NHS Improvement
Hospital Pharmacy and Medicines Optimisation
Ann Jacklin,
November2016
Timeline
• Summer 2014
–
–
–
Health Secretary asks Lord Carter to assess what efficiency
improvements could be generated in hospitals across England
Detailed work with 22 NHS acute hospital trusts initially –
range of trust types from large inner city teaching to rural
district general hospitals
Hospital Pharmacy and Medicines Optimisation Programme
(HoPMOP) established
• June 2015
–
–
–
Interim report published
Up to £5 billion of productivity saving identified
Concept of Model Hospital
• February 2016
–
–
2
Final report published
“In light of Lord Carter’s report, I can now announce that
we will act upon all his recommendations and have asked
Lord Carter to report back on progress with
implementation by spring 2017”
Report recommendations
Values & outcomes from
Medicines
Optimise medicines
(and staff…..)
Hospital Pharmacy
Transformation Plan
by April 2017
Clinical Pharmacy
Infrastructure services
Model Hospital metrics
3
Hospital Pharmacy Transformation
Programme HPTP
80% pharmacist time on CLINICAL
activity
EPMA
High Cost Drugs coding
Drug savings
Drug Procurement - CMU
Supply chain
Specialised Pharmacy Service NHS
Manufactured Medicines Catalogue
Transforming clinical and infrastructure
services
Currently 45% of time
5
Currently 55% of time
Clinical Pharmacy Services
Lord Carter said:
• Acute trusts must ensure their pharmacists and clinical
pharmacy technicians spend much more time on clinical
pharmacy services than on infrastructure activities
He also said:
• …more clinical pharmacy staff…..deployed…..working
more closely…..with patients, doctors , nurses and
independently….
• To deliver optimal use of medicines……informed
medicines choices….secure better value…..drive better
outcomes…..contribute to 7 day services….
He didn’t say:
• Current clinical services meet needs either in volume
or in ‘scope’
6
Pharmacy Infrastructure services
Lord Carter said:
• Are subject to stark variation
• Can be delivered more efficiently
• ..are most efficiently
delivered…..through..…collaboration or shared
service…..local, regional, national
• Need not be delivered by NHS employed staff
Lord Carter didn’t say:
• Are not valued
• Are not essential
• Are not required
• Don’t require expertise
7
HPTP governance arrangements (proposed)
Chief Pharmaceutical Officer (SRO)
NHSI Pharmacy Lead
HPTP Programme Board
NHSI Programme Management
& Delivery Team
Professional lead
Subject matter experts
Programme Support
NHSI Region
1
8
NHSI Region
2
NHSI Region
3
Medicines
Optimisation Project
Model Hospital &
Metrics Project
All MO
Recommendations.
Stakeholders involved:
• NHS trusts
• NHSI
• CQC
• NHS E MO
• NHS E SPS
• HEE
• RPS
• ABPI/BGMA
All MH
Recommendations
Stakeholders
involved:
NHS trusts
NHSI
CQC
HSCIC
MH stakeholders
Pharmacy system
suppliers
•
•
•
•
•
•
Programme
Management
Office & Data
Analyst support
NHSI Region
4
Infrastructure
Projects
All infrastructure
Recommendations
Stakeholders
involved:
• NHS trusts
• DH/MPI/CMU
• NHSI
• NHSE SPS
• National
Information Board
(for Meds Digital
Strategy)
• GS1 & Peppol
• HDA (BAPW)
HPTP Landscape
NHS
Improvement
Dept of Health
• Carter Implementation
role
• 7 day services
• MPI
• Rebalancing
NHS England
• Right Care
• Specialised
commissioning
• SPS
• Meds Optimisation
• RMOC
Professional
bodies
Trade bodies &
suppliers
•RPS
•APTUK
•GPhC
• ABPI
• BGMA
• HAD
HPTP
Metrics
PMSG
NPSG
CMU
•MH Hospital
•CQC
•NHS Benchmarking
NHS Information
Board
Workforce
•HEE
•CPPE
136 NHS
acute trusts
9
•DM&D
•FMD
•Scan for safety
Making it business as usual
Failure
10
Success
HPTP timeline
11
12