Procuring the homecare support package
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1 Procuring the homecare support package Phil Deady Pharmacy Procurement Manager Leeds Teaching Hospitals NHS Trust &
2 Plan of session Leeds Teaching Hospitals and homecare medicines management National Homecare Medicines Committee Collaborative approach to procurement Purchasing for safety Key performance indicators
3 Leeds Teaching Hospitals NHS Trust Over 3,000 inpatient beds 5 hospital sites across the city Patients from Leeds, Yorkshire & Humber and further afield Many tertiary specialities Good working relationship with commissioners on medicines
4 Leeds Teaching Hospitals NHS Trust Homecare medicines facts and figures First homecare patient in 1981 (parenteral nutrition) 5,500 patients on homecare medicines services (April 2011) ~30 different homecare therapies Total spend on homecare medicines and services 37M (2010/11) 40+ reported homecare medicines incidents (2010/11)
5 National Homecare Medicines Committee Sub-group of the national Pharmaceutical Market Support Group (PMSG) Formed in 2005 Chaired by Allan Karr, with representation from Pharmacy procurement specialists Primary and secondary care Chief Pharmacist, Consultant Nurse, Commissioning Lead Royal Pharmaceutical Society General Pharmaceutical Council Facilitated by members of the Department of Health Commercial Medicines Unit homecare team
6 National Homecare Medicines Committee Act as the national focus for developing and improving processes for medicines homecare services Advise the NHS on matters relating to homecare services Develop SLA s and contracts suitable for medicine home care services Liaise with the homecare suppliers and co-ordinate developments and best practice Produce and maintain a list of potential home care products and suppliers Develop performance standards and regular processes for auditing home care services Provide expert support for any other matters relevant to homecare medicines services
7 Collaborative approach to procurement medicines procurement Trust Consortia Commercial Medicines Unit
8 Homecare medicines services procurement NHS agreements Pricing agreements Service Level Agreements Formal tenders Trust Consortia (pharmacy/hubs) National framework agreements Pharmaceutical company agreements Formal agreements between pharma company and homecare supplier With SLA between homecare supplier and NHS Trust No SLA between homecare supplier and NHS Trust
9 Procurement risks for the NHS No formal agreements in place Clinical governance Financial governance Operational efficiency Pharmacy vs Speciality management of homecare medicines services
10 Purchasing for Safety National Patient Safety Agency Alert 20 Promoting safer use of injectable medicines Implement a purchasing for safety policy to promote procurement of injectable medicines with inherent safety features Purchasing for safety principles embedded in all medicines procurement
11 Purchasing for Safety Homecare medicines services National Homecare Medicines Committee Formal tenders Service specifications/standardisation + Service Level Agreements Kite marking homecare medicines services? Engagement with key stakeholders + Quality assessment Contract implementation/change management + Performance management
12 Purchasing for Safety service specification 1. Instructions 2. Introduction 3. Core specification 4. Delivery 5. Prescribing 6. Dispensing/Compounding/Quality 7. Training 8. Equipment 9. Nursing 10. Performance management
13 Purchasing for Safety engagement with key stakeholders Patient/carer/patient groups/lay people NHS Clinical multi-disciplinary team NHS Pharmacy multi-disciplinary team NHS Management team Pharmaceutical company Commissioning Finance
14 Purchasing for Safety implementation/change management Critical part of tender /service specification Identified and agreed roles and responsibilities Discussions start in advance of contract start date Agreed timescales Minimising workload for NHS teams Transfer of information Patient engagement/communication Transfer of equipment Patient survey
15 Performance management Performance management framework included in service specification/sla Augments and formalises service review meetings, providing quantitative and qualitative supporting information Must be patient centred and relevant Must have an impact on improving the patient experience Clarity from outset of what, when and how?
16 Key Performance Indicators Provides quantitative information on performance Can act as an indicator for qualitative performance Needs discussion and peer review with the supplier and the NHS team Work on standardising KPI monitoring template Will require modification depending on the complexity of the homecare medicines services being delivered
17 Typical KPIs Number of patients Number of newly registered patients Number of on hold patients Number of items Number of deliveries % of deliveries on time Spend (medicines/ services) Number and description of: Errors Incidents Complaints Service failures (Lessons learned/ improving the patient experience)
18 KPIs for the NHS Policy/procedures: Trust policy/strategy on homecare medicines management Introduction of new homecare medicines services Risk assessment/ management process Best practice Self-audit tool: Arrangements with Commissioners Trust policy/governance Trust clinical arrangements Trust financial arrangements Arrangements with homecare suppliers
19 Summary Patient focus Patient experience Collaboration Standardisation Performance management Formal agreements
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