1. MUR and NMS Respiratory Toolkit.
Somerset LPC
11/11/2018

2. Why is asthma being targeted for MUR’s and NMS ?
5.4 million people in the UK are currently receiving treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12).
Asthma prevalence is thought to have plateaued since the late 1990s, although the UK still has some of the highest rates in Europe and on average 3 people a day die from asthma.
In 2014 (the most recent data available) 1216 people died from asthma.
The NHS spends around 1 billion a year treating and caring for people with asthma.
Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases, including chronic bronchitis, emphysema and chronic obstructive airways disease.
It affects an estimated 3 million people in the UK.
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3. Why focus on Asthma and COPD for MUR’s and NMS ?
To access Quality payments the contractor must be offering MUR’s or NMS or be registered for NHS Urgent Medicines Supply.
Over 90% of pharmacies provide Mur’s and NMS.
Results of a Independent academic evaluation (2014) gave a positive reinforcement for the service with improved patient outcomes and reduced cost for the NHS.
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4. Benefits of MUR’s / NMS improve medicines adherence
increase patient engagement with their condition and medicines, which will support them in making decisions about their treatment and self management
reduce medicines wastage
reduce hospital admissions due to adverse events associated with medicines
increase reporting of medicine adverse reactions by pharmacists and patients
positive patient assessments
provide evidence base on the effectiveness of the service
enable the development of outcome and/or quality measures for community pharmacy
For MUR’s limited to 400 per year can generate £11200.
NMS is unlimited range £20 - £28 per intervention.
Somerset LPC
11/11/2018

5. Part of the Quality Payments !
Asthma patients dispensed more than 6 short acting bronchodilator inhalers without any corticosteroid inhaler within a 6-month period are referred to an appropriate health care professional for an asthma review.
There are two review points for this criterion:
 Friday 28th April 2017; and  Friday 24th November 2017.
At each review point, meeting this criterion is worth 10 points (£640), therefore a total of 20 points (£1,280) can be claimed in 2017 for achieving this criterion.
Somerset LPC
11/11/2018

6. CPPE Support .
The Centre for Pharmacy Postgraduate Education (CPPE) has a distance learning course and e-assessment on asthma, as well as inhaler technique training e- learning and videos, which pharmacists or pharmacy technicians may find useful to complete before incorporating the QP criterion into their daily practice.
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7. Asthma BT guidelines.
While you would normally recommend the NICE COPD guideline over the GOLD guideline, the NICE COPD guideline is out of date, having not been updated since 2010.
NICE undertakes a more comprehensive review of the evidence and prepares their guidance in the context of the English/Welsh NHS.
NICE also involves GPs and nurses in developing their guideline.
The next review of the NICE guideline was scheduled to start in May 2016 , so we cannot expect a revised version until late 2017 or early 2018.
Clearly there have been many new treatment options introduced since 2010, which are therefore not covered by NICE currently.
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8. Asthma Resources
BTS ( New British Guidelines for the management of asthma)
Formulary ( Inhaler technique videos and checklists)
Asthma UK (Asthma Action Plans)
In-Check Inspiratory Flow Measurement Device
Inhaler technique training videos / CPPE Online
Teva Respiratory Resources
11/11/2018

9. Somerset CCG Formulary Chapter 3 – Respiratory system
Introduction
Asthma inhaler pathways
Asthma step down guides
Summary of recently introduced inhalers and their equivalents
3.1 Bronchodilators
3.2 Corticosteroids
3.3.2 Leukotrine Receptor Antagonists
Guidance for managing COPD
3.4.1 Antihistamines
3.7 Mucolytics
Click & Check.
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