City Wide Update Event

Programme Overview 6.30pm Buffet & Networking 7.00-8.15pm Chris Boyle, Commissioning Officer, Sheffield City Council (SCC): MAR Chart Service 8.15-9.00pm Steve Freedman, NHS Sheffield CCG: Care Navigation & Refer Back to Practice 9.00-9.15pm Garry Myers, Regional PSNC Representative: National Update

Medication Administration Record Service Sheffield LPC City Wide Update Event 29th January 2018 Chris Boyle Commissioning Officer

Context March 2017: Phil Holmes, Director of Adult Services, formally committed to an agreement being implemented Spring 2017: Commissioning and LPC began collaboration, along with other professionals and providers, to develop a service specification and related processes July 2017: Funding approved by Cabinet December 2017: Procurement approved by Cate McDonald, Cabinet Member for Health and Social Care 17th January 2018: Tender went live. Not a competitive process; we are seeking 100% coverage

Aims Financially viable for Pharmacists to provide MAR charts Governance and data around MAR chart provision strengthened Consistent approach to provision of MAR charts A safe ‘holding position’, allowing time for the Medication Policy to be reviewed and revised

Service Specification The specification describes the service that is to be delivered, plus additional information and context The specification also includes: An updated ‘medication authorisation form’ that providers will use to request a MAR chart The standardised MAR chart The agreed pricing schedule

Tender: Timetable Stage Dates / deadlines Invitation to Tender released onto YORtender 17th January @ 17:00 Deadline for tender queries 8th February @ 17:00 Deadline for submission of tenders 16th February @ 17:00 Clarification questions on bid submissions 26th February @ 17:00 Evaluation of tenders 19th February - 1st March  Notification of result of evaluation 2nd March Contract start date 5th March 2018 Contract end date 4th March 2020

Tender: Guidance Read the guidance within the ITT documents before completing. Don’t be put off by the overall size of the documents – quite a few sections are ‘tick boxes’. If you know the question isn’t relevant, then put ‘n/a’ and move on.  If you’re not sure, raise a query via YorTender and we’ll respond as quickly as possible. We’re more than happy to respond to queries, if you’re unsure please ask.  The responses to queries asked via YorTender are published which may help others who have the same query.

Tender: Guidance The method statement question isn’t an essay writing competition.  Read the service specification before responding and make sure your response is clear, concise and evidence-based. Don’t put it off – it may be best to break it up into smaller tasks and complete it over a number of days. Give yourself enough time.  Late submissions can’t be accepted so don’t leave it too late!

Pharmoutcomes When a request for a new individual is received, the information from the Authorisation Form must be added to the ‘patient registration’ page. When a request for an existing service user is received, add as much information as available to the ‘patient registration’ page. When the home care provider completes a review and submits an Authorisation Form, add the new details to the ‘patient registration’ page.

Pharmoutcomes Prior to issuing a MAR chart, the following is recorded in Pharmoutcomes: Name of person Date MAR issued First issuing: yes/no Any changes: yes/no Number of medication covered by MAR Payment requested at start of each month. Same process as other SCC services, such as needle exchange, to be used.

Any questions?

Care Navigation & Refer Back to Practice

Care Navigation A referral from the surgery to pharmacy (one of up to six alternative care providers) Improves Primary Care delivery Integrates pharmacy within Primary Care Improves relationship with GP practices Introduction: Claire/Susie. In this presentation I am going to cover these 3 things; Why navigate patients to pharmacies? Who could you navigate to a pharmacy? Tips for helping the navigation process

Why Navigate to Pharmacies? Frees up GP appointments A wide range of common conditions can be managed safely and effectively Pharmacist can provide advice and medicines to support patient self-care In some cases this may be Minor Ailments Community pharmacists & their staff can help patients manage a wide range of common conditions with selfcare &/or medication. Many common/minor conditions are what we call ‘self-limiting’ i.e. they ultimately resolve themselves without treatment and often all that is required is advice and reassurance about what the patient should expect to happen before the condition has resolved and what they can do to manage their symptoms until the condition has resolved. In some instances e.g. with a cough/cold over the counter products are available that can help relieve symptoms until the condition has resolved. In Sheffield community pharmacies are commissioned to be able to supply treatment to patients for a wide range of common/minor conditions without the patient having to see the doctor (these will be listed on the following slide). Patients who are exempt from prescription charges will be able to receive treatment free of charge. Through this scheme community pharmacies can also provide treatment/medicines to patients experiencing common side effects from cancer treatment (chemotherapy).

Care Navigation Reception staff ‘signpost’ patients to pharmacy Template in SystmOne and EMIS Basic Triage ‘Red Flag’ symptoms

Red Flag Symptoms Symptoms that require investigation Patient to be referred to GP or, if serious, to A&E Reception staff not expected to make clinical decisions - Pharmacists to take clinical responsibility

Roll Out of Care Navigation Workshops have been held with all localities Attended by GPs, practice managers and reception staff Pharmacy option well received

Refer Back to Practice Applies to ALL patient consultations Care Navigation Minor Ailments Support for Self-Care

Refer Back to Practice Vital to provide information Concerns raised by LMC and practices (Negative impact on relationships - GP & Patient) Referral note can be:- Given to patient (Generated by PharmOutcomes or manually entered on paper form) Emailed automatically to surgery (PharmOutcomes)

Refer Back to Practice Recording referrals Good clinical practice Evidence of delivery of Support for Self-Care and CPD reflection

Refer Back to Practice PharmOutcomes Quick and easy Automatically maintains a record Captures benefit measures Produces a ‘Notification Letter’ Emails directly to the practice

PharmOutcomes https://pharmoutcomes.org/pharmoutcomes/system/login

Patient Consent

Patient and Pharmacist Details Selecting ‘Yes’ opens GP List & opens consultation questions Select ‘No’ opens consultation questions

Diagnosis and Request Symptoms Diagnosis Additional Info’

Diagnosis and Request Actions for Surgery

Timescale

Benefit of Intervention

Notification Letter Notification Letter

Patient Form To be used prior to (or instead of) using PharmOutcomes

PharmOutcomes Form To be used when there’s no access to PharmOutcomes at the point of the consultation

PharmOutcomes Messages

CCG Outbox Introduction: Claire/Susie. In this presentation I am going to cover these 3 things; Why navigate patients to pharmacies? Who could you navigate to a pharmacy? Tips for helping the navigation process

Email Message

Recipient “Home” Page

Opened Message – Non Urgent

Opened Message - Urgent

Any Questions?

National Update Garry Myers Regional PSNC Representative

PSNC Contractor Briefing Retained Margin & Cash flow Price concessions DH Correspondence – interim funding 17/18 EP SAF QP FV EPS4 PhAS New Contract Framework (Universal Care Framework & Care Plan) New National Contract Funding Models Ashridge & LPC Conference

CPS Request for Information Questionnaire will be sent to all pharmacies Please respond Will help to explore potential local service development opportunities

Close Thank you all for attending Thank you to all of our guest speakers Looking Forward