1. Background PM Challenge Fund Local General Practice EPiC Choice of pharmacy Workstreams

2. Vision of the service Pharmacists will have a key role to play supporting general practice to manage the routine, non urgent case mix and those people who struggle to access primary care in working hours. Pharmacists will offer an enhanced service underpinned by access to the patient’s medical record, PGDs, training and a robust clinical governance framework. There will be more opportunities for people to access this enhanced service. Ultimately by redirecting a proportion of routine case mix to Pharmacists it will contribute to increased capacity within general practice to see more complex or frail patients.

3. Vision for Pharmacy Incorporate Pharmacy as part of the first line primary care team Provide appointments for patients in a familiar and accessible environment Use Pharmacists to their full potential, up- skilling and supporting them to work in an extended role Work with Pharmacists to optimise use of medicines in the city and reduce medicine waste

4. 3 Levels of Service EPiC Pharmacies Level 1 Access to medical records. Pharmacist trained to use them and answer medication queries Level 2 Level 3 Trained Pharmacist working with PGD’s. 3-4 trained Pharmacist per module Independent Prescriber provides clinical consultations

5. Costs 2014-15 Normal working hours M-F No. Appts/day Module 1 (34wks) Module 2 (34wks) Module 3 (26wks) Module 4 (26wks) No. appts/wk Total no.appts Cost @ £6.25/appt Total Cost £56,248 15 75 2550 £15,938 25501950 £15,938£12,187

6. Costs 2014-15 Extended hours Sat/Sun No. Appts/day Module 1 (34wks) Module 2 (34wks) Module 3 (26wks) Module 4 (26wks) No. appts/wk Total no.appts Cost @ £6.25/appt Total Cost £7,500 Evenings M-F No.appts/day No appts/wk Total no appts 5555 10 340 £2,125 2 10 340 260 £2,125 2 10 340 £1,625 2 10 260 £1,625 2 10 260

7. IMT solutions IM&T requirements for Pharmacies are: Access to a booking system with appointments made in real time; Access to the full patient record to support clinical decision making Two way feedback mechanism between GP and Pharmacist to be put in place. Progress to date: All Pharmacies have N3 and SMART cards. Pilot to Load System1 onto a Pharmacy system was successful but connectivity centrally was not achieved probably because of firewall issues. Ongoing challenges with EMIS, especially in relation to a two way interaction between the GP and the Pharmacy system.

8. Training Pharmacy training plan needs to be developed for Fast Starters to include: IM&T: Booking system, Accessing the medical record, EPiC metrics Clinical: PGDs PGD tracking system Relationship building with GPs Learning from first wave will then inform on going training needs for the Fast Starters as well as the Early Adopters.

9. Outstanding issues IM&T: Work to resolve existing issues of connectivity with System1 as well as with EMIS. Finalise and sign off PGDs for inclusion with go live Fast Starters Develop training plan for Pharmacists in Fast Starters group and implement Develop Communications for all parties in Fast Starters group and implement. Consider team building session. Financial: Finalise and agree payment schedule for EPiC Pharmacists both in and out of hours. Agree method of re-imbursement for medication supplied by EPIC Pharmacies Get final agreement to participate from Pharmacies and prepare and agree rotas of clinical appointments