Background

• PM Challenge Fund• Local General Practice• EPiC • Choice of pharmacy• Workstreams

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.

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

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

Costs 2014-15Normal 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/apptTotal Cost

£56,248

15 15 15 15

7575 75 75

2550

£15,938

2550 1950 1950

£15,938 £12,187 £12,187

Costs 2014-15Extended 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/apptTotal Cost

£7,500Evenings

M-F

No.appts/day

No appts/wk

Total no appts

5 5 5 5

1010 10 10

340

£2,125

2

10

340

340 260

£2,125

2

10

340

£1,625

2

10

260

£1,625

2

10

260

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.

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.

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