The Medicines use and Procurement QIPP Programme

PDIG June 2012

Clare Howard

National Lead for QIPP Medicines use and Procurement

Success Factors

• A well established network of senior pharmacists• Executive sponsorship (REG)• Leadership from SHA • Great project management• A simple plan• Good data and reporting• Communication (meetings, newsletter, heat map)• Integrating local resources e.g. Procurement

Pharmacist, Specialist Pharmacists etc.

Successes and challenges in 2011/12

The Headlines:•Delivery above and beyond planned QIPP savings estimated at £26.4 million (still confirming)

•Regional roll-out of Inhaler Technique project (almost 5,000 interventions)

•National launch of New Medicines Service and Targeted MURs

•Regional social marketing campaign on tackling medicine waste – with widespread media interest

•Development of Patient Safety Metrics and association of cost savings – with plans for National database

The NHS Change Model Inhaler technique

WasteHeat map

Meds recINR

Allergy

Linda Tait REG

Heat mapAsthma and COPD admissions

Money £Primary care prescribing

Gain sharingNMS

Discharge MURsQuality Schedule

CQIUNS

Senior Pharmacists Network

Pharmacy teamsLPCsREG

SHAAnne Eden CEO

Senior Pharmacists

Project issues and challenges

• Executive leadership role (REG)• Maintaining continuity and avoiding loss of momentum

with current programme management structure. (SHA)• Continued Primary Care engagement• Securing CCG support, engagement and ownership• Progress on Community Pharmacy NMS currently lags

slightly behind national levels

Key milestones and delivery for 2012/13

• Annual planning event 20th June• Medicines waste social marketing report – July 2012• Launch of national database to record medicines safety metrics across

teaching hospitals – July 2012• Evaluation of inhaler technique project - July 2012• Development of opportunities in secondary care through collaborative

working• Pilot of ‘medicines safety pathway’ approach at OUH• Focus on medicines waste in secondary care and zero tolerance

approach to pharmacy returns• Regional stock take of Home Care toolkit - September• Delivery of £17.5million in QIPP savings – March 2013

Clare Howard National QIPP lead for Medicines use and procurement.

Qualit

y a

nd p

roduct

ivit

yHow well are we doing?

Qualit

y a

nd p

roduct

ivit

yQIPP Medicines use and Procurement

• Need to ensure that the programme isn't over reliant on the primary care prescribing budget.

• Programme to encompass the breath of the medicines pathway.

• Will set the foundations for the medicines optimisation agenda.

Qualit

y a

nd p

roduct

ivit

yHave separated the work out into categories.

• Primary Care Prescribing• Secondary Care procurement• Home Care• Community based support for patients taking medicines• Medication waste• Medication safety• Patient/ public/ Professional and Industry engagement.

Primary Care Prescribing

QIPP Prescribing Comparators

New KPIs to be added to BSA Toolkit

Implement the planned modernisation of the

prescribing and dispensing information

system.

Work with Primary Care National QIPP work

stream to prioritise QIPP comparators for CCGs

Secondary care procurement

Promote regional collaboration on

procurement initiatives

Framework to share PbR excluded drugs.

Work with PMSG and NPSG to ensure QIPP is

integrated into their annual plans

Smarter use of Hospital Medicines data

• To drive up the collaborative arrangements for procurement in secondary care

• To develop and embed a framework for sharing efficiencies around PbR excluded drugs.

• To support wider clinical engagement in the procurement process.

• To support and develop wider patient engagement in the procurement process.

• To develop a culture of performance management and holding to account in regional procurement arrangements.

• To outline a picture of “best practice procurement arrangements” and to support all regions in reaching the standard.

Secondary care procurement

Promote regional collaboration on

procurement initiatives

Framework to share PbR excluded drugs.

Work with PMSG and NPSG to ensure QIPP is

integrated into their annual plans

Smarter use of Hospital Medicines data

Support regional collaboration between QIPP and Procurement specialists where it doesn't already exist.

Ensure each region is able to identify savings

Work with PMSG and NPSG to each region has a procurement plan in place

Support CMU to appoint two posts to scope current regional arrangements and recommend best practice models.

Agree more uniform method of collating the data

Work with PMSG/NPSG to develop PbR excluded drugs framework.

Work with Mark Hackett to engage CEO s around gain sharing.

Begin to work with CCGs to understand gain sharing.

Ensure each region is able to benchmark Trust efficiencies

Support the project plan to develop Pharmex data

Clinical engagement

Leadership in

Procurement Performance management

£££Safety

Improved outcomes

Good practice, integrated procurement model

Home Care

Implementation of National Home Care

Report

Back Office Collaboration

Data capture

Improved financial and clinical governance

Work with Mark Hackett to ensure CEO level engagement with both the report and the QIPP potential

Patient Engagement Acute Trust Engagement Systems: Homecare Modules and

Functionality PbR Excluded drugs Expertise, Toolkit and Standards

(kitemarking) Development of Procurement Model

This work will produce a wealth of products aimed at supporting the NHS to implement the Hackett report. Products includeA framework for gain sharing across PbR excluded drugsA set of standards for companies wishing to provide Homecare services to the NHSA template annual report for Trusts to use at Board levelAn initial “quick” stock take outlining current status of Homecare by regionAn in depth national assessment of progress on Homecare built up from every Trust self-assessment.A specification for Homecare modules for e prescribing systemsA specification for Homecare providers (e invoicing etc.)A procurement model to support consistent procurement processes.A template Patient charter for Homecare provision.

Community based support for patients taking medicines

Data capture/ evaluation

Shared decision making

QIPP/ Medicines Optimisation and

Community Pharmacy

Post discharge MURs

Medicines Waste•will be further refined on publication of the waste report

Support the implementation of QIPP

related aspects of the national waste report

Primary Care/ Community Pharmacy

Secondary Care

Care Homes

Await the national report and then identify areas where QIPP can support implementation.

Medication safety

National benchmarking of Medicines

Reconciliation rates

Baseline of all region-wide medication safety

initiatives

Translation of safety initiatives into QIPP

efficiencies.

Reduction of low dose antipsychotics for

patients with dementia

PODs

Omitted and delayed doses

Controlled drugs

Engaging patients/ public and other healthcare professionals

Stakeholder development

Scope successful regional initiatives.

Develop a plan for patient engagement/

comms

Promote the concept of shared decision making

Qualit

y a

nd p

roduct

ivit

yMedicines Optimisation

The issues highlighted at the beginning mean that we can’t keep doing more of the same.

Medicines optimisation offers a step change in the way we address these issues

Key differences• Patient engagement• Outcome focussed• Pharmaceutical leadership