Integration of community pharmacy with PCNs Ash Pandya – CEO lpc Mahua Das – Community Pharmacist

Nine care processes √ Intervention Pharmacy delivers Pharmacy Could deliver Accurate Diagnosis of COPD Co-Morbidity and Frailty Index Offer Flu Vaccine √ Offer Smoking Cessation Offer Pulmonary Rehabilitation Record Cat, MRC, exacerbation Inhaler technique device optimisation Self management options Care Navigation & Patient empowerment

Pharmacy Advanced services Medicine Use Review (MUR) New Medicine Service (NMS) NHS Urgent Medicine Supply Service(NUMSAS) Ventolin /Salbutamol still in top 5 requested items Quality Payment Scheme (QPS)

Pharmacy QUALITY PAYMENT SCHEME (QPS) Clinical Effectiveness - Referral for Asthma Review On 15 February 2019, was the pharmacy able to show evidence that relevant asthma patients were referred for an asthma review?

Community Pharmacy Smoking Cessation 12 CONTRACTORS PROVIDING Smoking Cessation (25%) 117 QUITS IN 2018/19 285 REGISTERED FOR SMOKING CESSATION COUNTLESS MORE OFFERED SMOKING CESSATION DO GPs HAVE THESE FIGURES? – PCN OPPORTUNITY TO ENGAGE AND SHARE DATA

Community PHARMACY INTEGRATING with pcn Community pharmacist as PCN DES Pharmacist All pharmacies aligned with PCN Dedicated Pharmacy lead for engagement with PCN Specialisation with some Independent Prescribers Shared Workload e.g Hypertension service Better use of NHS Estates

Case STUDY 87 year old woman – Visits Pharmacy for cough medicine (started 3 weeks ago whilst on a cruise) On long term steroids and coming to end of 7 day amoxycillin Assessed in pharmacy SATs 93-94% ,Temp 37.6.BP 111/65 (usual BP 139/85) Reports slight improvement but still breathless not feeling herself Pharmacist does an MUR (includes assessment of inhaler technique –fine) Pharmacist referred patient back to GP for chest x-ray Concerned could be Atypical Pneumonia X-ray suggest pneumonia – doxycycline initiated (hospital admission prevented)

Pharmacist early detection Patients often self care for cough and cold Known respiratory patient pharmacist can Check Peakflow Review Asthma / COPD Plan Check oxygen Sats Empower and engage the patient

Routine MONITORING Smoking Cessation Inhaler Technique MRC and CAT scores Check Medicines being used correctly Refer for Pulmonary Rehabilitation Empower patient to self care Sees patient 12-18 times a year

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