Exploring opportunities within the pharmaceutical supply chain to

develop innovative solutions for better health and wellbeing

outcomes

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John Geddes

Commercial Development Director

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NHS facing biggest challenges in recent history

7 in 10 NHS trust finance directors are

concerned about balancing their books in 2015/16.

60 percent of NHS trust finance

directors said their trust relied on additional financial support or drawing down their reserves last year.

£2 billion NHS providers are

forecasting £1bil deficit in 2014/15, rising to £2bil in 2015/16.

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Future Vision

• Over the next five years and beyond, the NHS will

need to dissolve the traditional barriers between

family doctors and hospitals, between physical and

mental health, and between health and social care

• Innovation and collaboration key to success

• New models of care will be essential to deliver the

personalised and co-ordinated services that

patients need

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Homecare / Home Delivery

Manufacturer Pre-wholesaler

5

Patient at Home

RDC

Cold chain

Channel specific

Product specific

OPD

Emergency order

Dispensing Doctors

Pharmacies

Hospitals

Nursing homes

The Supply Chain provides significant opportunities to

drive efficiencies through new operating models

Wholesale

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A configurable integrated supply chain capability

Manufacturer

Patients Wholesale Services

Logistics Services

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Alan Ball

Head of NHS Partnerships

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• In December 2012 Alcura entered into an agreement with a large oncology

Trust to run their pharmacy service.

• 1st venture of its kind in the UK

• Previous – outsource limited to outpatient outsourcing.

• In scope: • Procurement & Stock management

• In patient and outpatient dispensing

• Ward stock supply

• Supply of medicines to other locally base clinics

• Other services…….

• Trust focus on clinical care at patient bedside

Pharmacy outsourcing

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The vision of the Trust Tr

ust

Reduce wastage

Better medicines management at ward level

Reduced errors – consistent pharmacy team

Offer patient convenience and service

Development of clinical services

Responsiveness

Clinical safety

Desire to Innovate

Pat

ien

t Greater pharmacy contact with patients

Improve patient care and patient experience

Improve turnaround times (in patient / outpatient)

Closer to Home

Improve Patient Journey

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Surveys

1. Continuous high level of patient

satisfaction.

2. Patients informed of expected

waiting times.

2. Patients waiting time reduced by:

urgents - 25% (8 minutes)

complex - 27% (15 minutes)

discharge - 21% (25 minutes)

3. Meds ready on time

Procurement

1. Reduction in supplier deliveries (120

to 20)

2. Greater adherence to CMU contracts

4. Reduction of out of stocks

5. Maximise e-ordering for all suppliers,

better management of product delays.

Outcomes

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Robotics

1. Consolidation of stock in robot

lead to quicker dispensing.

2. Uptime for robot improved from

92% to 99.79%

3. Greater product availability

Trust / provider working

1. Very close working relationship

developed

2. Continuous improvement working

programme

3. High level of governance &

adherence

4. Continual progressive work streams

introduced to maximise the benefit

to the Trust.

5. Further roll out of services.

Outcomes

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Service model

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Cheryl Vidall RGN

Head of Nursing and Governance

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CLINICAL HOMECARE •Nursing support plus patient help line • Patient training for self management

• Preparation of intravenous / injectable medication in the patients home

• Medication adherence programmes • Convenient drug and devices delivery

• Prescription management • Specialised product packaging and

distribution services to patients homes

Clinical home care

Medicine support

Dispensing services

Medicine preparation

MEDICINE SUPPORT •Personalised medicine adherence programmes

•Interactive communication leading to better medication adherence

•Health assessments and barriers to adherence monitored through patient reported scores

•Dedicated nurse caseload to provide continuity of care

•Developing personalised care plans •Patient self medication training

•Pharmacist / MSO support & advice

MEDICINE PREPARATION •Prescription management and supply of

ancillary items •Partnering with NHS Trusts •Compounding of products

•Semi-industrial reconstitution •Nurse reconstruction at bedside

•Unlicensed medicines preparation

DISPENSING SERVICES •Homecare dispensing and delivery service from

central Alcura Pharmacy •MDS (monitoring dosage systems and other

dispensing aids systems) solutions •Central filling and personalised package

preparation for targeted patients •Outpatient dispensing (hospital pharmacy)

PATIENT TRAINING VISITS • Nurse visits for a range of injectable

medications to encourage independence • Rheumatology • Dermatology

• Gastroenterology • Endocrine disorders

Patient training

visits

Oncology services

Dedicated Endocrinology

team

Infusional services

DEDICATED ENDOCRINOLOGY TEAM • Paediatric and adult trained nurses

• Assessment and review for levels of nursing support and intervention required

• Independence training for injectable medications

• Regular review, audit and follow up

ONCOLOGY SERVICES • Medication adherence support – telephone

review and monitoring • Patient support programmes – visits and telephone support with 24hr nurse on call

• Infusional services at home or work • Injectable medication administration

INFUSIONAL SERVICES • Desferrioxamine infusion training and support

• Patient self administration training for immunoglobulin therapies

• Home Parenteral Nutrition (HPN) training and support

• Intravenous antibiotics self administration

• Patient Support Programme (PSP)

• Improves adherence

• Reduces hospital bed days

• Improves patient understanding of

their condition

• Allows continuity of care by an

oncology/homecare nurse

• Allows early intervention for side

effect and toxicity management

• Protects product reputation

through correct usage

• Reassurance that patient is ‘safe’

at home to manage therapy

• Benefits to the NHS

• Remote patient monitoring by

qualified nurses

• Early intervention for side effects

• Timely communication and feedback

to clinical team

• Prescribing clinician maintains

clinical responsibility for patient

• Reduces pressure on outpatient

departments

• Inpatient bed and chair day

cost savings – releases

capacity on pressured

units

Patient support programme benefits

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The Alcura North West Oncology nursing team

who provide infusional oncology services at home were awarded Third Prize in the British

Journal of Nursing (BJN) Nurse of the Year

Awards (the nursing Oscars) in March 2014

Dedicated Quality and Governance team driving the quality agenda through the whole Alcura

business

Continue to build our nursing capabilities, whilst

ensuring that we mitigate risk and keep a focus on what we do well for future expansion

Our people

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• Opportunities exist within the pharmaceutical supply chain to develop

innovative solutions to meet the challenges of today and to deliver the future vision for the NHS

• Alliance Healthcare is uniquely placed with a range of assets and capability to

provide a fully integrated supply chain solution to the NHS

• Our assets can be configured to provide tailored, innovative solutions to the

NHS to create efficiencies whilst improving health and wellbeing outcomes

• We are keen to engage and partner with you to discuss the ‘art of the

possible’ and would welcome and opportunity to start a conversation

Summary

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Contact information

www.alliance-healthcare.co.uk

Email: information@alliance-healthcare.co.uk

www.alcura-health.co.uk

Email: info@alcura-

health.co.uk

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