Annex

B.

10 | Annex A: System leadership for pharmacy

Annex A: System leadership for pharmacy

Learning from the integrating pharmacy and medicines optimisation (IPMO) pilots

1. Since September 2018, pilot sites in each of the seven NHS England and

NHS Improvement regions have been working on developing a Pharmacy and

Medicines Optimisation Framework within an existing STP/ICS footprint. The

focus for the work has been to develop the leadership model, workforce

planning tools and medicine optimisation measures that can be used to

ensure efficient use of medicines in line with national priorities and NHS Long

Term Plan commitments. An important driver has been to set up and test

models of leadership and integrated governance for pharmacy and medicines

optimisation. The use of pharmacy and medicines optimisation metrics has

been identified as a priority for each ICS to develop and agree to inform

performance management recognising the expertise of professional pharmacy

leadership to establish and deliver them.

2. Through a series of national action learning sets, local workshops and access

to organisational development support, the seven pilots have identified the

scope and key responsibilities for an ICS pharmacy system leadership model.

The pilot evaluation Phase 1 and 2 reports are available from NHS Futures

collaboration platform.3

3. The overriding message from the evaluation is that the success and progress

of local medicines optimisation programmes has been dependent on the

existence of a named system-wide lead supported by a collaborative senior

leadership group and where the pharmacy professional lead role sits in the

STP/ICS structure and the strength of their pharmacy and wider system

relationships and consequent ability to influence and engage within and

across the system. The key factors that influenced the ability for systems to

deliver pharmacy and medicines optimisation were identified as the availability

3 South Central and West Commissioning Support Unit, Leadership development evaluation for the IPMO pilots; Phase 1 report, March 2019 and Phase 2 report January 2020.

11 | Annex A: System leadership for pharmacy

of a professional and sustainable workforce, the system background maturity,

system challenges, governance structures and the influence of and

engagement with the leadership model.

4. The system maturity index for integrated care systems published in July 2019

provides the reference to describe system maturity. The pilot STP/ICS

localities were either described as emerging or developing in their maturity.

The most mature pilot sites have been able to demonstrate the most progress

in securing a pharmacy and medicines optimisation plan that was developed

through a collaborative approach and a process of collective decision making

led by a professional pharmacy lead. Case studies for each pilot are available

from the NHS Futures platform.

5. The key factors identified by the pilots that influenced the delivery of an

integrated system-wide pharmacy and medicines optimisation programme are

set out in Table 1.

Table 1: Key factors for achieving a system-wide pharmacy and medicines optimisation model identified by the IPMO pilots

Influencing factors of system-wide pharmacy and medicine optimisation

Workforce • A single system-wide workforce vision that has been communicated and secures engagement with commitment to review and re-shape as the system matures;

• Establishment of a named pharmacy workforce workstream lead to ensure momentum in implementation of the strategy;

• Establishment of cross -sector working for individuals and teams;

• Access to system leadership development and training for the system leader and leadership team.

System background

• Commitment and support from the host organisation for the pharmacy leadership role;

• Existing system maturity within integrated care providers/places (ICPs) and across sectors;

• Existing system leadership, partnerships and change capability;

• Existing system architecture and strong financial and management planning.

System challenges

• Collaboration and collective decision making perceived as a positive enabler to finding solutions to system-wide operational problems;

• Agreed metrics for programmes of work essential to clarify objectives and secure stakeholder support;

• Merging available funding to support integrated delivery models and creating new funding models to support new ways of working;

• Using “business as usual” meetings and projects to develop system-wide collaboration and ways of working and move to

12 | Annex A: System leadership for pharmacy

formal structured processes to increase pace in decision making across interfaces/sectors.

Governance structure

• Securing executive level sponsorship and senior level support for the pharmacy and medicines optimisation programme;

• Creating links through to finance, commissioning, quality and clinical workstreams as a priority as the system matures;

• Ensuring the meetings supporting the governance structure include transparent decision making and not just information sharing;

• Defining workstreams with named pharmacy leads that can be linked to accountable leaders within the system;

• Investing in the pharmacy leadership team with support and training in system thinking;

• Piloting workstreams and testing structures through an iterative process to inform an effective and efficient system-wide leadership model;

• Reducing duplication and consolidate governance across the system as it matures.

Influence and engagement

• Access to professional communications expertise to inform strategic plan and ensure integration with the whole system approach;

• Focussing on initial relationship building across all sectors and build consensus on the priorities for each identified workstream;

• Utilising existing communications and stakeholder events for the whole system to articulate the pharmacy and medicines optimisation priorities;

• Enlisting support from regional and national pharmacy leadership to support the delivery of the transformation plan.

6. As localities move towards a ‘system by default’ during the period of recovery

and restoration as a result of the COVID-19 pandemic, it is proposed that

each STP/ICS establishes a pharmacy and medicines optimisation

governance framework using the learning from the IPMO pilots and the

COVID-19 tripartite leadership adopting a system pharmacy leadership model.

This leadership model is expected to have collective responsibility through

senior decision makers across the system and take responsibility for

developing an ICS transformation plan for pharmacy and medicines

optimisation. The leadership group will be drawn from senior pharmacy

leaders across acute, mental health and community services NHS Trusts,

CCGs and community pharmacy. Senior pharmacists from PCNs such as

those in clinical director roles or taking a leadership role within a GP

federation may also form part of this group as the system matures.

7. Through the regional pharmacy and medicines optimisation team, support will

be provided in developing the plan and in a coordinating role between national

13 | Annex A: System leadership for pharmacy

programmes including the Medicines Value Programme, NHS Right Care and

Getting It Right First Time medicines optimisation workstream. Their focus will

be to optimise the contribution clinical pharmacy plays in improving clinical

productivity with respect to medication safety, reduction in medication errors,

reduction in prescribing of low value medicines and increasing the use of

technology to drive best practice and remove duplication. The RMOCs,

regional directors of primary care, NHS Specialist Pharmacy Services, Health

Education England pharmacy deans and regional medicines procurement

leads will be able to co-ordinate and provide support across their region. Other

organisations such as the academic health science networks (AHSNs), NHS

Digital, NHSX and Public Health England, as well as professional bodies and

regulators, are national resources able to support system working.

8. Once the group is established it is expected that where affordable, systems

should use the transformation plan to establish an ICS chief pharmacist role

to take forward a programme of work to support the integration of the

pharmacy workforce and deliver medicines optimisation across the system.

We will work with systems to identify an appropriate funding resource where

useful. It is anticipated the leadership group will also identify workstream leads

from across the ICS to specifically take a leadership role for priority areas,

including workforce training and education; clinical pharmacy; digital

medicines, safety and governance; improvement; aseptic and specialist

medicines. The workstreams will develop over time as the ICS matures and

needs of the system develop.

9. It is anticipated that the ICS chief pharmacist role and workstream leads will

be provider-based or hosted through the commissioning CCG aligned with the

ICS boundaries. Consideration may be given to the role being jointly shared to

achieve the senior leadership required across a whole system. The ICS

pharmacy leadership group will work with place-based clinical and

multidisciplinary teams to support the integration of pharmacy and medicines

optimisation across health and social care.

14 | Annex A: System leadership for pharmacy

Figure 1: Example ICS pharmacy leadership system leadership model within the system4

4 Specific examples of governance structures developed by the pilots are available through the NHS Futures website.

15 | Annex B: Priorities for workforce, medicines value and safety

Annex B: Priorities for workforce, medicines value and safety

System priorities for the pharmacy and medicines optimisation workforce

1. The creation of ICS chief pharmacist roles to provide senior system-wide

leadership and co-ordination of resources for the delivery and implementation

of integrated pharmacy and medicines optimisation plans and services across

the local health system.

2. Develop cross-system leadership teams (eg senior managers network

comprising of community services, community pharmacy, secondary and

primary care).

3. Provide a focus for pharmacy workforce planning and deployment in line with

the workforce operational model emerging from the Interim NHS People Plan.

4. Support the development and delivery of workplace-based foundation training

across all settings for all pharmacists, replacing the existing pre-registration

year, subject to consultation, that equips them to work clinically across

healthcare settings while leading to independent prescribing pharmacists on

registration.

5. Pharmacy technicians to have access to placed-based pre-registration training

across secondary, community and primary care leading to foundation

development to be able to provide a pipeline for a sustainable pharmacy

technician workforce across PCNs, community pharmacy and hospital trusts.

6. Support access to education and training resources to enable the pharmacy

workforce to use digital tools such as robotics, health related apps and

develop skills in health informatics as highlighted by the Topol Review.

7. The pharmacy workforce confidently using shared decision-making to agree

with patients that they need prescribed medicines, through careful initiation,

16 | Annex B: Priorities for workforce, medicines value and safety

monitoring and review, and through offering alternative interventions, such as

mental health support or social prescribing.

8. Pharmacists trained to consultant level and supporting system-wide delivery of

evidenced-based, clinical and cost-effective patient care. In addition,

increasing advanced clinical practice and consultant pharmacist roles across

care settings to provide clinical leadership across systems.

9. By 2023/24 new clinical pharmacists in each primary care network based in

general practice and working directly with patients so that each PCN will have

access to a team of clinical pharmacists building on the initial roles already in

place. These roles will be working as part of a multidisciplinary team along

with pharmacy technicians, care home pharmacy teams, integrated urgent

care clinical pharmacists, community services and mental health pharmacy

teams as well as community pharmacy and acute care:

i) delivering structured medication reviews for key group of patients to

improve quality of care, reduce medicines related harm and improve

efficiency (eg less medicines waste)

ii) supporting medicines optimisation specifically through reducing addiction

to prescribed medicines including opiates, reducing overprescribing and

polypharmacy, and improving clinical research with medicines in primary

care.

10. Community pharmacy as the first port of call for self-care, prevention and

minor illness consultation, working closely with general practices and within

primary care networks, and always working to reduce health inequalities,

including in people from Black, Asian and minority ethnic communities

11. Additional specialist mental health pharmacists across all local areas to

support delivery of the Mental Health Implementation Plan.

12. Integration of clinical pharmacists within community mental health teams

supporting the delivery of community mental health for adults and older adults.

13. Pharmaceutical public health pharmacists working within local authorities and

across the system to plan and deliver population health approaches to

17 | Annex B: Priorities for workforce, medicines value and safety

medicines optimisation and pharmacy services, and linking into emergency

planning, resilience and response activities.

14. Pharmacists working within newly forming NHS Genomic Medicine Service

(GMS) Alliances and across the system to deliver pharmacy workforce

transformation and embed genomics and personalised medicine into clinical

care in the form of pharmacogenomics, gene therapies and targeted

treatments for cancer and rare disease.

15. Making health services and clinical research across all sectors a priority for

the pharmacy workforce, including through clinical academic careers

supported by the National Institute for Health Research.

System priorities for medicines value and safety

16. Deliver pharmaceutical advice to senior ICS colleagues, including establishing

and leading an ICS medicines optimisation committee that will link through to

the regional medicines optimisation committee, reducing the duplication of

work created by local area prescribing committees.

17. Consolidate and rationalise vital NHS pharmacy support functions such as

procurement, medicines governance, education and training, medicines

information services and aseptic production to free pharmacist and pharmacy

technician time for patient-facing roles.

18. Link robustly to regional and national priorities through the regional chief

pharmacists, and through them the regional medicines optimisation

committees, and onwards to the Office of the Chief Pharmaceutical Officer

and national policy directors.

i) Deliver the government five-year anti-microbial strategy across care

settings to ensure antimicrobial stewardship across systems.

ii) Support and delver against the national medicines safety agenda.

iii) Extend the STOMP/STAMP reviews of medicines use for people with

learning disability and mental illness.

18 | Annex B: Priorities for workforce, medicines value and safety

iv) Increase the resilience, standardisation and efficiency of the NHS

medicines supply chain for all medicines including elective surgery,

aseptically produced products particularly for critical care and cancer

treatments.

v) Develop system wide metrics that focus on pathways and prescribing that

demonstrate the impact on health outcomes

19. Use population health approaches to promote medicines safety and reduce

medication errors, over medication and waste.

i) Use population data to identify those patients who would benefit most

from targeted medicines, structured medicines use reviews and support

and prevention services.

ii) Develop meaningful ICS/STP pharmacy and medicines metrics through

the use of cross-system datasets, digital medicines systems including

integrated electronic prescribing systems and electronic rostering

iii) Support the implementation of the community pharmacy Discharge

Medicines Service, building on the AHSN Transfers of Care Around

Medicines (TCAM) programme to ensure patients are prioritised for

support with their medicines at discharge from hospital.

20. Provide professional leadership for the pharmacy quality scheme and clinical

services delivered through the Community Pharmacy Contractual Framework

2019 to 2024 (eg NHS Community Pharmacist Consultation Service and the

New Medicines Service).

19 | Annex C: IPMO transformation plan

Annex C: IPMO transformation plan

IPMO transformation plan timeline

1. Indicative timeline showing key dates in the IPMO planning process is shown

below:

2. Each STP/ICS is asked to deliver an IPMO transformation plan setting out

how the opportunities of collaboration and transformation across the local

health system can support the creation of a flexible and sustainable workforce,

supporting patients across care settings and into their homes. It will focus

explicitly on the need to develop professional pharmacy leadership and the

local and regional infrastructure for medicines optimisation and pharmacy in

health and social care systems.

3. The aim is to develop a draft plan by November 2020 building on strategic

system plans for the STP/ICS as they come together to serve communities

through a partnership board, using existing work in the hospital pharmacy

transformation programmes and the learning from the IPMO pilots in the

seven ICS pilot areas.

4. A final IPMO transformation plan should be submitted to the STP/ICS board

by February 2021. Key elements of the IPMO transformation plan include:

September

2020

Guidance issued

Webinars for pharmacy leaders

November

2020

Draft plans submitted to

NHSE&I Regional Pharmacy leadership team for feedback

Nov 2020-Jan 2021

Feedback on draft plans

Revise plans if necessary

February 2021

IPMO plan presented to

STP/ICS board with BC for the

ICS Chief Pharmacist

From April 2021

Final IPMO transformation

plans implemented

20 | Annex C: IPMO transformation plan

(i) a business case to create an ICS chief pharmacist role that would attract

highly experienced staff to provide professional leadership on behalf of all

the NHS organisations and supporting the delivery of NHS commissioned

services within each geographic footprint to deliver the IPMO transformation

plan from April 2021 as part of the ICS plans for workforce, efficiency and

effectiveness

(ii) NHS Long Term Plan pharmacy and medicines optimisation priorities

incorporating the COVID-19 restoration and recovery priorities for the ICS

explicitly linked to approved strategic system plans and balanced to ensure

that quality and finance are given equal prominence

(iii) a credible and costed ICS pharmacy workforce strategy incorporating a

cross system governance framework

(iv) quality indicators to ensure that health outcomes and quality improvements

can be monitored and delivered with respect to medicines value and safety.

An action planning tool and resources will be shared through the NHS

England and NHS Improvement regional pharmacy leadership team to

support development of the plan and coordinating support through the

regional directors of primary care, medicines procurement leads, and Health

Education England pharmacy deans within their geographies.

NHS England and NHS Improvement

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