Think Pharmacy First Minor Ailment Scheme

16th July 2015

Urgent and Emergency Care Vision - Gateshead

• ‘‘Right Care, Right, Time, Right Place – a modern sustainable 24 hour, 7 days a week urgent and

emergency care system designed to meet the needs of the people of Gateshead’

NHS England’s Review of Urgent and Emergency Care, Domain 2 - Faster, Convenient, Enhanced Services

• Support the co-location of community-based urgent care services in coordinated Emergency/Urgent Care Centres.

• Same day, every day access to general practitioners, primary care and community services.

Commissioning Intentions 15/16

Overall objective: Ensure that urgent and emergency care services (which includes access to primary care) are developed and modernised into a 24 hour, 7 days a week model appropriate for the health needs of the people of Gateshead - providing the right care, at the right time in the right place.

Action: develop a fully integrated urgent primary care service (and would include GP OOH service)

3 Key Project OutputsExtended Access

GP & Nurse

3 Hub Sites8am-8pm M-F9am-2pm S-S

GP Home Visiting Service

2 Hub Sites4pm-8pm M-F8am-8pm S-S

EMIS Web, Enterprise &

Mobile Technology Solutions

Remote Access & Interoperability

Prime Ministers Challenge Fund

NHS England’s Review of Urgent and Emergency Care, Domain 2 - Faster, Convenient, Enhanced Services

• Support the co-location of community-based urgent care services in coordinated Emergency/Urgent Care Centres.

• Same day, every day access to general practitioners, primary care and community services.

• Harness the skills and accessibility of community pharmacy.

Minor Ailments• Current scheme

– Set up in July 2010 as an NHS Enhanced Service– Renewed in subsequent years on the same terms – Underutilised – Only pharmacies who are signed up to original

scheme able to deliver– Awareness of the scheme can be low

• Opportunity to reinvigorate scheme and align with local UEC vision

The New Scheme

• Appropriate and competent member of the pharmacy team (Pharmacist, Pharmacy Technician, Dispensing Assistant or Pharmacy Assistant) is able to undertake consultation with patient

• Required to operate for the full opening hours of the pharmacy and any patient can access (i.e. patient does not need to live in Gateshead)

Aim of the Scheme

• Increase patient choice to access primary care in alternative settings.

• Contribute towards a reduction in demand for appointments at GP surgeries and patients attending A&E with minor conditions

• Bring care closer to home for patients.• Contribute towards the cost-effective use of

medicines.• Promote self-care and make every contact a

health improvement contact

Which ailments are included?Aches and pains: Back Pain Headache Migraine Muscular ache Period pain Teething Toothache

Gastrointestinal care: Constipation Diarrhoea Dyspepsia Haemorrhoids Indigestion Reflux Threadworm Vomiting

Skin care: Athletes foot Chickenpox Cold sores Contact Dermatitis /

Atopic eczema Fungal skin infections Impetigo Nappy Rash Pruritis Scabies Warts and verrucae

Allergy: Bites and stings Hay fever Skin reaction

Ear care: Earache Ear infection Ear wax

Mouth Care: Cold Sores Oral Thrush Ulcers

Colds and Flu: Cough Congestion Sore Throat Fever / temperature

(including Post-immunisation pyrexia)

Eye care: Bacterial Conjunctivitis Styes

Head Lice Vaginal Thrush Sundries

Who can access the service?• Any patient accessing the community

pharmacy, regardless of where they live presenting with symptoms associated with the agreed list of ailments.

• Adult patients (over the age of 16) should be in attendance in order to access the service.

• In the case of a child under 16 years of age, a parent, guardian or carer must be in attendance, but the child being treated need not be present.

How do patients access the service?

• Self-referral / community signposting• Accessed through triage or signposting:

– GP practice staff – A&E– NHS 111

• Non-participating pharmacies will signpost patients accordingly

However…

• People who usually manage their own minor ailments through self-care and purchase of Over the Counter (OTC) medication should continue to self-manage and treat their minor ailments.

• A patient requesting to purchase an over the counter medication should not be used as an automatic referral.

The Consultation• Consultation

– Assess patient’s condition. For some of the conditions a limited examination will be necessary.

– Identify any concurrent medication or medical conditions, which may affect treatment of patient.

– Consider any prior medication used and assess appropriateness of further supply.

– Provide advice on the management, the self-limiting nature and time course of the condition.

– Provide an appropriate and relevant information leaflet.

Consultation

• Treatment– Provide medication from the formulary appropriate to

the patient’s condition as required.– Provided in line with clinical knowledge summaries.

• Records– Complete record of the interaction on

PharmOutcomes using standardised dataset.– If a product is supplied, ensure supply is recorded on

the PMR system.

Onward Referrals

• Quick and seamless referral to GP or other health professional

• Change4Life Standardised Point of Access

Payment & Reporting

• £3.40 per patient consultation• Reimbursement of formulary medications

– to be agreed annually between Commissioner and LPC

• Claims to be made quarterly to

NECSU.EnhancedServices@nhs.net

Payment & Reporting• Monthly submission of PharmOutcomes

data• Annual service evaluation including

service user questionnaire • Support for system resilience through

better and regular dialogue between LPC and the CCG

Think Pharmacy First Marketing & Public Launch

Background

• Think Pharmacy First– This branding has operated in Newcastle,

North Tyneside and Northumberland– Previously has never had any significant

investment– To develop the marketing and

communications campaign market research and segmentation has taken place

Target audience

• Patients – advertising and promotional activity – Segmentation has taken place:

• Children under age of 16• Unemployed residents under age of 65 years• Residents over the age of 60

• Health professionals – increasing awareness and encouraging referrals

Key messages

• Greater choice and better access to treatment for minor ailments.

• Using the skills and knowledge of pharmacists to provide the right treatment for patients at the right time, in a place which is convenient to them

• Easier access to treatment for minor ailments without having to make an appointment to see their GP

Tactics

• Public launch september• Low level activity throughout the year• High level activity in:

– June/July – hayfever and aligned to pollen levels

– September – children and going back to school

– December – general winter illnesses

Activity• Materials for pharmacies including point of sale• Leaflet to target the specific target groups• Digital advertising• PR launch• Posters in community venues eg libraries, bus

stops, Metro system• Door-to-door distribution in key areas• Work with local press• Work with schools• Promotional staff out on street

Examples of materials in situ