1. Integrating Medicines Optimisation into the Commissioning Agenda Helen Liddell, Leeds South & East CCG,

2. Session looks at: Variations in the development of Medicines Management Commissioning across England – what are the implications? What are the key Commissioning priorities of organisations and how does Medicines Optimisation fit in What are the challenges for Medicines Optimisation in Commissioning over the next few years?

3. Commissioning landscape

4. Projected funding gap in 2021/22 – Base Case Context: Projected funding gap in 2021/22

5. Context

6. What’s happening? Questionnaire to colleagues England wide –Variable. CCG Vs CSU for MO provision –50% of CCGs have their own MO teams Range: –All services provided by CSU –Commissioning services only from CSU (not provision) –Provision services only (not Commissioning) –Core Service to review CSU contract within CCG –Medicines Management Teams lifted and shifted employer –New teams being developed –Provision service bought externally: Community Trust, private provider

7. Key Priorities of Commissioning Organisations: Active Support for self management Disease prevention Improving the care of people with LTCs (physical and mental) Person centred care through integrated health and social care teams Avoiding hospital admissions - Managing urgent and emergency activity Managing elective activity- quality of referrals Reducing health Inequalities Treating patients closer to home Improving the patient experience QIPP - Improving quality of care (Frances report)

8. Key priorities of Commissioning Organisations COPD CVD Dementia Cancer End of Life Care Medicines Management

9. New Characters! RIVOT Reduction in Variation Over Time MOMOT Movement of Mean over Time

10. Priorities - CCG Outcomes NHS Outcomes Framework CCG Outcomes Indicator Set JSIP “Clear and Credible” CCG Plan

13. What are the key gaps Specialised Commissioning arrangements Patient engagement / understanding and shared decision making

14. What are the Key challenges? Reducing waste Joining up systems Consistency & quality of service provision by pharmaceutical services providers Medicines Optimisation integration - underpinning all other work streams Manpower Managing across the new organisation arrangements Patient adherence

15. Commissioning from Support organisations? May be outside NHS & commercially driven? Commission and provide services? Opportunity to link with other agendas? Requires insight of role and potential role of Medicines Optimisation across agendas MO Leadership from supporting organisations?

16. Future? CSU Vs CCG?

17. Questions?