Changes to the Community Pharmacy Contractual Framework in Wales Jayne Howard Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
Llais Fferylliaeth yng Nghymru October 2016 - the UK Government announced proposals to cut the funding available to community pharmacies in England Vaughan Gething, clarified the position in Wales – Welsh Government considers the community pharmacy sector to be a fundamental part of a strong primary care service. Commits to investing in community pharmacies to take pressure off GP services, reducing unnecessary appointments and making sure people are able to see the right professional in the right setting at the right time. The current financial year does not include any proposals to reduce investment in community pharmacy. In October 2016 the UK Government announced proposals to cut the funding available to community pharmacies in England from 1 December 2016. The cuts amounted to a reduction of 4% to the sector in England in 2016-17 and over 7% in 2017-18. Following the announcement, Vaughan Gething, Cabinet Secretary for Health, Wellbeing and Sport, clarified the position in Wales and made it clear that the Welsh Government considers the community pharmacy sector to be a fundamental part of a strong primary care service. The programme the government set out in Taking Wales Forward, commits to investing in community pharmacies to take pressure off GP services, reducing unnecessary appointments and making sure people are able to see the right professional in the right setting at the right time. To support this the health and social services budget in Wales for the current and next financial year does not include any proposals to reduce investment in community pharmacy. Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
Llais Fferylliaeth yng Nghymru The next 5 years Redistribution of the funding to address Government priorities into the following areas: More clinical services Commitment to improvements in quality and safety Information Technology Workforce development Collaborative Working Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
Llais Fferylliaeth yng Nghymru 2017/18 More Clinical Services Through increase in delivery of Enhanced Services Improvements in Quality & Safety (in Q4 Jan-Mar 2018) New element – under discussion Collaborative Working (September 2017 onwards) New element - agreed Oct 2017 Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working Llais Fferylliaeth yng Nghymru To encourage community pharmacy in Wales to engage with primary care cluster and develop and improve collaborative working relationships with Gps and other healthcare professionals Priority Areas: Repeat/Batch Dispensing Repeat Prescribing Common Ailments Flu Discharge Medicine Reviews Clusters Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working Llais Fferylliaeth yng Nghymru REPEAT DISPENSING/BATCH PRESCRIBING Priority Area: Promotion and establishment of repeat dispensing/batch prescribing (RD) Rationale: Improving systems to reduce waste and GP practice workload Essential Services element of the CPCF. All pharmacies must be able to offer this service - pharmacy contractors should ensure that all pharmacists are accredited to do so. Dispensing Operation Manuals for Pharmacies and GPs developed. Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working Llais Fferylliaeth yng Nghymru REPEAT PRESCRIBING/MANAGED REPEATS Priority Area: Improving the operation of repeat prescribing systems (other than – repeat dispensing/batch prescribing) with a particular focus on reducing waste Rationale: Improving systems to reduce GP practice workload Often referred to as “Repeat Prescription Collection and Ordering Services” or “Managed Repeats” and are not contractual Frequently involve ordering, collecting and delivering prescriptions on behalf of patients. Some cluster areas have introduced specific requirements for operating these systems and ABMUHB has gone as far as piloting a Prescription Ordering Hub to take orders from patients. The introduction of any specific systems/requirements should be done in collaboration with all involved, including pharmacies. Pharmacists may wish to discuss: The detail of the service(s) that they offer to patients How patients access the service and communicate to pharmacies what items that they require. Opportunities with the service to work closer together and opportunities for feedback where patients are stating issues (on either side). Potential for pharmacies to use the service to direct into Repeat Dispensing/Batch Prescribing Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working Llais Fferylliaeth yng Nghymru COMMON AILMENTS SERVICE Priority Area: Ensuring the benefits of the common ailment service to patients and the NHS are maximised Rationale: Improving access and appropriateness of care Rolled out in parallel with the Choose Pharmacy IT platform Common 76/77 pharmacies eligible in Cwm Taf UHB to provide the service – last figures indicate 71/76 had started delivering the service. All commissioned pharmacies should ensure that all pharmacists, including locums, are accredited to provide the service Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working Llais Fferylliaeth yng Nghymru INFLUENZA VACCINATION SERVICE Priority Area: Developing arrangements for maximising the uptake of influenza vaccination within the community Rationale: Improving vaccination rates and health Memorandum of Understanding has been developed between CPW and GPC (Wales) to encourage the development of arrangements for maximising the uptake of influenza vaccination within the community. Work together to identify specific groups who would perhaps benefit from Community Pharmacist targeting. Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working Llais Fferylliaeth yng Nghymru DISCHARGE MEDICINES REVIEW SERVICE (DMR) Priority Area: Making arrangements for undertaking discharge medicines reviews particularly for patients discharged from hospital to a care home to which the pharmacy provides dispensing services and the GP provides the General Medical Services care homes directed enhanced service Rationale: Reducing medicines related harm resulting from transfers of care eDALs available via the Choose Pharmacy IT platform Working with GP practice to identify eligible patients particularly those patients discharged to a care home for which the GP provide a General Medical Services care homes directed enhanced service will ensure this service is provided to the most vulnerable. Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working ENGAGING WITH PRIMARY CARE CLUSTERS Priority Area: Understanding and engaging in primary care cluster priorities through attendance at primary care cluster meetings Rationale: Improving communication and engagement of community pharmacies 21 Pharmacies in Taff Cluster – Engagement? Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
2017/18 – Collaborative Working Llais Fferylliaeth yng Nghymru Details set out in Drug Tariff: At least one of the claims for collaborative work relates to work undertaken by a pharmacist. In the case of the first five areas, the collaborative work is undertaken by a pharmacist or pharmacy technician who regularly works at the pharmacy In the case of meeting with clusters the collaborative work is undertaken by a pharmacist who regularly works at the pharmacy A detailed report of the visit is maintained at the pharmacy (which is updated with current status of any actions agreed) for inspection by the local health board. (i.e. on two or more days per week for a period of four weeks prior to and immediately after the visit) Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
Llais Fferylliaeth yng Nghymru Pharmacy’s Voice in Wales Llais Fferylliaeth yng Nghymru
Taff Cluster Pharmacies