in support of Primary Care Clusters : COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Community Pharmacy: in support of Primary Care Clusters : Anglesey & Arfon Presentation is designed to be an overview of how community pharmacy can support and become integrated within Primary care clusters. Intention is to look at the identified needs/ targets of the cluster and be solution focused as to how community pharmacy can support those needs, in particular outlining activities that can decrease GP workload. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Welsh Community Pharmacy Basics COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Welsh Community Pharmacy Basics 716 community pharmacies 35 million patient visits each year 74 million prescriptions dispensed 96% of pharmacies have private consultation rooms The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Medicines Issues 30% - 50% of medicines not taken as intended COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Medicines Issues 30% - 50% of medicines not taken as intended 4%-5% of hospital admissions due to preventable adverse effects of medicines Pharmacists as “experts in medicines”. Pharmacist training is a 4 year Masters degree followed by a year of supervised pre-registration training and then a further exam before qualifying. Pharmacists are required to undertake mandatory Continuing professional development throughout the careers and further accreditation requirements are needed to carry out Advanced Services (Medicine use Reviews and Discharge Medicine Reviews) plus some Enhanced services. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Community Pharmacies Can Help COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Community Pharmacies Can Help Helping People Live Healthier Lives Supporting People to Self Care Supporting People to live independently Optimising use of medicines The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Medicines Optimisation COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Medicines Optimisation Dispensing & Repeat Dispensing Medicines Use Reviews Hospital Discharge Medicines Service Safe Disposal of Unwanted Medicines & Diabetic Sharps Palliative Care “Just in Case” Boxes Emergency Supply Services Possible Future Services Management of Chronic Conditions Polypharmacy : STOPP/START 70% of Medicines use reviews are required to be in targeted groups, these include respiratory patients and additional services have been developed in some LHB areas (or this LHB area…… expand as required) Existing services could be used better e.g. collaborative approach to refer patients for MUR who would benefit The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Supporting Patients to Self Care COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Supporting Patients to Self Care Existing Services Self Care Advice Self Limiting Conditions Long Term Conditions Signposting to other healthcare providers (contractual obligation) Over the Counter Sales Future Services Choose Pharmacy Common Ailments Service (roll out) Triage & Treat Services Further information about CAS and Triage and treat The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Supporting Independent Living COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Supporting Independent Living NHS Repeat Dispensing Service & support for ordering repeat medicines Provision of Multi-Compartment Compliance Aids & MAR Charts Medicines Delivery Services (not contractual) Signposting to Additional Resources & Support Pharmacist responsible for undertaking assessment with patient in relation to compliance aids etc. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Supporting People to Live Healthier Lives COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Supporting People to Live Healthier Lives Healthy Lifestyle Advice NHS Dispensing & MUR Services Six Public Health Campaigns per year Locally Commissioned NHS Services Stop Smoking Substance Misuse Flu Vaccination Emergency Contraception Public health campaigns form part of community pharmacy contract – currently 3 are national campaigns with up to 3 organised by the LHBs – potentially in future the LHB campaigns could be done at cluster levels. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Supporting People to Live Healthier Lives COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Supporting People to Live Healthier Lives Possible Future Services Health Checks CV Screening Dementia Screening Diabetes Screening COPD Screening The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

The Local Position: North Wales COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 The Local Position: North Wales 156 Community Pharmacies in North Wales Consultation Rooms in 152 13 commissioned services available which could be further utilised to : Take pressure off GP Services Help Improve Health & Wellbeing across the Locality Discussion about the specific primary care cluster presenting to. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

The Local Position: Anglesey & Arfon COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 The Local Position: Anglesey & Arfon 13 Community Pharmacies in Anglesey 10 Community Pharmacies in Arfon All have designated consultation rooms 13 commissioned services available which could be further utilised to : Take pressure off GP Services Help Improve Health & Wellbeing across the Locality Discussion about the specific primary care cluster presenting to. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

The Local Position Existing NHS Services available in Anglesey & Arfon COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 The Local Position Existing NHS Services available in Anglesey & Arfon Advanced Services Medicines Use Reviews Hospital Discharge Medicines Reviews Enhanced Services Smoking Cessation Level 3 Service Palliative Care Services – 2 available Needle & Syringe Exchange Supervised Consumption EHC Flu Vaccination Diabetic Sharps Boxes Respiratory Service Emergency Supply to Temporary Residents Emergency OOH Supply Service Common Ailments service Rota services Explanation of what is there currently – all funded by NHS. Briefly touch on what the services are. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

The Local Position Priorities Priority: COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 The Local Position Priorities Priority: Smoking Cessation Community Pharmacy could support by: Smoking Cessation Level 3 Services in all pharmacies: Active Referral to pharmacies Smoking Cessation Level 2 Service commissioned in pharmacies How community pharmacy could support the cluster on their identified priorities. These were all cluster priorities stated by a cluster. Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

The Local Position Priorities Priority: COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 The Local Position Priorities Priority: GP Capacity Issues Community Pharmacy could support by: Common Ailments service Repeat Dispensing Chronic Conditions Management Better integration and understanding of priorities (QOF etc) How community pharmacy could support the cluster on their identified priorities. These were all cluster priorities stated by a cluster. Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

The Local Position Priorities Priority: COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 The Local Position Priorities Priority: Palliative Care Community Pharmacy could support by: Just in Case Boxes In hours palliative care service How community pharmacy could support the cluster on their identified priorities. These were all cluster priorities stated by a cluster. Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

The Local Position Priorities Priority: COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 The Local Position Priorities Priority: Medicines Management topics Community Pharmacy could support by: Falls Prevention service Polypharmacy Respiratory Service Domiciliary Support AKI - MURs How community pharmacy could support the cluster on their identified priorities. These were all cluster priorities stated by a cluster. Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Unscheduled Care Priority: Community Pharmacy could support by: COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Unscheduled Care Priority: Patients attending A&E Re-admittance to hospital Pressure on Out of Hours Community Pharmacy could support by: Choose Well Promotion Referral to pharmacies Triage and Treat Discharge Medicines Review Chronic conditions Management Emergency supply service Temporary Resident service Common Ailments Service How community pharmacy could support the cluster on their identified priorities. These were all cluster priorities stated by a cluster. Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

Primary Care Pharmacists in GP Clusters COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Primary Care Pharmacists in GP Clusters Employed Pharmacists Working in GP Practices and across cluster/ locality Support Prescribing Initiatives Community Pharmacies can support this work and reinforce patient messages How can we work together to deliver improved patient outcomes? Setting up regular dialogue between employed pharmacists and community pharmacists to develop integration and better relationships. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016 Next Steps ? Community Pharmacy involvement in Locality / Cluster Teams – as well as LHB pharmacists Identify areas where community pharmacy can support locality priorities - integrated working The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru