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Can we afford to waste medicines? - update on possible national strategies

Can we afford to waste medicines? - update on possible national strategies. Bhulesh Vadher Clinical Director of Pharmacy and Medicines Management , Oxford University Hospitals. South Central Experience. Many thanks for Leadership and support from : Clare Howard

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Can we afford to waste medicines? - update on possible national strategies

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  1. Can we afford to waste medicines?- update on possible national strategies Bhulesh Vadher Clinical Director of Pharmacy and Medicines Management , Oxford University Hospitals

  2. South Central Experience Many thanks for Leadership and support from: Clare Howard QIPP Medicines use and Procurement Lead Linda Trait ProgrammeManager Medicines use and Procurement Liz Bere NHS Southampton Clinical Commissioning Group South Central Chief Pharmacists and Medicines Management Leads

  3. Old South Central Geography

  4. Recognising a National Issue From defining in 2010 …… To planning in 2012

  5. Regional Collaboration Hospital Waste Audits The NHS South Central Project: 2010 - 2012 Zero tolerance policy to medicines waste now in place in a number of Trusts

  6. Medicines Waste Self Assessment • Policy - Return Drug Policy to manage risk and return all reusable medicines • Resources - Cost effective staffing mode • Process -Ensure a Zero tolerance approach is taken. • Process - Ensure part pack reuse systems are in place • Training - In place for returning all appropriate medicines • Monitoring - Monitor month on month financials • Audit- Annual sample of a 1 week to 1 months returns • Senior staff - Visual inspection to identify potential benefits

  7. Collaborative working: Key: Shared self assessments Heat Map • Waste Audit (1 week) • Total Returns ( Annually 2009 to date) • Returning all available medicines (Self Assessment) • Outcomes Achieved • 100% savings returned to pharmacy budget • Year on year reduction in waste • Raised Board awareness

  8. An Action Plan • Trust Board level reporting of medicines waste • Invest to save: install resource to facilitate waste • reduction and recycling • Conduct annual waste audits

  9. POD Green Bags Regional Collaboration Hospital Waste Audits The NHS South Central Project: 2010 - 2012 Zero tolerance policy to medicines waste now in place in a number of Trusts Second annual utilisation and £ savings audit complete

  10. An Action Plan • Conduct annual POD volume • Plan to increase volume and improve management of patient’s own drugs • Remove barriers to patient’s routine arrival with PODs • Review discharge process • Support patients beyond discharge

  11. Use of Green Bags and POD’s

  12. POD Green Bags Regional Collaboration Regional awareness campaign Hospital Waste Audits The NHS South Central Project: 2010 - 2012 Zero tolerance policy to medicines waste now in place in a number of Trusts Second annual utilisation and £ savings audit complete Incorporating secondary care for the first time

  13. Awareness campaign • Population of 4 million • 694 Community Pharmacy's • 494 GP surgeries • 11 hospital trusts • 4000 pre and post evaluation patient questionnaires • 510 patient surveys • 260 professional surveys.

  14. Key Message using Dynamic Advertising Group • Think before you order • Only order what you need • Unused Medicines can not be recycled • Wasted Medicines cost NHS South Central £20million per year • Look after your medicines • Picture of standard pharmacy Green bag • The Green Medicines bag helps keep your medicines with you when you move wards and go home from or come into hospital.

  15. Observations of the campaign are: A social marketing campaign is hard work:- • diligent planning • resource intensive • early engagement of health professionals (clinicians vs patients) A medicines waste social marketing campaign is about long term cultural change

  16. The main findings of the evaluation are as follows: • Need to sustained over a longer period • Regular and repeated evaluation • Materials and messages should be reinvented • Market segmentation • Multi-faceted or multi-modal. • Effective utilisation of media channels • Alignment to practical interventions • Targeting by disease type • Good recall but no significant variations in behaviour

  17. Synthesis of Food Waste Compositional Data 2010Comparison of national food waste arising estimates for England (kg per household per year) Ref: WRAP( Waste Resource Action Program)

  18. UK Supermarket Retailers Voluntary Carrier Bag Agreement 2011 Carrier Bag Use WRAP July 2012

  19. UK Supermarket Retailers Voluntary Carrier Bag Agreement 2011 Carrier Bag Use WRAP July 2012

  20. POD Green Bags Meds Rec database Regional Collaboration Inhaler Technique Four innovation pilot projects Regional awareness campaign Hospital Waste Audits The NHS South Central Project: 2010 - 2012 Zero tolerance policy to medicines waste now in place in a number of Trusts Showing demonstrable reductions in emergency admissions Second annual utilisation and £ savings audit complete From a regional initiative to a national database Incorporating secondary care for the first time The first pilot project delivering £10K per annum with potential for £1.6m region-wide!

  21. POD Green Bags Meds Rec database Four innovation pilot projects Regional Collaboration Regional awareness campaign Inhaler Technique Hospital Waste Audits The NHS South Central Project: 2010 - 2012 Zero tolerance policy to medicines waste now in place in a number of Trusts Showing demonstrable reductions in emergency admissions Second annual utilisation and £ savings audit complete From a regional initiative to a national database Incorporating secondary care for the first time The first pilot project delivering £10K per annum with potential for £1.6m region-wide!

  22. Improving Quality, Safety and Cost

  23. The team won an NHS Innovation Challenge for its collaborative approach to tackling medicines waste. Our three challenges now … • To prove the value of the collaborative concept • To go further, faster and make a real difference to patient care • For the project to sustain itself in the new NHS structures

  24. POD Green Bags Meds Rec database Regional Collaboration Inhaler Technique MDS boxes Patient pathways & adherence Waste Audits Care Homes and carers Regional awareness campaign Four innovation pilot projects The NHS South (TV and Wessex) Project 2013 Report levels of waste to Trust Boards Engage and evaluate scale of waste Process review to maximise POD Utilisation Learn from pilot and scope Map links between systems and improve patient supports Develop a campaign to empower the patient: ‘collect what you need’ Assess opportunities for wider role out and implement a second round of pilot projects

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