East & outh East England pecialist Pharmacy ervices East of England, London, outh Central & outh East Coast Medicines Use and afety afe and Cost Effective Commissioning and Procurement Tracy Rogers East & outh East England pecialist Pharmacy ervices MU Team: Winner: RP Pharmaceutical Care Award 2013; Finalist: HJ Patient safety award in primary care 2013; Winner: UKCPA/Guild Conference Best Poster award 2013; Winner: UKCPA Pain award 2012; Winner: UKCPA Respiratory award 2012
Medicines Use and afety Presentation Plan Drivers P resources Formularies Procurement Commissioning for quality - CQUINs
Medicines Use and afety Cost The total cost to the NH of caring for patients with wounds was estimated in 2005/2006 to represent around 3% of the total NH budget. Dressings contribute to this but must not be focussed on in isolation. Reducing nursing time and hospitalisation are important factors
Medicines Use and afety Unused prescription medicines cost the NH in the UK an estimated 300million every year. Waste Perceived that dressings are often wasted when wound heals or patient dies
Medicines Use and afety Quality Ten Guiding Principles for improving the systems and processes for the supply and prescribing of wound dressings April 2012
Medicines Use and afety Optimising ystems and Processes of Wound Care - A QIPP resource of good practice Formularies Procurement Commissioning for quality
Medicines Use and afety Formularies NPC principles document (Principle 2) suggests having a prescribing policy which includes a formulary 80% of patients can be treated using dressings from a limited list or formulary P Resource Developing and Implementing a Wound Care prescribing Policy
Product selection Medicines Use and afety Robust methodology of product selection Overarching guidance - NICE formulary guidance Users perception of how product performs Remember You are unlikely to please everyone!
Medicines Use and afety Formulary Development Examples of formularies Product focussed Wound focussed Examples of controlling use of specialist products Traffic light systems Use of TVN only formularies Exception reporting
Medicines Use and afety Formulary Implementation Procurement initiatives Education Commissioning another provider to manage the service including formulary implementation
Medicines Use and afety Procurement NPC principles document (Principle 3) recommends that local health economies understand their local procurement and prescribing arrangements for dressings Historically in primary care have used FP10 prescription route Non-FP10 route P Resource Procurement and Prescribing Options for Dressings
Medicines Use and afety Non-FP10 route Community Pharmacies and Legal issues VAT, Claw back and Dispensing fees Tendering, Implementation and Invoicing Ownership, Deliveries and torage Ordering and Adherence to formulary
Medicines Use and afety Non-FP10 route - continued NMP and Education of nurses Data monitoring and Reporting Working with industry Implementing in care homes
Medicines Use and afety Non-FP10 procurement options In house purchasing using organisation s ordering portal Online ordering system provided by wound care product manufacturer Online ordering system provided by NH upply Chain
Medicines Use and afety Commissioning for quality NPC principles document (Principle 9) suggests commissioners use financial and other incentives to improve wound management NH safety thermometer Pressure ulcers national CQUIN 2014/15 then in NH tandard Contract pecific Medicines Optimisation CQUIN and KPIs linked to wound care P Resource Commissioning incentives to improve wound management and prevention
Medicines Use and afety MO CQUIN and KPIs Development of wound care formulary and/or Adherence with agreed wound care formulary taff training in wound care Audit of practice against wound care pathway Development of patient information Reducing expenditure on high cost items
Medicines Use and afety P Resources http://www.medicinesresources.nhs.uk/en/communities/nh/p-e-and-e- England/Meds-use-and-safety/QIPP/Wound-Care/Optimising-ystems-and- Processes-of-Wound-Care---A-QIPP-resource-of-good-practice/