1. City Wide Update Event

2. Programme Overview 6.30pm Buffet & Networking
pm Chris Boyle, Commissioning Officer, Sheffield City Council (SCC): MAR Chart Service
pm Steve Freedman, NHS Sheffield CCG: Care Navigation & Refer Back to Practice
pm Garry Myers, Regional PSNC Representative: National Update

3. Medication Administration Record Service
Sheffield LPC City Wide Update Event
29th January 2018
Chris Boyle
Commissioning Officer

4. Context
March 2017: Phil Holmes, Director of Adult Services, formally committed to an agreement being implemented
Spring 2017: Commissioning and LPC began collaboration, along with other professionals and providers, to develop a service specification and related processes
July 2017: Funding approved by Cabinet
December 2017: Procurement approved by Cate McDonald, Cabinet Member for Health and Social Care
17th January 2018: Tender went live. Not a competitive process; we are seeking 100% coverage

5. Aims Financially viable for Pharmacists to provide MAR charts
Governance and data around MAR chart provision strengthened
Consistent approach to provision of MAR charts
A safe ‘holding position’, allowing time for the Medication Policy to be reviewed and revised

6. Service Specification
The specification describes the service that is to be delivered, plus additional information and context
The specification also includes:
An updated ‘medication authorisation form’ that providers will use to request a MAR chart
The standardised MAR chart
The agreed pricing schedule

8. Tender: Timetable Stage Dates / deadlines
Invitation to Tender released onto YORtender
17th 17:00
Deadline for tender queries
8th 17:00
Deadline for submission of tenders
16th 17:00
Clarification questions on bid submissions
26th 17:00
Evaluation of tenders
19th February - 1st March 
Notification of result of evaluation
2nd March
Contract start date
5th March 2018
Contract end date
4th March 2020

9. Tender: Guidance
Read the guidance within the ITT documents before completing.
Don’t be put off by the overall size of the documents – quite a few sections are ‘tick boxes’.
If you know the question isn’t relevant, then put ‘n/a’ and move on.  If you’re not sure, raise a query via YorTender and we’ll respond as quickly as possible.
We’re more than happy to respond to queries, if you’re unsure please ask.  The responses to queries asked via YorTender are published which may help others who have the same query.

10. Tender: Guidance
The method statement question isn’t an essay writing competition.  Read the service specification before responding and make sure your response is clear, concise and evidence-based.
Don’t put it off – it may be best to break it up into smaller tasks and complete it over a number of days.
Give yourself enough time.  Late submissions can’t be accepted so don’t leave it too late!

11. Pharmoutcomes
When a request for a new individual is received, the information from the Authorisation Form must be added to the ‘patient registration’ page.
When a request for an existing service user is received, add as much information as available to the ‘patient registration’ page.
When the home care provider completes a review and submits an Authorisation Form, add the new details to the ‘patient registration’ page.

12. Pharmoutcomes
Prior to issuing a MAR chart, the following is recorded in Pharmoutcomes:
Name of person
Date MAR issued
First issuing: yes/no
Any changes: yes/no
Number of medication covered by MAR
Payment requested at start of each month. Same process as other SCC services, such as needle exchange, to be used.

13. Any questions?

14. Care Navigation & Refer Back to Practice

15. Care Navigation
A referral from the surgery to pharmacy (one of up to six alternative care providers)
Improves Primary Care delivery
Integrates pharmacy within Primary Care
Improves relationship with GP practices
Introduction: Claire/Susie. In this presentation I am going to cover these 3 things;
Why navigate patients to pharmacies?
Who could you navigate to a pharmacy?
Tips for helping the navigation process

16. Why Navigate to Pharmacies?
Frees up GP appointments
A wide range of common conditions can be managed safely and effectively
Pharmacist can provide advice and medicines to support patient self-care
In some cases this may be Minor Ailments
Community pharmacists & their staff can help patients manage a wide range of common conditions with selfcare &/or medication. Many common/minor conditions are what we call ‘self-limiting’ i.e. they ultimately resolve themselves without treatment and often all that is required is advice and reassurance about what the patient should expect to happen before the condition has resolved and what they can do to manage their symptoms until the condition has resolved. In some instances e.g. with a cough/cold over the counter products are available that can help relieve symptoms until the condition has resolved.
In Sheffield community pharmacies are commissioned to be able to supply treatment to patients for a wide range of common/minor conditions without the patient having to see the doctor (these will be listed on the following slide). Patients who are exempt from prescription charges will be able to receive treatment free of charge. Through this scheme community pharmacies can also provide treatment/medicines to patients experiencing common side effects from cancer treatment (chemotherapy).

17. Care Navigation Reception staff ‘signpost’ patients to pharmacy
Template in SystmOne and EMIS
Basic Triage
‘Red Flag’ symptoms

18. Red Flag Symptoms Symptoms that require investigation
Patient to be referred to GP or, if serious, to A&E
Reception staff not expected to make clinical decisions - Pharmacists to take clinical responsibility

19. Roll Out of Care Navigation
Workshops have been held with all localities
Attended by GPs, practice managers and reception staff
Pharmacy option well received

20. Refer Back to Practice Applies to ALL patient consultations
Care Navigation
Minor Ailments
Support for Self-Care

21. Refer Back to Practice Vital to provide information
Concerns raised by LMC and practices
(Negative impact on relationships - GP & Patient)
Referral note can be:-
Given to patient (Generated by PharmOutcomes or manually entered on paper form)
ed automatically to surgery (PharmOutcomes)

22. Refer Back to Practice Recording referrals Good clinical practice
Evidence of delivery of Support for Self-Care and CPD reflection

23. Refer Back to Practice PharmOutcomes Quick and easy
Automatically maintains a record
Captures benefit measures
Produces a ‘Notification Letter’
s directly to the practice

24. PharmOutcomes

25. Patient Consent

26. Patient and Pharmacist Details
Selecting ‘Yes’ opens GP List & opens consultation questions
Select ‘No’ opens consultation questions

27. Diagnosis and Request
Symptoms
Diagnosis
Additional Info’

28. Diagnosis and Request
Actions for Surgery

30. Timescale

31. Benefit of Intervention

32. Notification Letter
Notification Letter

34. Patient Form
To be used prior to (or instead of) using PharmOutcomes

35. PharmOutcomes Form
To be used when there’s no access to PharmOutcomes at the point of the consultation

36. PharmOutcomes Messages

37. CCG Outbox
Introduction: Claire/Susie. In this presentation I am going to cover these 3 things;
Why navigate patients to pharmacies?
Who could you navigate to a pharmacy?
Tips for helping the navigation process

38. Message

39. Recipient “Home” Page

40. Opened Message – Non Urgent

41. Opened Message - Urgent

42. Any Questions?

43. National Update
Garry Myers Regional PSNC Representative

44. PSNC Contractor Briefing
Retained Margin & Cash flow
Price concessions
DH Correspondence – interim funding 17/18 EP
SAF QP FV
EPS4
PhAS
New Contract Framework (Universal Care Framework & Care Plan)
New National Contract Funding Models
Ashridge & LPC Conference

47. CPS Request for Information
Questionnaire will be sent to all pharmacies
Please respond
Will help to explore potential local service development opportunities

48. Close Thank you all for attending
Thank you to all of our guest speakers
Looking Forward