Patients Experience of GP Based Practice Pharmacists #PCPA16 Heather Eardley, Development Director

The Patients Association Long established independent charity Non-disease specific Campaigning on patients and carers issues Raised at our national Helpline Work locally with NHS trusts/Clinical Commissioning Groups on projects to impact upon patient experience Use of patient stories, feedback and reports

How the Patients Association listens to patients, helps find solutions and speaks up for change We are a national independent non-disease specific health and social care campaigning charity that also works locally to improve experience of care Working with NHS Trusts and other organisations across the country, we are able to speak up for change and help influence service improvement for the benefit of patients, carers, members of the public and staff. Our independence is very important in this.

Key aspects of our work Information Information Patient Involvement Patients’ rights and responsibilities NHS Constitution Information Patients’ rights and responsibilities NHS Constitution Patient Involvement Shared decision making at all levels Individual to strategic Move to co-production Relationship of equals Patient Experience Independent Gathering patient feedback independently Improving complaints processes Good practice standards Complainants survey & benchmarking Peer review

Examples of our projects with links to Francis report recommendations Improving Dementia Care - 173 129. Mystery shopper 173 129. 109. Patient/Carer Perspective of Intentional Rounding 238. 241 Meeting Patients Needs at Mealtimes 241 129. Patient Information Review 135. 109. Observation audit in A&E 241 Shared decision making in medical training 185. 135. 3. Health information in primary care & libraries 4. 3. GP checklist – NHS Constitution 3. Community Reporting –films patient stories 160 135. 129. CARE campaign and audit 160 Patient feedback on facilities 238. 241 129. Patient information about medication 4. Customer Care Training 109. 4. Staff leadership 160 Observations – to understand quality of interaction between staff and patients 185. 241 129. 109. Carer Experience in the Emergency Department 109. Identifying Carers’ Views and staff training 129. 109. Introduction of Patient Experience Tracker 129. 109. Patient feedback on Gynaecology Services 129. 109. Council of governors training 129. 4. Involving patients and carers in commissioning 135. 109. Achieving compassion in practice - improving response times to patient needs using the 6Cs 238. 185. 160 Patient leaders and involving local community in owning their hospital ( Keogh review site) 129. 109. Complaints improvements and outcomes 135. 129. 134. 109. 113. Review of electronic patient feedback systems 241 129. 109. Review of lost property 109. Discharge to care homes 239 109. National Audit of intermediate care – film 241 Unheard voices – care homes outreach 239 129. Discharge to escalation wards 129. Ambassadors on Keogh and CQC review 58

Patient must be at the centre NHS is under considerable strain Increasing demands and reorganisations Duty of candour and better regulation Must be implemented properly Frustrated callers call our helpline in despair  Gap between commitments in the NHS Constitution and reality of being a patient Never been more of a need to gather patient feedback and make use of it

Patient Participation Groups - benefits for GP practices Requirement in GP Contract 2015/16 To gather views of local community Breaks down barriers, builds understanding patient needs and staff limitations Assist with Friends and Family Test CQC Registration/inspection Health Promotion and Information A valuable resource to support the practice...from public health campaigns to fundraising Projects in Devon and Cornwall /Waltham Forest

Project with PCPA Aim To gather feedback from patients and carers about their understanding and experience of pharmacists in GP practices How? Quantitative and qualitative survey of patients and carers across England and Wales

Timescales Survey currently being distributed So far… 273 respondents Questions 5-18 – 98-110 responses Closing date end June Please circulate widely Early findings providing some useful information which I will outline next

Early findings.. Of the 273 respondents so far 77.3% felt a clinical pharmacist would be a positive addition to their surgery Only 10.3% felt it wouldn’t be a positive addition 12.5% were unsure

Early findings Reviewing Medicines 78.4% would like a clinical pharmacist to review their medicines Only 15% answered no 6.6% were unsure

Early findings How often have you spoken to the clinical practice pharmacist in the last year? Of those who responded 58.2% once, 28.2% more than once 13.6% no contact And the reasons…. 22% face to face review 19% question to ask 15% phone review 15% stated ‘other’

Early findings 57.5% felt confident in discussions about stopping medicine 21.3% felt strongly against this 12.5% had some confidence 8.8% were only slightly confident

Early findings Attitudes 78.8% felt welcomed, 12.1% answered yes but not fully, 6.1% felt slightly welcomed Only 3% did not feel welcomed at all. 78.1% of respondents felt their clinical pharmacist showed a caring attitude 11.5% felt they did not fully show a caring attitude 8.3% felt their pharmacist showed a slightly caring attitude 2.1% didn’t feel their pharmacist showed a caring attitude.

Early findings Involvement 74.5% felt completely involved in discussions 14.3% felt somewhat involved 5.1% had little involvement 6.1% had no involvement. Clinical Knowledge 75.5% of respondents felt fully confident that their pharmacist had good clinical knowledge 14.9% felt mostly confident 5.3% were slightly confident 4.3% were not at all confident.

Early findings 75% of respondents felt their questions were completely answered by their clinical pharmacist 14.6% answered ‘yes but not fully’ 6.3% stated ‘slightly’ 4.2% felt their questions weren’t answered. 83.3% stated they weren’t given an explanation on reporting medicines for patient safety 16.7% said they were given an explanation on this matter

Early findings Access to services 80.2% felt they had better access to services with a clinical pharmacist 19.8% felt it made no difference Effect on making appointments 73.2% felt they didn’t have to make an appointment to see the GP after speaking with a clinical pharmacist 26.8% felt it made no difference with regards to making appointments with the GP

Examples of comments “Should be implemented all over.” “There was an element of difficulty, and therefore repetition required, in understanding - due to language/accent challenges. Overall it was a positive interaction. However, older people might find it more difficult to understand what was being said.” “In my former professional capacity I have seen how important it can be for a pharmacist to review medications, especially in relation to medications for mental health problems and elderly care where polypharmacy can do more harm than good.” "This type of service would help patients to avoid the potential problems caused by taking multiple medications for different medical conditions” “It would also reduce the cost to the surgery and the NHS as a whole - let’s try to avoid prescribing even more drugs especially if they are to resolve a problem caused by prescribed drugs!"

Summary Clinical pharmacists have an important role to play in GP practices Better understanding needed by patients of the role and function Review of medications particularly useful Reduces need to see GP Need better explanation on reporting medicines for patient safety Importance of involvement in reaching decisions about medication

Any Questions? www.patients-association.com Heather Eardley Development Director Heather@patients-association.com Helpline 020 8423 8999 Email: helpline@patients-association.com www.patients-association.com