1 / 28

Contract monitoring 2009/10

Contract monitoring 2009/10. Matthew Whitty Specialist Pharmacist for Commissioning June 2010. Overview. Background Process for 2009/10 Learning from 2010/11 Draft Process for 2010/11 Multidisciplinary team audit results. Background. April 2005 - Pharmacy Contract

cicely
Download Presentation

Contract monitoring 2009/10

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Contract monitoring 2009/10 Matthew Whitty Specialist Pharmacist for Commissioning June 2010

  2. Overview • Background • Process for 2009/10 • Learning from 2010/11 • Draft Process for 2010/11 • Multidisciplinary team audit results

  3. Background • April 2005 - Pharmacy Contract • Community Pharmacy Assurance Framework (CPAF) • Tool developed by NHS Primary Care Contracting Team (PCC) and Pharmaceutical Services Negotiating Committee (PSNC) • Shorter version developed for 2009/10 • 4 year rolling programme for visits

  4. Process for 2009/10 • Shorter, targeted questionnaire sent to existing contractors • Longer, detailed questionnaire sent to new contractors • Most questionnaires returned on time • 20 visits undertaken in Oct / Nov • 19 as part of rolling programme • 1 due to submitted questionnaire

  5. Why were there changes for 2009/10? • Robust, detailed process undertaken in 2008/9 • New contractors were required to complete the more detailed questionnaire • Allowed for a targeted approach in 2009/10 • Particular focus on • Clinical governance • Child protection • Record keeping • Waste medicines

  6. Returned questionnaires • Shorter questionnaire = positive feedback from contractors • Only 6 questionnaires not returned on time • 1 due to a pharmacy closure • Worse than in 2008/9 with the longer questionnaire where only 2 were returned after the submission date

  7. 2009/10 Outcomes • 65/68 pharmacies signed off • 2 outstanding with minor issues • 1 outstanding with major issues

  8. Process: Learning from 2009/10 • Oct / Nov – better time for visits • Reduced signatures – better • Some questionnaires still returned to PCT rather than TVPCA • Visit slots of 3hrs+ are too long and will be shortened to 2 hour slots for 2010/11

  9. Good practice • Improvement in staff child protection knowledge – even amongst new staff • Excellent level of staff training • Good systems for learning from near misses / errors • Excellent systems for communication between staff • Good arrangements for patients with disabilities • SOPs – well ordered, accessible & staff aware

  10. Good practice • Excellent understanding of the importance of patient confidentiality • Good information dissemination for locums • Record keeping improved from 2008/9 • Dispensing interventions well recorded • Improved multidisciplinary audit return • 71% by analysis deadline (2008/9 – 49%)

  11. Areas for improvement Record keeping • Improvement from 2008/09 in quality and quantity • Signposting • Support for self care • Promotion of Healthy Lifestyles • Submitting evidence from enhanced or advanced services is not enough (will not be accepted for 2010/11)

  12. Record keeping contd. • Contractual requirement under essential services • Better patient follow up • Protects the pharmacist • Demonstrates value of pharmacy services • Highlights opportunities for business development

  13. Other areas that have been highlighted • Failure to open policy – question worded poorly? • Still get calls through to the PCT • Disappointing awareness of PCT public health campaigns – confusion with other promotions • Minority had serious problems with hazardous waste

  14. Draft process for 2010/11 • Completion of rolling visits • + Late submissions / submissions that highlight concerns • + New pharmacies (opened before 1 Oct 2010) • Support available from both TVPCA, Medicines Management Team and Primary Care Commissioning • Keep short questionnaire (except for new pharmacies) • For visited pharmacies increase response time to draft report to 4 weeks

  15. Draft process for 2010/11 • LPC consultation • Timeline: • 16th July 2010 (5pm) -Consultation deadline • w/c 26th July 2010 – Questionnaires sent out • July August –MDT audit and public health campaigns sent out • 10th September 2009 (5pm) - Submission Deadline • Mid Oct - Visits

  16. Multidisciplinary Team Audit – waste medicines • Audit of returned medicines over a consecutive 5 day period • 71% of BW contractors returned audit by the assessment deadline • Around 1,500 items were returned • For approximately 400 patients • Total Estimated by contractors at £15,921 • Pro rata estimate £1.03m to £1.18m per annum • There are also additional NHS costs to manage and dispose of this pharmaceutical waste • Approx. 2% of the primary care prescribing budget • National estimates vary from 2-4%

  17. Analysis • Imperfectdata • The top 5 returns (quantity): • Paracetamol • Warfarin • Glucomen testing strips/lancets • Ibuprofen • Simvastatin • Many analgesics returned

  18. Analysis • Top 5 returns (cost): • Ribavirin • Seretide inhaler • Epipen (these have short shelf life requiring annual update) • Asacol • Lyrica • Top 10 account for 33% of total cost • 14 instances of CDs returned • 4 cytotoxic returns

  19. Reasons for returns • 28% unknown • 28% death • 18% due to side effects • 10% change in circumstances eg patient going into care • Other common reasons – out of date & medication or dose changes

  20. Analysis • Trends difficult to pick up • Pharmacist input for non deceased patients approx 6% • Counselling / MURs (9 occasions) • Contacting GPs (9 occasions) • Not always patient returning medicines • Possible areas – for counselling • Analgesics • Inhalers • Cardiovascular drugs

  21. Support • TVPCA contract performance team • Switchboard 0118 918 3333 • Alison Marshman 0118 918 3379 • Veebha Desai 0118 918 3374

  22. Support • Medicines Management Team • Switchboard (Bath road) 0118 950 3094 • Switchboard (Wokingham Comm. Hosp) 0118 950 3094 • Matthew Whitty 0118 982 2736 • Sanjay Desai 0118 982 2764 • Jillian Powell 0118 982 2908 • Beena Patel-Parker 0118 949 5222 (Wokingham Comm. Hospital)

  23. Support Primary Care Commissioning team • Switchboard (Bath road) 0118 950 3094 • Sarita Rakhra 0118 982 2899

  24. Summary • Excellent local service • Lots of good practice • The issues we have discussed must be in the context of how many patients use our pharmacies every day • Still some room for improvement particularly with records – show how much good work you do! • Challenging times ahead for the NHS and for pharmacy • Threats and opportunities • Support available from • Medicines Management Team • Primary Care Commissioning • Contract Performance team

  25. Worst answer 2010/11? • Runner up: • “Patient presented with breathing difficulties, advised to make GP appointment” • Winner: • An waste medicines audit recorded the return packet of…

  26. Questions? ?

More Related