NHS Improvement Hospital Pharmacy and Medicines Optimisation Ann Jacklin, November2016 Title slide with embedded images

Timeline Summer 2014 June 2015 February 2016 Health Secretary asks Lord Carter to assess what efficiency improvements could be generated in hospitals across England Detailed work with 22 NHS acute hospital trusts initially – range of trust types from large inner city teaching to rural district general hospitals Hospital Pharmacy and Medicines Optimisation Programme (HoPMOP) established June 2015 Interim report published Up to £5 billion of productivity saving identified Concept of Model Hospital February 2016 Final report published “In light of Lord Carter’s report, I can now announce that we will act upon all his recommendations and have asked Lord Carter to report back on progress with implementation by spring 2017”

Report recommendations Values & outcomes from Medicines Optimise medicines (and staff…..) Hospital Pharmacy Transformation Plan by April 2017 Clinical Pharmacy Infrastructure services Model Hospital metrics

Hospital Pharmacy Transformation Programme HPTP 80% pharmacist time on CLINICAL activity EPMA High Cost Drugs coding Drug savings Drug Procurement - CMU Supply chain Specialised Pharmacy Service NHS Manufactured Medicines Catalogue

Transforming clinical and infrastructure services Currently 45% of time Currently 55% of time

Clinical Pharmacy Services Lord Carter said: Acute trusts must ensure their pharmacists and clinical pharmacy technicians spend much more time on clinical pharmacy services than on infrastructure activities He also said: …more clinical pharmacy staff…..deployed…..working more closely…..with patients, doctors , nurses and independently…. To deliver optimal use of medicines……informed medicines choices….secure better value…..drive better outcomes…..contribute to 7 day services…. He didn’t say: Current clinical services meet needs either in volume or in ‘scope’

Pharmacy Infrastructure services Lord Carter said: Are subject to stark variation Can be delivered more efficiently ..are most efficiently delivered…..through..…collaboration or shared service…..local, regional, national Need not be delivered by NHS employed staff Lord Carter didn’t say: Are not valued Are not essential Are not required Don’t require expertise

HPTP governance arrangements (proposed) HPTP Programme Board NHSI Programme Management & Delivery Team Professional lead Subject matter experts Programme Support Infrastructure Projects Model Hospital & Metrics Project All MH Recommendations Stakeholders involved: NHS trusts NHSI CQC HSCIC MH stakeholders Pharmacy system suppliers All infrastructure Recommendations Stakeholders involved: DH/MPI/CMU NHSE SPS National Information Board (for Meds Digital Strategy) GS1 & Peppol HDA (BAPW) Programme Management Office & Data Analyst support Chief Pharmaceutical Officer (SRO) NHSI Pharmacy Lead NHSI Region 1 NHSI Region 3 NHSI Region 2 NHSI Region 4 All MO Recommendations. Stakeholders involved: NHS E MO NHS E SPS HEE RPS ABPI/BGMA Medicines Optimisation Project

Trade bodies & suppliers HPTP Landscape HPTP NHS Improvement Carter Implementation role NHS England Right Care Specialised commissioning SPS Meds Optimisation RMOC Trade bodies & suppliers ABPI BGMA HAD PMSG NPSG CMU NHS Information Board DM&D FMD Scan for safety 136 NHS acute trusts Workforce HEE CPPE Metrics MH Hospital CQC NHS Benchmarking Professional bodies RPS APTUK GPhC Dept of Health 7 day services MPI Rebalancing

Making it business as usual Failure Success

HPTP timeline