Medicines optimisation
What are our overall aims by 2028?
To have embedded a cross-sector system Senior Leadership Team for medicines optimisation that represents all sectors of pharmacy.
Under the above leadership, to have established a ‘One Medicines Team’ across the system with shared goals, cross team networks and relationships.
To have integrated pharmacy into the ICB’s Clinical and Care Professional Leadership Framework.
To have completed development of a pharmacy faculty that will be a focus for pharmacy workforce planning and deployment across the system.
To have well developed system governance arrangements, including an established ICS Medicines Optimisation Committee that links to the Regional Medicines Optimisation Committee and has a foundation within the ICB’s formal governance structure and processes.
A single medicines and devices formulary, setting out the list of medicines and medical devices available to prescribe to patients in our area, is used in all organisations across the system.
What’s our starting point?
We have established a distributed Senior Pharmacy Leadership Team, the Integrated Pharmacy and Medicines Optimisation (IPMO) Team consisting of senior leaders representing primary care (including community pharmacy), secondary care, and mental health.
Through collaboration and engagement across system partners, we have developed and published a strategy for Integrated Pharmacy and Medicines Optimisation, and established a number of workstreams through which we will progress delivery of the strategy.
Work has begun on a number of the above workstreams during 2022/23 and will continue in 2023/24. Alongside this our focus will be on delivering the agreed priorities within our IPMO Efficiency and Quality Programme – these include general practice referrals into the Community Pharmacy Consultation Scheme and supporting the Discharge Medicines Service.
What are some of the key links to other parts of the plan?
Clinical and Care Professional Leadership – one of our key aims is to embed the IPMO Strategy within the ICS Clinical and Care Professional Leadership Framework so that pharmacy is represented at every level of decision making within the ICS.
Population Health Management and Health Inequalities – as our system’s PHM capability matures, PHM data and evidence will play an increasingly critical role in enhancing our decision making and enabling our efforts to tackle health inequalities through medicines optimisation.
Improving Access to Services and Collaboration and Integration – in line with the national Delivery Plan for Recovering Access to Primary Care, we strongly recognise the potential to further develop and expand the role of community pharmacy as part of our system’s broader out of hospital transformation goals.
Quality and Finance – optimising medicines will improve quality and outcomes, as well as providing greater value for money.
What will we be focusing on in the next 2 years?
Leadership
IPMO structure, sustainability and positioning within the ICS.
Formation of formal system wide ICS Medicines Optimisation Committee, that succeeds the current Area Prescribing Committee, and takes lead responsibility for agreeing medicines pathways and the development of a single medicines formulary across the system.
Making integration standard work – supporting the following areas:
Community Pharmacy Consultation Service (CPCS) – enabling local GP practices to refer patients that present with minor/low acuity conditions into the CPCS, ensuring that patients are seen by the right healthcare professional for the condition presented.
Discharge Medicines Service – enabling patients ready for discharge from hospital and identified to have extra needs regarding their new medicines prescribed on discharge, to be referred to their local community pharmacist for extra support.
Emergency Department to CPCS – enabling patients presenting to the emergency department with minor conditions to be referred to their local community pharmacist.
Community Pharmacy Independent Prescribing Service Pathfinder – in 2026/27 all graduating pharmacists will graduate automatically with an independent prescribing qualification. This pathfinder will seek to develop the best use of this qualification by pharmacists in community pharmacy.
Workforce strategy
Developing a pharmacy faculty which will provide a one stop shop for pharmacy workforce planning and developing a skilled and flexible pharmacy workforce across the system.
Covid Medicines Delivery Unit (CMDU)
Developing a patient pathway for vulnerable covid positive patients to access antiviral therapy in the community.
Medicines safety
Developing an Antimicrobial Resistance Strategy across the system to ensure the optimal use of antimicrobials and reduce the need for, and unintentional exposure to, antibiotics.
Mental Health
Community mental health prescribing advice project – working in partnership with the local mental health provider to ensure that advice is available to primary care on complex mental health prescribing issues.
Sustainability
In line with our ICS Green Plan (see Addressing Climate Change section), focusing on the green agenda related to medicines e.g. the appropriate use of inhalers and anaesthetic gases in the system.
Aseptic medicines resilience across the system
Working as a system to focus on ensuring stability and timely access to aseptic (namely cancer) medicines across the system.
Access to key medicines not readily available
Ensuring access to medicines, such as those used in end of life care, in defined community pharmacies which otherwise would not be immediately available.
Key Challenges
Finance
Sustain an integrated accountable leadership and delivery structure, ensuring that the distributed leadership model delivers on the IPMO Strategy.
Achieving the challenge of the IPMO Efficiency and Quality Programme within the limitations of the ICB running costs.
Workforce
Overcoming the workforce challenge across all sectors of pharmacy within the system.
Internal transformation of the ICB’s medicines optimisation workforce within the current running cost envelope and expanding the workforce to cover South Warwickshire and Warwickshire North Places.
Engagement
Maintaining consistent engagement and ownership of the pharmacy programme across organisations.
Digital
Linking data from investment in medicines to patient outcomes.
Key Metrics and Deliverables
By end of quarter 1 2023/24:
- Refreshed Antimicrobial Resistance Strategy across the system.
- Covid Medicines Delivery Unit pathway established with a prime focus in primary care.
- Appointment of Community Pharmacy Clinical Lead.
- Development of Community Pharmacy Independent Prescribing Service Pathfinder project plan completed.
- Development of prescribing quality dashboards for South Warwickshire Place and Warwickshire North Place, that emulate the dashboards currently being used in Coventry Place and Rugby Place.
By end of year 2023/24:
- Establishment of the ICS Medicines Optimisation Committee.
- Set up of the pharmacy faculty.
- Development of new sustainability strategy around medicines completed.
- Achievement of the IPMO Efficiency and Quality Programme.