1. 3D Commissioning

2. Existing models of service delivery How can we make better use of these intervention opportunities? The integrated commissioning of new pharmacy services or development of existing services to maximise patient outcomes What is 3D Commissioning? Medicines Use Review Local Enhanced Services.

3. Improved uptake of Hepatitis B vaccine in at risk group Rapid referral of Clients screening positive to Hepatitis B or C to secondary care team plus support for clients by BBV lead. Conclusion – Some patient groups are only hard to reach because the wrong service delivery model is applied! Service Expansion December 1 st 2009 – World Aids Day to Include HIV testing. - One asymptomatic patient identified and referred for treatment - Hepatitis B vaccination service made available to all at risk groups. - BBV testing service made available to all. Improved outcomes for service users

4. 2008-2009 campaign stand alone GP service - Percentage of under 65 years with co-morbidity engaged = 17% 2009-2010 campaign integrated service delivery including C.P - Percentage of under 65 years with co-morbidity engaged >30% - 721 vaccines administered by community pharmacists 2010-2011 campaign – integrated service delivery - 1200 vaccinations provided by community pharmacists in first 2 weeks of service delivery - Under 65 years with co-morbidity engaged = 38% Improve choice.......improve uptake.......engage hard to reach groups No impact on uptake of vaccine via GP service providers Seasonal Influenza Campaign

5. Pharmacy based H1N1 vaccination centres for under 5’s Best use of skill mix – pharmacists already trained 7 Pharmacy based vaccination centres set up in areas of the Island where, due to increase demands on service, GP colleagues identified capacity issues Additional training support – paediatric vaccination technique, paediatric anaphylaxis and BLS, use of multi-dose vials Outcomes – over 400 under 5’s vaccinated via pharmacy service. Isle of Wight PCT uptake best in SHA, one of the best in England. Flu pandemic 2009-2010 Vaccination services – more pharmacy involvement

6. First Contraception Service - Uses EHC as platform for service delivery - 1987 provisions of EHC via community pharmacy in 2009 cf. total 422 via all other providers Opportunity to do more - Identify suitable clients for contraceptive initiation. - provide education on safe sex, STI’s and contraceptive choice, particularly LARC - 28 days POP under PGD, with onward referra l to mainstream CASH services Joined up working – building on successes!

7. TARGETED AND INTEGRATED MURS

8. Outcomes: IOW Respiratory MUR Emergency admissions to hospital due to asthma have fallen by 57.8% Hospital length of stay due to asthma has fallen by 50.9%Asthma related deaths have fallen by 75% Prescriptions for selective beta 2 agonists have fallen by 22.7% (£58k)

9. Outcomes: Portsmouth Respiratory MUR 594 patients seen35% not seen by another HCP in previous 12 months30% were smokers, 75% recruited for stop smokingAverage asthma quality of life score = 16/2574% uncontrolled6% referred to GP70% seen second time improved

10. Distribution of Green Bags to Patients Emergency admissions - Distributed via Ambulance Service Elective admissions - Distribution via Community Pharmacies Green bag hand over - trigger for pre-admission MUR - Information transferred to pre-admission team Notification to GP Post Discharge MUR Opportunity – formalise referral for post discharge MUR