1. Nottinghamshire & Derbyshire GP / Pharmacy Transformation Programme Unlocking the Potential of Community Pharmacy Cathy Quinn Pharmacist Lead Newark & Sherwood and Mansfield & Ashfield CCGs Nottinghamshire LPC Annual General Meeting - 15 September 2016

2. Policy & National Context
‘’We can capitalise on the untapped potential, and convenience, that greater utilisation of the skills and expertise of the pharmacy workforce can offer.”
Transforming urgent and emergency care services in England - Urgent and Emergency Care Review End of Phase 1 Report’, 13 Nov 2013
‘’We are committed to ensuring we maximise the part community pharmacy can play in delivering a sustainable long term solution’’
Simon Stevens, Oct 2014 , Five Year Forward View

3. Background
Business case to explore ‘untapped potential’ of Community pharmacist independent prescribers in supporting GPs (July 2014)
NHS England local office funded 18 month project
Hosted and managed by Newark & Sherwood CCG
Initially 4 sites across both Derbyshire & Nottinghamshire
Extended to 6 sites

4. Project Aims & Objectives
Improve Primary Care access
Release GP time
Improve patient experience
Improve Health outcomes
Medicines optimisation
Quality & Safety
Better use of healthcare system

5. GP / Pharmacy Transformation Pilot Sites
Lister House –pear tree suburb of Derby city

6. Project Overview and Progress
First site went live July 2015
Implementation over 9 months, final site started April 2016
Pharmacists undertaking clinical reviews:
Medication reviews including care homes (56%)
Long term disease management reviews (asthma, CHD, CKD and hypertension) (29%)
Urgent care (7%)
Other (8%)
‘Other’ includes medication queries, discharge information, travel queries, anticoagulant review
NB: some dual recording

7. Emerging Outcomes At end August 2016:
6400 consultations – face-to-face and telephone
Estimated 1,250 hours of GP time saved
Favourable cost per consultation - £21.00 to £38.00
Evidence of significant clinical interventions
Medicines changed in 59% of cases
Safety and quality improvements
side-effects18%, blood tests 15%, self-care advice 23%
8.5% potential reduction in secondary care referrals
Excellent patient feedback

8. Next Steps and Sustainability
Project is delivering positive outcomes but still to reach its full potential
Due to end November 2016, but each site will remain live for at least one year
Project now runs alongside National Clinical Pharmacists in GP practice pilot
Business case being explored to extend pilot and expand model for Community Pharmacist Independent Prescribers in General Practice
Sustainability will require coherent planning and workforce development

9. Benefits of Programme Community Pharmacy Independent Prescribers
Medicines expertise in multi-disciplinary team
Contractor model
Reduced employment risk
Corporate indemnity
Dedicated GP mentorship
Project management
Bespoke training
Local independent evaluation
Potential to transfer work to Community Pharmacy

10. What do patients think?
“She is lovely, fantastic, I learnt all about my tablets which I didn’t know before”
“I have not always been able to understand all of the information I have been given before about my health.”
“This is the first time I have been able to
properly discuss my medications with an
expert”.
“She went over everything you can ask her questions if you don’t understand and you don’t feel like
you are on the clock…”
“Very good. It should be done for everyone as it points you in the right direction.”
“The pharmacist was very helpful. He answered the questions I asked and explained himself well. I felt really at ease with him.”

11. Discussion Any questions?
Further information at: /gppt_2.pdf
Discreet but complimentary project