1. Medicines

2. About the team Claire Vaughan Head of Meds Optimisation
Lindsay Harper Director of Pharmacy SRFT
Jim Corcoran Clinical Director for Theatres SRFT
Karen Proctor Director of Commissioning
Liz Walton Designated Nurse Adult Safeguarding
Jennifer Bartlett Snr Clinical Pharmacist NIPPS
Siobhan Farmer Public Health Consultant
Elizabeth Lamerton Principal Clinical Pharmacist, SRFT

3. Safer Medicines Examples include
There is currently a wealth of improvement work being done around medicines within the Salford economy.
A review by the Head of Medicines Optimisation at SCCG and the Director of Pharmacy at SRFT identified over 20 current projects.
PrISMS work (a breakthrough series collaborative in primary care)
Salford standard medication safety domains
Clinical pharmacists in general practice
CQUINs on medicine related admissions and medicines reconciliation at discharge
Safer clinical systems health foundation work
EPR work
Refer to pharmacy

4. Integration and learning
Aim: to ensure medicines are always correct at any point in the patient journey in Salford
Currently measure at SRFT entry
Starting to measure at intermediate care entry
Starting to measure at return to primary care
Starting to measure in care homes
Aim: Shared understanding of safety across the health economy with medicines
Health economy medicines safety group
Integrated workforce

5. Leading measures 1
Medicines reconciliation within 24 hours at entry into SRFT on EAU/AAA

6. Current Medicines Safety Initiatives Across Salford
Neighbourhood Integrated Practice Pharmacists in Salford
Measuring medicines related admissions to SRFT
Improving accuracy of information regarding medicines on discharge
Pharmacy staff employed in intermediate care
Electronic three way pharmacist referral system
Standardisation of medicines policies and procedures across Salford

7. Neighbourhood Integrated Practice Pharmacists in Salford
Team of practice pharmacists employed by SRFT and Salford Health Matters GP Practice commissioned by Salford CCG.
Oct 2017
26 pharmacists( 18 wte)
Now supporting all 46 Salford Gp practices.
Menu of services provided to GPs
Medicines Reconciliation post discharge
Poly pharmacy reviews
High risk medicines- shared care review pilot compliance with monitoring improved from 44% to 100%
Future work areas:
AKI & CKD, Respiratory , AF, Mental Health

8. NIPPS- SMASH Dashboard review of patients at risk of having an adverse incident due to medicines

9. 16/17 CQUIN- Medicines Optimisation
SRFT Clinical Pharmacists identifying if a patient’s admission is related to medicines
Recording it on the EPR and alerting the clinical team
Referral made to the relevant GP practice pharmacist for post discharge medicines review
SRFT pharmacists identifying ~ 40 a month
Challenge- correctly coding the admission and the medicine involved.

10. SRFT Medicines related admissions
The role of the medicine in the admission was confirmed in 132/305 (43%) cases.

11. Improving accuracy of information regarding medicines on discharge prescriptions
Audits completed on the % accuracy of documented medication changes on EAU and B6.
Improvements seen on EAU but not B6
Training delivered to junior doctors by GP and pharmacy staff
Discharge checklist developed for junior doctors
Test of change- to enter whether medicine- new, dose changed or stopped on electronic prescriptions

12. Introduction of Pharmacy Staff to Intermediate Care Unit
Through Salford CCG innovation money pharmacy technician employed for the Limes and Barton Brook in addition to Pharmacy Technician at Heartly Green
Improvements seen:
Increased number of medicines reconciliations
Increased documented allergies
Reduced omitted doses

13. Electronic Pharmacy referral systems
Working with GM AHSN and GM LPC
Generic specification written to include referral to GP practice pharmacists and community pharmacists, two way communication
Develop a system that can be spread across GM (Workstream 1- Public Health- seamless care)
Secure electronic transfer of hospital discharge prescription
Enable referral for medication counselling and follow up
Develop referral criteria to ensure appropriate referral

14. Safer Salford innovation fund 17/18
Funding secured for a medicines safety pharmacist to continue the medicines related admission work
To trial pharmacy technicians directly working in two care homes in Salford to improve medicines management in the care homes and reduce the wastage of medicines.

15. Salford innovation fund locality call
Funding secured for a trial of the EPIFFany system which provides a blended learning approach to increase prescribing competence, performance and safety behaviours of junior doctors.
Within Salford this will also be extended to new non medical prescribers.
The components of the education included eLearning, simulation, clinical decision support and personalised teaching with feedback from pharmacists and clinicians.

16. Even more pharmacists and pharmacy technicians !
Developments from Salford Together are seeing pharmacists and pharmacy technicians skills being used in the new
Falls team
Crisis team
Neighbourhood teams
Ensuring medicines optimisation and safety is at the centre of the new system we are developing in Salford

17. Thoughts of the team Good Things Challenges TIME!
Increased opportunities to improve medicines safety across the health economy
Effective teamworking between SRFT, CCG and community Pharmacy Teams
The support of the CCG with innovation money
Excellent electronic systems
Datasharing
Traditional boundaries
Sharing our learning
TIME!

18. Safer medicines report summary