Summary Evaluation Report for In-Practice Pharmacist (IPP) Project
and Options Assessment
Benefits and Limitations of IPP Support Pilot
Benefits/Positive Outcomes
 Potential savings identified (annualised): £280,000
 Realised cost savings (annualised): £200,000
 675 quality/safety interventions made
 Support provided for audits of high risk prescribing areas (e.g. antibiotic) and prescribing
process reviews (e.g. repeat prescribing)
 Practices actively supported and engaged with the project
 Working practices agreed and good working relationships formed
 Regular liaison between IPP and practice ensured the medicines optimisation agenda
remained a high priority
 Feedback obtained from practices (post role questionnaire) and:
 was positive and supported the continuation of the role
 raised no issues with providing relevant space and access to clinical systems
 Both pilot localities have indicated their support for the continuation of the role
Limitations
 Work mainly prioritised to focus on cost savings so there are further opportunities for
medicines optimisation initiatives on quality, safety, prevention & process reviews
Impact of IPP Support Pilots Stopping
 Savings made last year will continue into this year so no impact on this
 Ongoing impact on prescribing cost savings and other benefits difficult to establish as
data post cessation of IPP not all available – practices may not have acted on all
suggested work areas themselves
 No regular attendance by an IPP so practices may not be prioritising the medicines
optimisation agenda:
 Lack of support for implementation of new cost saving areas
 Lack of support for medicines optimisation initiatives on quality, safety, prevention
& process reviews
 Practices will be addressing day to day prescribing issues themselves as no IPP to
liaise with taking time that could be spent on other commissioning functions/patient care
 Locality Pharmaceutical Advisers will be being asked for practical support thereby
detracting them from strategic objectives for the Locality as a whole
IPP Options Assessment
See table pages 2-3
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In-Practice Pharmacist (IPP) Options Assessment for Roll-Out after Pilot Phase
Option
Benefits/Advantages
Disadvantages/Risks
1. Not to approve ongoing
funding for IPPs

No additional investment


Demonstrated benefits for LLV/SVV not sustained
Demonstrated benefits not realised in other localities
2. Approve funding for IPPs
(equivalent to pilot level) to be
targeted at other localities

Other localities are larger with greater prescribing
saving opportunities
Disseminated support for quality/ safety/ prevention/
process medicines optimisation initiatives



Additional investment
Demonstrated benefits for LLV/SVV may not be sustained
Demonstrated benefits from piloted support level may not be fully
achieved with reduced support levels
No formalised support for IPP from all localities
Working practices/relationships not established
Will be difficult to truly embed IPP in all practices
Unlikely that all practices will get support every week
Will be difficult to provide support for all practices/work areas so
prioritisation will be needed




Established support for IPP
Working practices already established
Support for new saving initiatives
Support for further quality/ safety/ prevention/ process
medicines optimisation initiatives





Maximise medicines optimisation potential of IPP
Continued support for LLV/SVV so sustained benefits.
Established support for IPP and working practices
within LLV/SVV
Other localities will gain benefit
Other localities are larger with greater prescribing
saving opportunities
Support for quality/ safety/ prevention/ process
medicines optimisation initiatives
Contact with IPP likely to be weekly




3. Approve funding for IPPs
(equivalent to pilot level) in SVV
and LLV
4. Approve funding for 6 WTE
IPPs (to cover all localities - if
allocated by practice equates to
approximately 0.5 days/ practice/
week)












Additional investment
Reduced saving opportunities as work on many saving areas
completed
Demonstrated benefits not realised by other localities
Other Localities have a worse predicted 2014/15 financial outcome
at present
Additional investment
No formalised support for IPP from all localities
Working practices not established for all localities
Reduced saving opportunities for LLV/SVV as work on many
saving areas completed
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Option
Benefits/Advantages
Disadvantages/Risks
5. Approve funding for 3 WTE
IPPs (to cover all localities - if
allocated by practice equates to
approximately 0.25 days/
practice/ week)

Further expansion of medicines optimisation potential
of IPP
Some continued support for LLV/SVV so some
sustained benefits
Established support for IPP and working practices
within LLV/SVV
Other localities will gain some benefit
Other localities are larger with greater prescribing
saving opportunities
Some support for quality/ safety/ prevention/ process
medicines optimisation initiatives


Improved engagement of community pharmacy with
GPs
No employment implications for CCG
Likely to have similar level of local/practice knowledge
to IPP









6.Community Pharmacy
Providers





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
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
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
7. Pharmaceutical Industry
Support



Services may be free of direct costs
No employment implications for CCG
Potential opportunity to demonstrate joint working










Additional investment
Demonstrated benefits from piloted support level may not be fully
achieved with reduced support levels
Will be difficult to truly embed IPP in all practices
Will be difficult to provide support for all practices/work areas so
prioritisation will be needed
Unlikely that all practices will get support every week
No formalised support for IPP from all localities
Working practices not established for all localities
Reduced saving opportunities for LLV/SVV as work on many
saving areas completed
Investment needed uncertain, will require on-cost and profit margin
Potential conflicts of interest
Potential for patient confidentiality issues
May be issues and costs associated with ‘back filling’ of day to day
work meaning pharmacist cannot be freed
Benefits have not been piloted
Unlikely to have the initial competencies required - likely training
requirements. Uncertain who would undertake this
Not all may be willing to provide service which may mean that
service not available in all areas
No support and expertise from PMOT
Unlikely to be able to answer all queries eg on specialist medicines
CCG time spent on commissioning a local service, performance
managing it and providing governance oversight.
Benefits have not been piloted
Potential conflicts of interest
Work will potentially be guided by their priorities rather than being
targeted at any Locality/practice need area
Level of medicines optimisation competency uncertain.
Uncertain who would undertake work – Pharma often use nurses
for clinical projects in practices
Potential for patient confidentiality issues
Follow-up support uncertain
No support and expertise from PMOT.
Unlikely to be able to answer all queries eg on specialist medicines
Unlikely to have day-to-day local knowledge
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