Northampton General Hospital
NHS Trust
Pharmacy
Clinical strategy
15th August 2009
1
Contents
Page
Purpose and objectives of this document
Strategic context
What is Pharmacy?
Pharmacy PESTLE analysis
Pharmacy SWOT analysis
Pharmacy strategic direction
Pharmacy strategic bridge
Pharmacy - ANSOFF matrix
Pharmacy – five year plans
Pharmacy strategic risk analysis
Pharmacy – capital
Pharmacy – Information management and technology
Pharmacy – estates
3
4
13
14
16
21
22
24
25
31
32
33
34
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Purpose and objectives of this document
This document summarises the outputs from the pharmacy
directorate business planning process.
This directorate strategy is a component of the Trust’s overarching
clinical strategy which in turn is integral to the Trust’s integrated
business plan and Foundation Trust application.
3
Strategic context: vision and values
NGH has developed a clear, agreed vision for the future in
response to the operating environment and changes in the target
market…
“The Trust’s prime focus is to provide excellent quality care to
our patients, regardless of the setting where this is
undertaken”
In this context, the Trust’s
vision is to….
4
Strategic context: what the Trust vision means
Achieve
excellent
clinical
outcomes for
patients
Attain upper quartile benchmark for clinical outcomes, productivity and efficiency
measures.
Achieve year on year improvement of patient satisfaction, measured by the annual
patient survey and local surveys/ forums/ complaints.
Achieve / implement all patient safety related national targets and guidance.
Provide
accessible
services for all
patients and
commissioners
Equitable access to services for all of the local population including the disadvantaged
and hard to reach.
A reduction in the numbers of the local population leaving the county for treatment/
care.
Waiting times that are shorter than the national targets.
An increase in our market share from local commissioners.
Invest in our
future – our
staff, our
services and
our facilities
Re-invest surpluses to enhance our workforce in terms of attracting high calibre staff,
training and education, team development and succession planning.
Re-invest our surpluses and/ or realign service plans to embrace new clinical
techniques and technologies in accordance with national best practice guidance.
Re-invest our surpluses to re-provide or upgrade the physical estate to maximise
clinical productivity, efficiency and patient satisfaction.
Be responsive
to the changing
environment
Flexible workforce to enable upsize/ downsize in capacity to meet demand.
Innovation and willingness to create and adopt new ways of working including off site
provision.
Businesses agility to respond to commissioning intentions.
5
Strategic context: strategic goals
The Trust’s vision will be achieved through three strategic goals:
•
•
•
Continued improvement to the clinical quality, productivity and
efficiency of existing services.
Strengthening our specialist and tertiary services in order to
provide care to the local population.
Enhancing secondary care services in appropriate facilities away
from the acute site, offering services closer to patients’ homes.
Working towards this vision will ensure that…
• All services will have excellent outcomes.
• All services are supported by commissioning intentions.
• Where there is statutory duty to provide a service, it will be provided.
• All services will be financially viable.
6
Strategic context: the operating environment
2009/10 – 2014/15
The operating environment 2009/10 – 2014/15 will be shaped by…
• Key national policies and initiatives especially:
• NHS Next Stage Review: High Quality Care for All (‘Darzi’).
• Transforming Community Services (TCS).
• The development of World Class Commissioning (WCC).
• Local implementation of national policies and initiatives through:
• Local commissioners’ WCC strategies and plans.
• Specialist commissioning plans.
• The global economic downturn and resulting contraction in
public spending at both national and local level.
7
Strategic context: the operating environment
2009/10 – 2014/15
The combined impact of these mean an operating environment that
will…
• Require even greater emphasis on quality, spanning three areas: patient safety;
patient experience; and effectiveness of care. Patients’ perception of the quality of
care they receive will directly impact on funding.
• Require holistic and collaborative approaches to service delivery, achieved
by developing partnerships with a range of partners, depending on local need, to
provide integrated services.
• Demand improved choice: providing patients with an informed choice of
treatment and provider and piloting personal health budgets.
• Continue to push for improved access to services: including better services in
the community and closer to patients’ homes.
• Drive the reinvigoration of practice-based commissioning, including piloting
new integrated care organisations.
• Require financial savings, productivity and efficiency on a scale not seen
before leading to downward pressure on tariffs, decommissioning of some
services, increased market testing/tendering, ‘activity caps’ in contracts and
further tariff unbundling.
8
Strategic context: the operating environment
2009/10 – 2014/15
In summary, the new operating environment will need us to…
• Deliver higher quality services that meet patient and customer
expectations.
• Find greater efficiencies and levels of productivity across all our
service lines.
• Find new ways of collaborating with others to deliver services.
• Develop greater responsiveness to our commissioners’ needs
and plans.
• Improve access to services for our population.
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Strategic context: our target market
Our target market is…
Our aim is to remain the
provider of choice in all of
our target markets
• The local population - we provide general hospital services to around
370,000 people in and around Northampton.
• Specialist commissioners and a wider catchment population for
some services - as a designated Cancer Centre we provide specialist
services to approximately 880,000 people in East Northamptonshire, and
parts of North Buckinghamshire and South Leicestershire.
• NHS Northamptonshire - our main commissioner of services.
• Nene Commissioning - a practice-based commissioning organisation
representing 76 participating practices across key areas of the County; it
is responsible for a budget of £275m to cover day case, elective and nonelective activity.
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Strategic context: factors driving demand
National policy
Current competitors
Socio-demographics
Health need
Disease prevalence
New market entrants
Technological changes
Models of care
Market place
opportunities
and
risks
Trust strategy
Local health economy strategies
Local health economy finances
Commissioner intentions
Factors that influence supply
Factors that influence demand
As illustrated opposite, the key factors
driving demand are: national policy,
demographics, health, healthcare of the
Trust’s operating markets, age and gender
within the Trust’s core catchment area,
health risks, birth rates, current economic
downturn and associated effects and other
factors including political direction –
contestability and plurality.
Models of care
Market share/
Consumer choice
Other competitive factors and demand drivers include:
• The threat of substitution – There are increased healthcare options available to
patients in the local markets e.g. laparoscopic rather than open surgery and an
increased focus on self-care models and community based care.
• Bargaining power of suppliers – There is a high fixed cost base preventing ability to
limit costs to meet reduced tariffs.
• Bargaining power of customers – There is a range of hospitals at which GPs and
patients can choose to access healthcare.
• Threat of new entrants.
• Competitive rivalry.
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Strategic context: demand for our services is likely to be shaped
by…
A rapidly expanding population, with particular growth in the number of older people,
which will increase demand for our services.
The leading causes of death in our catchment - circulatory disease (heart disease
and stroke) and cancer - which will maintain demand for specialist services.
NHS Northamptonshire’s strategy, which makes provision for:
• A reduction in growth monies from 5.3% in 2009/10 to 3% in 2012/13.
• Clear metrics to measure improvement in key areas such as stroke and cancer.
• A commitment to providing patients with a choice in how and where their care is
provided.
• Plurality of provision to deliver services.
• The development of cancer services at NGH, including enhanced provision of
radiotherapy.
• The provision of additional services in the community by NGH where
appropriate.
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What is Pharmacy?
Patients
at Home
NHS PASA
Thames Valley Consortium
Pharmacy Model of Service v6
DH Licences, MHRA
All
Wards/Depts
Homecare
NHT, PCTs,
BMI Three
Shires,
Two Shires
Ambulance,
GPs,
Chemists
etc
Patients,
Healthcare
Practitioners
PCTs:
Cynthia Spencer,
Favell House,
BMI Three Shires
Danetre
Med-N
Discharge
Scheme
Aseptic Services
(Procurement, Distribution and
Dispensing)
(Manufacturing and Dispensing)
Quality Assurance
Pharmacy
KGH
NHT
IT Support &
Development
(Pharmacy EDS System
& Other Systems)
Clinical
Services
(Clinical Advice)
Patients’ Own
Medicines
Scheme
GPs, Community,
Ambulance Service
F/Planning/Pharmacy Model of Care/April 05
MKGH,
KGH,
Hinchingbrook
Theatres,
SSD
20% of work
is not done
for NGH
(Environmental Monitoring, Gas Testing)
Medicines
Information
Directorate Support
Nuclear Medicine
NGH
Procurement & Supply
Ward Visits
Pharmacy
PMH
Patients/ wards
Porters
(Advice on
Medicines)
GPs,
Community,
PCT
MKGH, KGH, PCTs
BMI Three Shires
Training/
Support
MMC/
FC
Administration/
Management
Doctors in Training,
Nurses, Healthcare
Professionals
E Midlands, London
Anglia,
Clinical Networks
Electronic
Data
Interchange,
REVIVE etc
Community Students
(Pre-registration)
NPAG
PCT
GPs
Formulary &
Dressings
Formulary
Contractual and Other
Support:
Oxford Radcliffe Trust,
LNR WDC, UWCC Diploma,
UKCPA, Leicester College,
Others
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Pharmacy PESTLE analysis
Political
The following “political” areas have/will have an impact on the pharmacy directorate and need to be
managed/considered in line with future strategic plans administered:
With patient choice, co-payments will mean that patients may elect to pay for non-NHS funded medicines in
addition to their NHS care.
In the national in-patient survey the discharge questions lead to focus on pharmacy provision of discharge
medicines and there is a perception that delays are due to pharmacy.
Care Quality Commission (CQC) and the NHS Litigation Authority (NHSLA) Standards and NHS targets impact on
each part of the medicines pathway from admission, in-patient stay through to discharge. All aspects require
increased pharmacy focus with same or reduced staff numbers.
The directorate and the Trust also needs to consider independent sector competition. Community pharmacy
chains/commercial sector may look to provide parts of hospital pharmacy services.
There is a workforce challenge which has to be met. An increase in the number of non-medical prescribers would
improve convenience and possibly the efficiency in supply.
Economic
The following “economic” issues have/will have an impact on the pharmacy directorate and potentially
beyond and need to, therefore, be managed/considered in line with future strategic plans administered:
Within the PbR framework there are no HRGs/ tariffs for specifically for pharmacy.
With regards to the risk sharing schemes, NICE is approving more medicines for NHS use linked to funding/
reimbursement schemes with manufacturers.
The changes anticipated in NHS Funding is another reality which all the directorates will need to consider as a key
variable in their strategy. There are already shortfalls in pharmacy provision and the financial climate will lead to
less funding and not more. Pharmacy's activity contributes around £1,000,000 per annum towards medicines
savings/containment. The achievement of this is threatened by the need for pharmacy itself to achieve its cost
improvement plan.
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Pharmacy PESTLE analysis
Socio-Cultural
The shift in population changes are being reflected in numbers of admissions.
With regards to population demographics, more patients will be elderly, more will have diabetes, more will have
heart disease etc, leading to more complex medicines treatment with expected reduced length of stay.
This forecasted scenario will require prioritisation/focussing of clinical pharmacy activity on the wards.
The labour market is also a key issue. There is a shortage of qualified hospital pharmacy staff. It is an aim of the
directorate to make the NGH pharmacy directorate the best pharmacy to work in.
Technological
Extend automated dispensing, the procurement of an e-chemotherapy prescribing system, the change from
Revive e-discharge system to Teleologic and e-prescribing for DGH [2013/14] will all have a positive impact on the
directorate.
Technological advances such as the pneumatic tube delivery system, more biologicals and targeted therapies and
more oral chemotherapy, and less injectable would improve delivery and governance arrangements.
Legal
Key legal challenges are based around NICE technology appraisals and the increase in the number of National
Patient Safety Agency (NPSA) alerts related to medicines, achieving the good manufacturing practice and good
distribution practice level to ensure manufacturer's and wholesale dealer's licence is maintained. There is also
pressure from the monitoring use of controlled drugs to consider.
Environmental
Key issues here are around pharmacy and car parking space. More is required as it is constraining the ability to
manage workload safely.
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Pharmacy SWOT analysis
Strengths
Good portfolio/range of functions [compared to surrounding DGHs].
Department of Health licensed specials unit and licensed wholesaler dealer.
Integration into clinical teams in some areas, e.g. heart and kidney centre, HIV.
Several specialist posts.
Services provided to other Trusts/organisations.
Strong formulary and medicines management committees.
Effective MM technicians and patients own medicines scheme [in some areas].
Robust formal training [Trainee MTO, pre-registration pharmacists, diploma].
Low sickness absence.
Automation.
Physical location of NGH pharmacy.
Pharmacy staff access to IT hardware, systems, expertise.
Accurate discharge medicines information for GPs.
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Pharmacy SWOT analysis
Weakness
Some gaps in service provision:
- Reconciliation on admission [45-50%].
- Audit of medicines use and practice.
- Pre-op assessment.
- A&E.
- Theatres.
- Obstetrics.
- Corporate medicine incident monitoring and management.
- Week-end and out of hours (OOH) access to pharmacy.
Little training/ education for pre-and post-registration doctors/nurses.
Functional responsibility for ‘safety’ within pharmacy structure.
Supervision and management of junior pharmacists.
Matching staff numbers/skills to discharge and dispensing workload.
Poor IT systems to audit medicines use for governance and expenditure reporting.
Tracking and apportioning medicine CIPs.
Physical space at NGH pharmacy and departmental configuration.
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Pharmacy SWOT analysis
Opportunities
NHS and NGH safety focus.
More integration of pharmacists into directorates.
Linking cost improvement plans on medicines to pharmacy cost improvement plans and better
‘tracking’.
Service improvement projects within Trust.
More non-medical prescribers for convenience and efficiency.
Electronic prescribing of chemotherapy.
Replacement of revive with Teleologic [e-discharge system].
Replacement of pharmacy computer system [2010/11].
Out-reach. Danetre? And homecare?
Closer working with primary care trust in managing long-term conditions and prescribing costs.
Pharmacy White Paper and recognised need for pharmacy input at strategic health authority
level.
Physical space problems now recognised by Trust.
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Pharmacy SWOT analysis
Threats
National shortage of qualified pharmacy staff.
Reductions/changes to NGH services eg. cancer status, stroke, vascular etc.
National and local pressure on points of admission, in-patient stay and on discharge, leading to
conflicting priorities.
Cash releasing cost improvement can only come from pharmacy staff budget.
Loss of income from BMI Three Shires.
High cost and commitment to training and reductions in HWD funding.
Provision of hospital pharmacy services by the private sector.
Likely agenda for change (AfC) changes to emergency duty remuneration.
Insufficient funding for medicines.
Increasing numbers of risk sharing schemes supported by the national institute for health and
clinical excellence systems.
Introduction of co-payments/top-up systems.
‘Responsible Pharmacist’ regulations?
New care quality commission standards relating to self-administration in hospital [from 2010].
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Summary weaknesses, opportunities and threats
Key weaknesses to address:
How to address them:
Gaps in provision [surveillance].
Prioritise and negotiate with directorates.
Gaps in provision [access].
Safety ‘function’ in pharmacy.
Develop options for improving access with Trust eg. Sundays;
one-stop/pre-packs etc.
Space.
Re-organise in pharmacy.
Identify and occupy space [Billing House?].
Key opportunities to address:
How to address them:
Directorate integration.
Service level agreements and developments via Trading a/cs.
Service Improvement eg. emergency care.
Implement recommendations.
Increase in oncology activity and outreach.
Redesign; shared care; ‘homecare’?, satellite dispensaries?
More non-medical prescribers.
Pharmacy/nursing/directorate strategies.
Self-administration [2010 care quality commission
standards].
Extend MM technicians responsibilities.
Key threats to mitigate:
How to address them:
National pharmacy staff shortage.
Make NGH best pharmacy to work in.
Pressure on admission, in-patient stay and on
discharge, leading to conflicting priorities.
Agree priorities with Trust via modernising medical careers
(MMC)/governance/ directorates.
Cost improvement plans [medicines and pharmacy].
Agree system with DoF; directorate integration.
Funding for training.
Stop/reduce or fund from elsewhere.
Increase in weekend discharges.
Agree process and support to enable.
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Pharmacy strategic direction
To maintain the efficiency of core services eg. ordering, receipt, storage, distribution, dispensing, prescription
surveillance and to maintain MRSA licences.
To develop services by focusing and prioritising with the emphasis on safety and efficient discharge, within
the context of increasing complexity of treatment with medicines, increasing expenditure on medicines, reduced
length of patient stay, reduced doctor’s hours etc.
To link cost improvement/cost minimisation of medicines to pharmacy activity.
To work with the primary care trust and other organisations to improve the safe use of medicines at transitions of
care [admission, discharge, out-reach, off-site provision and more services within primary care].
To create a pharmacy culture with two themes: safety in the use of medicines, and an environment of support for
staff.
To ensure tasks are done by appropriate staff whilst also ensuring safety and adequate training; in particular to
further develop technical staff to work with patients to improve their adherence and make savings by the efficient
use of medicines.
To support specialisation and personal development within the context of NGH developments and a possibly
reducing Trust workforce.
To develop IT systems and processes to improve safety, efficiency and audit.
21
Pharmacy strategic bridge
2014/15
2009/10
Extensive safety work,
audit etc, but little focus
and co-ordination. No
corporate analysis of
medication incidents.
46% of admitted patients
have a pharmacy
reconciliation of their
medicines; EAU covered
five hours per weekday.
35% of discharge
medicines dispensed as
one-stop; use of pre-packs
out-of-hours.
57% of e-discharges and
25% of in-patient
prescribed items require
pharmacy intervention;
little MM training of
medical and nursing staff.
Develop ‘safety function’ within
pharmacy
Extend reconciliation on admission to
reduce medicines management
problems.
Facilitate safe, efficient and effective
discharge.
Improve appropriateness of prescribing
via training and IT solutions
Improved safety in the use
of medicines evidenced by
audit and indicators in
quality accounts, NHSLA
and CQC standards.
90% of patients to have a
pharmacy reconciliation on
admission via extending
input at points of
admission and pre-op
assessment.
Most patients to be selfadministering, discharged
with pre-packs or one-stop
dispensed medicines all
high risk patients with a
pharmacy care plan.
Full e-prescribing with
decision support and
prescribing competence
assessment.
22
Pharmacy strategic bridge
2014/15
2009/10
Medicine and pharmacy
issues only integrated into
some directorate teams to
limited extent; levels of
service unquantified.
Out-of-stock occurrences
too frequent and process
times for dispensed
medicines too variable.
Integration of pharmacy into directorate
teams
Consolidate technical services to
maximise efficiency within pharmacy
[procurement, dispensing, etc].
Full integration of
pharmacy into directorates
to improve safety,
economical use of
medicines, service
planning, cost
improvement plans etc.
Less than 1% stock-outs,
90% of dispensed items to
be completed in less than
one hour.
Limited ‘specialist’
dispensing.
More specialist dispensing
eg. chemotherapy, HIV.
75% of staff with 15 month
appraisal. Limited use of
competence frameworks.
100% of staff with 15
month appraisal.
Extended use of national
development frameworks.
Two pharmacist
prescribers.
Improve staff development
More non-medical
prescribers.
Consultant pharmacist
post.
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New (wider)
Pharmacy - ANSOFF matrix
Markets
Clinical surveillance/ reconciliation on admission
to: A&E, pre-admission clinic, obstetrics.
MM technicians assessing for selfadministration.
More time on EAU; paediatrics.
Medicines management in theatres.
Patient’s Own Medicines schemes on more
wards.
Corporate medicines Incident management.
More pharmacist prescribers.
Paediatric total parenteral nutrition (TPN)
production [KGH same day service].
More training of medical and nursing staff.
Focus on core pharmacy services.
Sunday pharmacy service?
National patient safety agency (NPSA) safety
alert management.
Paediatric total parenteral nutrition production.
Existing
Medicine use/practice audit.
Existing
Services
New
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Pharmacy five year plans: Priority service developments [1]
Developments over the next five years
Year 1
Year 2
Priority 1
Safety
Create safety
function in
pharmacy.
Corporate
analysis of
medication
incidents.
Priority 2
Consolidation
Improve stores &
dispensary
performance.
Combine oral and
parenteral
chemotherapy
dispensing.
Expand space
available.
Refocus clinical
service.
Review patients
own medicines
scheme.
Priority 3 =
Reconciliation
Refine current
systems and
recording.
Year 3
Year 4
Year 5
Refined medicine
safety indicators
and robust audit
programme.
HIV and trials
dispensary?
Automate robot
filling.
Directorate
discussion:
extend EAU
coverage? start
pre-op
assessment?
extend
prescription only
medicines?
See also directorate integration
workstream.
Integrated
primary and
secondary
care
information.
25
Pharmacy five year plans: Priority service developments [2]
Developments over the next five years
Year 1
Priority 3=
Discharge
Increase use of
pre-packs where
appropriate.
Targeted onestop
dispensing.
Service
Improvement
project.
Enhanced
performance
management of
discharge
process.
Case for Sunday
service.
Priority 3=
Technology
Implement e-Rx
in chemotherapy.
Change to
Teleologic.
Priority 3=
Cost
improvement
plans
Year 2
Agree
management of
cost
improvement
plans on
medicines.
Year 3
Year 4
Year 5
Issues also tackled via directorate integration
workstreams.
Integrate
pharmacy with
e-discharge and
e-Rx chemo.
Implement
national eprescribing
solution in
NGH.
Plan for
replacement of
Pharmacy
system.
Replace
Pharmacy
system.
Enhance
system of
tracking and
apportionment.
Issues also tackled via directorate integration
workstreams.
26
Pharmacy five year plans: Priority service developments [3]
Developments over the next five years
Year 1
Priority 4=
Directorate
integration
Oncology
Clarify services
currently provided
to directorate.
Agreement to
up-grade to recruit.
Year 2
Year 3
Year 4
Discuss with directorate
re. managing growth,
cost improvement
plans, access, audit,
NMP etc.
Medicines and pharmacy
issues fully integrated into
directorate plans.
Priority 4=
Directorate
integration
Medicine
Clarify services
currently provided
to directorate.
Discuss with directorate
re. invest/divest to save
and/or improve quality
eg. EAU cover, cost
improvement plans ,
A&E, extend
prescription only
medicine/ reconciliation,
NMP?
Medicines and pharmacy
issues fully integrated into
directorate plans.
Priority 4=
Directorate
integration
Surgery/
anaesthetics/
critical care
Clarify services
currently provided
to directorate.
Discuss with directorate
re. invest/divest to save
and/or improve quality
eg. pre-op assess,
theatres, cost
improvement plans,
extend prescription only
medicines /
reconciliation, NMP?
Medicines and pharmacy
issues fully integrated into
directorate plans.
Year 5
27
Pharmacy five year plans: Priority service developments [4]
Developments over the next five years
Year 1
Year 2
Year 3
Year 4
Priority 4=
Directorate
integration
Child Health
Clarify services
currently provided
to directorate.
Clarify current
discussions re.
investment.
Discuss with
directorate re.
production of TPN,
cost improvement
plans, NMP etc.
HIV service?
Medicines and
pharmacy issues
fully integrated
into directorate
plans
Priority 4=
Directorate
integration
Trauma and
Orthopaedics
Clarify services
currently provided
to directorate.
Discuss with
directorate re.
invest/divest to save
and/or improve
quality eg. extend
prescription only
medicine/
reconciliation, cost
improvement plans,
NMP?
Medicines and
pharmacy issues
fully integrated
into directorate
plans.
Priority 4=
Directorate
integration
Obstetrics and
Gynaecology
Clarify services
currently provided
to directorate.
Discuss with
Directorate re.
invest/divest to save
and/or improve
quality eg.
obstetrics, cost
improvement plans,
CNST 2/3, NMP?
Medicines and
pharmacy issues
fully integrated
into directorate
plans.
Year 5
28
Pharmacy five year plans: Priority service developments [5]
Developments over the next five years
Year 1
Priority 4=
Directorate
Integration
Head and Neck
Clarify services
currently
provided to
directorate.
Year 2
Discuss with
directorate re.
invest/divest to
save and/or
improve quality
eg. extend
prescription only
medicines/
reconciliation,
cost
improvement
plans, NMP?
Year 3
Year 4
Year 5
Medicines and
pharmacy
issues fully
integrated into
directorate
plans.
29
Pharmacy five year plans: Priority service developments
Oncology:
Growth in oncology.
Loss of cancer centre status.
Child health – countywide child surgery service/development of HIV service could have big implications for
pharmacy.
The two areas listed above are the developments the pharmacy directorate will watch and keep talking to other
directorates about.
30
Pharmacy strategic risk analysis
Source
of risk
Trust service
changes
Supply of qualified
staff
Cost
Improvement
Available
funding/zero
growth
Pharmacy
objective
threatened by
risk
Stability of all pharmacy
services.
Improvements in
performance, access,
reconciliation, e-chemo Rx
implementation,
prescription only medicine
savings, paediatric HIV
etc.
Funding for adequate
staff.
Development of
pharmacy via
directorate
integration.
Risk
description
Loss/reduction of
oncology, stroke, trauma
etc will require pharmacy
costs to be removed.
Lack of staff limits
development; increased
use of locums;
prioritisation.
Pharmacy cost
improvement plan
from staff costs
unless linked to
medicines savings or
other Trust activity.
Directorates may
look to reduce
pharmacy costs
rather than from
medicines.
Action /
treatment
Protect non-NGH work;
better financial analysis.
Make NGH pharmacy best
place to work; train own
staff; skill mix.
Link pharmacy cost
improvement plan to
medicines/Trust
activity.
Discuss with
directorates.
Responsibility
Chief pharmacist and
finance.
Chief pharmacist.
Chief pharmacist and
finance.
Chief pharmacist.
Sources of
assurance
Scorecard.
Scorecard.
Finance monitoring.
Directorate
performance
meetings?
31
Pharmacy - capital
Implication Capital requirements
Year 1
Year 2
Key capital
requirements
Year 3
Year 4
Year 5
August 2012,
2013/14.
Robot lease
2 x ASU laminar
airflow cabinets
(£60,000).
1 x Positive
pressure isolator
(£30,000)
Details from finance asset register
32
Pharmacy – information management and technology
Implication Information management and technology requirements
Year 1
Key
information
management
and
technology
requirements
Year 2
Year 3
Year 4
Year 5
2010/11
2013/14
Replace
pharmacy EDS
system.
NGH eprescribing
interface to
pharmacy
system.
Interface with echemo
prescribing
system
PPM/
PPM/
PPM/
PPM/
PPM/
replacement
replacement.
replacement.
replacement.
replacement
33
Pharmacy - estates
Implication Estates requirements
Year 1
Key estate
requirements
More space;
Billing House
Identified as
option.
Aseptic
support room
expansion.
Year 2
Year 3
Consider
direct delivery
to pharmacy
[rather than
via Main
Stores].
Consider reconfiguration
to improve
patient and
visitor
reception.
Year 4
Year 5
34