1. Medicines Optimisation Update
CCG Council Meetings
April 2016

2. Evidence requests have been sent to all practices by the MOT.
Submission of Evidence must be complete by 13th May 2016.
MOT will inform each practice of their achievement by 29th May 2016.
Practices will have 2 weeks to submit an appeal for any target they have failed to achieve. Appeals received after 10th June will not be considered.
The Appeal panel will review all appeals on 15th June 2016.
Practices will be sent final confirmation of their achievement by 30th June 2016.
PQS 2015/16

3. The Prescribing QIPP for 2015/16 was £900,000.
We are proud to report that the 4 CCGs have actually delivered savings of
£1,026,700
Name of CCG
Value of QIPP savings
Newbury and District
£ 204,824
North and West Reading
£ 207,093
South Reading
£ 287,686
Wokingham
£ 327,096
Successes from 2015/6

4. OAB Review – (Based on evidence already received from 15 practices)
256 patients reviewed (Female patients aged 75 and over)
66 patients had medication stopped (25%)
41 patients had medication changed (16%)
The benefits of this review are better quality care, review
of anticholinergic load and hence reduced risk of cognitive
decline and dementia, fewer side effects and reduced
waste medication.
Epact data for Q shows that 254 fewer items of OAB
antimuscarinic agents were prescribed compared to the
same period in 2014, saving £6,229. If this is extrapolated for a
year this equates to £25,000 for the 15 practices.
Successes from 2015/6

5. Successes from 2015/6

6. Successes from 2015/6 Antibiotic Prescribing
Practices have continued to reduce their prescribing of antibiotics
as a whole and have also reduced the proportion of the 3Cs that
are prescribed.
Successes from 2015/6

7. Successes from 2015/6 3C Antibiotic Prescribing
The target was to achieve the national target ≤11.3% for 2014/15 but 10% for 2016/17.
Successes from 2015/6

8. The total MO QIPP for 2016/17 is £675,000.
PQS 2016/17
The total MO QIPP for 2016/17 is £675,000.
There is no requirement in this years scheme for practices to have a meeting with the Pharmaceutical Advisor to go through the PQS targets.
The PQS document clearly states the work that MOT will carry out on behalf of the practice and what is required of the practice as a result.
It is the responsibility of each practice to ensure that all clinicians are familiar with the content of the PQS document.
Wherever possible Scriptswitch will continue to prompt clinicians to select local formulary choices.

9. PQS 2016/17 – Diabetes BGTS LAIA SU in > 75s SGLT2 Needles
New initiations in line with formulary
Removal of BGT in patients inappropriately testing
New initiations (T2) must meet NICE criteria
New initiations (T2) prescribed as Abasaglar®
Review medication if HbA1C < 58mmol/L
Review effectiveness in newly initiated patients
Continued from 2015/16, to be in line with formulary
PQS 2016/17 – Diabetes

10. PQS 2016/17 – Renal and Respiratory
Respiratory LABA/ICS
SABA > 12/year
To continue building on the work carried out in 2015/16 to reduce risk of AKI
LABA/ICS inhaler to be prescribed by BRAND name
Continued from 2015/16 to assess impact of interventions made.
PQS 2016/17 – Renal and Respiratory

11. PQS 2016/17 – Cardiovascular NOAC HF AF Antiplatelets
Check compliance with treatment and provide appropriate education.
Use GRASP-HF to identify patients who may have undiagnosed/un-coded HF.
Use GRASP-AF to identify any high risk patients who are not prescribed anticoagulants.
To ensure treatment is stopped in patients 12 months post PCI
PQS 2016/17 – Cardiovascular

12. PQS 2016/17 – Antibiotics and Genito-Urinary
Otitis Media Audit
Antibiotic Prescribing
3Cs Prescribing
Continence Pads
OAB
To continue building on the work carried out in 2015/16 practice to undertake 2 audit cycles.
Continued from 2015/16 in line with the new QP targets
Identification of patients using pad and taking OAB medication.
Continued from 2015/16, for female patients aged
PQS 2016/17 – Antibiotics and Genito-Urinary

13. PQS 2016/17 – Repeat Prescribing
RP Review
RP Champion
Open-Up Campaign
ICS Inhaler
To continue building on the work carried out in 2015/16 to improve repeat prescribing systems.
To be a point of contact in the practice to disseminate good practice and general RP information.
To display a poster encouraging patients to be open about what medication they actually take.
To identify inappropriate usage and ensure dose instructions are written on prescriptions.
PQS 2016/17 – Repeat Prescribing

14. Evening Meetings
In Year Savings
Scriptswitch
Continuing the educational meetings from 2015/16, one evening event will be arranged each quarter. Topics and Dates to be confirmed.
Any savings which come to light in year will be communicated to the practices and support provided by MOT to implement any changes, where possible.
Continued from 2015/16, practices to have a pop up rate < 15%
PQS 2016/17 – Miscellaneous

15. Top Tips
Incorporate the quarterly work report left by MOT after each visit into an agenda for practice meeting.
Share the workload amongst all clinicians (including PNs)
All patient lists, where possible, are saved in the practice shared drive. Clinicians could record actions directly into the spreadsheet.
Practices may choose to identify a named a person within the practice, who is able to coordinate and collate actions for submission. 
Ensure that there is continuous learning from PQS
Targets that require “PRIMIS” - please ensure that the queries are run by date requested and exactly as instructed.

16. Any Questions?