The Medicines use and Procurement
QIPP Programme
PDIG June 2012
Clare Howard
National Lead for QIPP Medicines use
and Procurement
Success Factors
•
•
•
•
•
•
•
•
A well established network of senior pharmacists
Executive sponsorship (REG)
Leadership from SHA
Great project management
A simple plan
Good data and reporting
Communication (meetings, newsletter, heat map)
Integrating local resources e.g. Procurement
Pharmacist, Specialist Pharmacists etc.
Successes and challenges in 2011/12
The Headlines:
• Delivery above and beyond planned QIPP savings estimated
at £26.4 million (still confirming)
• Regional roll-out of Inhaler Technique project (almost 5,000
interventions)
• National launch of New Medicines Service and Targeted
MURs
• Regional social marketing campaign on tackling medicine
waste – with widespread media interest
• Development of Patient Safety Metrics and association of cost
savings – with plans for National database
The NHS Change Model
SHA
Anne Eden CEO
Senior Pharmacists
Inhaler technique
Waste
Heat map
Meds rec
INR
Allergy
Senior Pharmacists
Network
Pharmacy teams
LPCs
REG
Linda Tait
REG
Gain sharing
NMS
Discharge MURs
Quality Schedule
CQIUNS
Heat map
Asthma and COPD admissions
Money £
Primary care prescribing
Project issues and challenges
• Executive leadership role (REG)
• Maintaining continuity and avoiding loss of momentum
with current programme management structure. (SHA)
• Continued Primary Care engagement
• Securing CCG support, engagement and ownership
• Progress on Community Pharmacy NMS currently lags
slightly behind national levels
Key milestones and delivery for 2012/13
• Annual planning event 20th June
• Medicines waste social marketing report – July 2012
• Launch of national database to record medicines safety metrics across
teaching hospitals – July 2012
• Evaluation of inhaler technique project - July 2012
• Development of opportunities in secondary care through collaborative
working
• Pilot of ‘medicines safety pathway’ approach at OUH
• Focus on medicines waste in secondary care and zero tolerance
approach to pharmacy returns
• Regional stock take of Home Care toolkit - September
• Delivery of £17.5million in QIPP savings – March 2013
Clare Howard
National QIPP lead for Medicines use and procurement.
Quality and productivity
How well are we doing?
QIPP Medicines use and Procurement
Quality and productivity
• Need to ensure that the programme isn't over
reliant on the primary care prescribing budget.
• Programme to encompass the breath of the
medicines pathway.
• Will set the foundations for the medicines
optimisation agenda.
Quality and productivity
Have separated the work out into categories.
•
•
•
•
•
•
•
Primary Care Prescribing
Secondary Care procurement
Home Care
Community based support for patients taking medicines
Medication waste
Medication safety
Patient/ public/ Professional and Industry engagement.
Primary Care Prescribing
QIPP Prescribing
Comparators
New KPIs to be added to
BSA Toolkit
Implement the planned
modernisation of the
prescribing and
dispensing information
system.
Work with Primary Care
National QIPP work
stream to prioritise QIPP
comparators for CCGs
Secondary care
procurement
Promote regional
collaboration on
procurement initiatives
•
•
Framework to share PbR
excluded drugs.
•
•
•
Work with PMSG and
NPSG to ensure QIPP is
integrated into their
annual plans
Smarter use of Hospital
Medicines data
•
To drive up the collaborative arrangements for
procurement in secondary care
To develop and embed a framework for sharing
efficiencies around PbR excluded drugs.
To support wider clinical engagement in the
procurement process.
To support and develop wider patient
engagement in the procurement process.
To develop a culture of performance
management and holding to account in regional
procurement arrangements.
To outline a picture of “best practice
procurement arrangements” and to support all
regions in reaching the standard.
Secondary care
procurement
Promote regional
collaboration on
procurement initiatives
Framework to share PbR
excluded drugs.
Work with PMSG and NPSG to each region has a
procurement plan in place
Support CMU to appoint two posts to scope current regional
arrangements and recommend best practice models.
Agree more uniform method of collating the data
Work with PMSG/NPSG to develop PbR excluded drugs
framework.
Work with Mark Hackett to engage CEO s around gain
sharing.
Begin to work with CCGs to understand gain sharing.
Work with PMSG and
NPSG to ensure QIPP is
integrated into their
annual plans
Support regional collaboration between QIPP and
Procurement specialists where it doesn't already exist.
Ensure each region is able to identify savings
Ensure each region is able to benchmark Trust efficiencies
Smarter use of Hospital
Medicines data
Support the project plan to develop Pharmex data
Good practice, integrated procurement model
Clinical
engagement
Leadership in
Procurement
Performance
management
£££
Safety
Improved
outcomes
Home Care
Work with Mark Hackett to ensure CEO level engagement
with both the report and the QIPP potential
Implementation of
National Home Care
Report
Back Office Collaboration
Data capture
Improved financial and
clinical governance






Patient Engagement
Acute Trust Engagement
Systems: Homecare Modules and
Functionality
PbR Excluded drugs
Expertise, Toolkit and Standards
(kitemarking)
Development of Procurement Model
This work will produce a wealth of products aimed at supporting the
NHS to implement the Hackett report. Products include
 A framework for gain sharing across PbR excluded drugs
 A set of standards for companies wishing to provide Homecare
services to the NHS
 A template annual report for Trusts to use at Board level
 An initial “quick” stock take outlining current status of Homecare by
region
 An in depth national assessment of progress on Homecare built up
from every Trust self-assessment.
 A specification for Homecare modules for e prescribing systems
 A specification for Homecare providers (e invoicing etc.)
 A procurement model to support consistent procurement processes.
 A template Patient charter for Homecare provision.
Community based
support for patients
taking medicines
Data capture/ evaluation
Shared decision making
QIPP/ Medicines
Optimisation and
Community Pharmacy
Post discharge MURs
Medicines Waste
•
will be further refined on publication of the waste report
Await the national report and then identify areas where
QIPP can support implementation.
Support the
implementation of QIPP
related aspects of the
national waste report
Primary Care/
Community Pharmacy
Secondary Care
Care Homes
Medication safety
National benchmarking
of Medicines
Reconciliation rates
Controlled
drugs
Baseline of all regionwide medication safety
initiatives
Omitted and
delayed doses
PODs
Translation of safety
initiatives into QIPP
efficiencies.
Reduction of low dose
antipsychotics for
patients with dementia
Engaging patients/ public
and other healthcare
professionals
Stakeholder
development
Scope successful regional
initiatives.
Develop a plan for
patient engagement/
comms
Promote the concept of
shared decision making
Quality and productivity
Medicines Optimisation
The issues highlighted at the beginning mean that we
can’t keep doing more of the same.
Medicines optimisation offers a step change in the way
we address these issues
Key differences
• Patient engagement
• Outcome focussed
• Pharmaceutical leadership