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Prudent Healthcare Prudent Healthcare Prescribing Workshop Prescribing Workshop

April 2014April 2014

Howard Rowe Howard Rowe

Clinical Director: Clinical Director:

head of medicines head of medicines managementmanagement

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Introduction and AimsIntroduction and Aims

AimsAims

FormatFormat

Set the SceneSet the Scene

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AimsAims Understanding of Prudent Healthcare Understanding of Prudent Healthcare

and its application to Prescribingand its application to Prescribing

Produce recommendations for Produce recommendations for Change in prescribing arrangementsChange in prescribing arrangements

Identify where more work is neededIdentify where more work is needed

Capture lessons on "the workshop Capture lessons on "the workshop process"process"

Created with MindGenius Business Created with MindGenius Business 20052005®®

FormatFormat PresentationsPresentations

Understanding Prudent Healthcare and the Understanding Prudent Healthcare and the underpinning Principlesunderpinning Principles

To test the current arrangements for To test the current arrangements for Prescribing against those PrinciplesPrescribing against those Principles

Patients' perspectivePatients' perspective Clinicians' perspectiveClinicians' perspective

Group WorkGroup Work Define "what would good look like?"Define "what would good look like?" Test and Prioritise the Ideas that emergeTest and Prioritise the Ideas that emerge

Next StepsNext Steps

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Set the Scene: use of Set the Scene: use of medicinesmedicines 14,000 prescribed doses in a lifetime14,000 prescribed doses in a lifetime

Age and Use of MedicinesAge and Use of Medicines

Percentage of adults who reported being on regular prescribed medication

(for a year or more), by age and sex

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Set the SceneSet the Scene

Use of three or more prescription drugsin the past 30 days

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Set the SceneSet the Scene

65+ 10% of Population, Account for 30% of Medicines Expenditure in Primary Care

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Set the SceneSet the Scene Use of Medicines: Prescribing Volume Use of Medicines: Prescribing Volume

Primary CarePrimary Care 7.6 million items per annum7.6 million items per annum

200 million doses per annum or200 million doses per annum or 550, 000 doses per day550, 000 doses per day

Primary Care: rate of increasePrimary Care: rate of increase Volume: Wales 2.62%, Cwm Taf 1.52 Volume: Wales 2.62%, Cwm Taf 1.52

(gold)(gold)

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Set the SceneSet the Scene Medicines ExpenditureMedicines Expenditure

Primary CarePrimary Care £56 million per annum£56 million per annum £220,000 every working day (like today)£220,000 every working day (like today)

Primary Care: rate of increasePrimary Care: rate of increase Spend: Wales 2.05%, Cwm Taf 1.72% Spend: Wales 2.05%, Cwm Taf 1.72%

(bronze)(bronze)

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Set the SceneSet the Scene Medicines ExpenditureMedicines Expenditure

Secondary Care Secondary Care (within Cwm Taf)(within Cwm Taf)

£20 million per annum£20 million per annum £6 million arising from NICE/AWMSG£6 million arising from NICE/AWMSG

2014-2015 need £1m (26%) to £2.5m (42%) 2014-2015 need £1m (26%) to £2.5m (42%) for NICE/AWMSGfor NICE/AWMSG

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Set the Scene Set the Scene Do No HarmDo No Harm

Prescribing: LithiumPrescribing: Lithium

““Grandfather wins £1m drug blunder Grandfather wins £1m drug blunder payout”payout” (at East Glamorgan Hospital)

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Set the Scene Set the Scene Do No HarmDo No Harm

Dispensing: Peppermint WaterDispensing: Peppermint Water

Wednesday, 1 March, 2000, 18:31 GMT Wednesday, 1 March, 2000, 18:31 GMT

““Chemists fined after baby death”Chemists fined after baby death”

Administration: Penicillin AllergyAdministration: Penicillin Allergy

30th October 201330th October 2013

““Grandmother, 61, 'died after nurse gave her Grandmother, 61, 'died after nurse gave her

penicillin despite SEVEN warnings that penicillin despite SEVEN warnings that

she was allergic to it‘ “she was allergic to it‘ “

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Set the SceneSet the Scene Culture in the CommunityCulture in the Community

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Set the SceneSet the Scene Quality: Prescribing IndicatorsQuality: Prescribing Indicators

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Set the Scene Set the Scene QualityQuality

Realising potential from being Realising potential from being Integrated Health BoardIntegrated Health Board

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