New Medicines Service(NMS) Maximising Advances Services Mark Oak

In the beginning…… March 2014 Joined a forward thinking independent community pharmacy Strong client base offering a diverse range of services to patients Including EHC, MURs, Flu Vaccinations, Smoking Cessation and Minor Ailments The NEW MEDICINES SERVICE was not actively pursued, initially had engaged with service but time and resourses were limited

Why can’t we always deliver efficiently Biggest barriers to us delivering the service Time Three step process (Initiation/Consent, Intervention and Follow Up) , other services are a single interaction Staff training and awareness Something else to just add to the long list!

Lets look at the positives if we deliver…. Service Increases the scope of the pharmacy’s services Prevents patients using medicines incorrectly and increases likelihood of compliance Prevents unnecessary hospital admissions and adverse drug reactions Increases patient self-management and future health outcomes Improves the service provided to at risk patients We do this already every day!

Lets look at the positives if we deliver…. Business Remuneration is comparable to MURs if delivered in significant numbers Customers engage and appreciate the service, especially when we can make positive interventions Promotes repeat custom Limited expenditure needed (uses current resources – staff, expertise) Can promote patients coming in-store e.g. for blood pressure check, opportunity for further services

We need to share the responsibility… Often we find that the responsibility falls with the pharmacist for services, sometimes understandably. In this case identification and organisational aspects can be delegated Pharmacists Locums Technicians Dispensing Team Shop staff Apprentices and Pre-Reg’s

How did we set our team up? Engage with all staff about the service Dispensary team can identify and communicate about potential NMS candidates Shop healthcare assistants can give a brief overview of the service if a patient asks before the pharmacist takes over Feedback to the team at daily morning meetings and monitor performance

Lets keep it simple! Keep the service as simple as possible Consent forms ready, stapled to the intervention and follow up paperwork Keep this paperwork at arms reach NMS identification activated on PMR system to aid recruitment Folder set up with monthly patient list of those signed up and day of the month divider used to insert paperwork on the relevant day to action Try and keep on top of the interventions and follow up – daily basis? Senior members of the team understand service process for guidance to other team members and locums Medicines included in the service on dispensary wall, easily visible!

Shall we let others know? Our team decided to engage with the local GP practices we collect prescriptions from Letters were sent – promoting and explaining the service Meetings were held – this helped put a name to a face and promoted working relationships Little was known about the service at GP surgeries but once it was explained everyone was on board! Lets have a go!

Surprisingly good start to the service Patients were receptive to the service – their healthcare and medication we were taking an interest in, easy sell with positive benefits Highlighted the amount of new medicines we get through the door each day Couple of minutes with each patient explaining about dosage schedule, counselling points, learning a little about the patients condition and gaining consent Patients happy to hear from us when we made the calls, staff were SUPRISINGLY excited when they found one to recruit!

Teething problems Untidy folder! Stay organised, if you get chance get other members of the team to check for workload Getting the time to make the calls on the relevant day Try to spend a few minutes each day on it, a few calls can be made in quiet spells Claiming in time for month end If it becomes part of the day job it wont be an issue How to make interventions to the GP Pre-printed forms are difficult to fill in on the phone neatly, write basic letters to the GP Look at the weather!!!! Frustrating when we call and people are out Most people don’t like the rain, quiet shop and everyone is in!

Integration with other services Through appropriate referrals we can actually increase numbers…….. Healthy Living Pharmacy Blood pressure checks, NHS Health Checks Communication with surgery to get same or next day appointments for patients with high blood pressure Written communication to the GP - NEW NMS RECRUIT

Integration with other services By conducting regular and evidence based reviews we can increase numbers… Medicines Use Reviews Sub optimal therapy e.g. patients monitoring BP at home Side effects e.g. cough with ACEi Inconvenient treatment for patient e.g. warfarin – change to Rivaroxaban NEW NMS RECRUITS

Benefits to our pharmacy service Become part of the day job – no need to monitor and communicate on a daily basis Patients come back to see us each time, they appreciate the call and remind us when we haven’t called!! Staff are engaged with the service – e.g. taking blood pressures in store, something different for staff Numbers are significantly increased – majority if not all revenue is profit Lots of valuable interventions can be made increasing the health and wellbeing of our local population Improved GP surgery relationships Increases patient confidence in future services

Top Tips Stay organised with recruitment and intervention dates Visit the NMS folder on a DAILY basis Engage with your local surgeries and doctors in regard to specific patients you may be able to help

Thanks for your time!