NICE, in collaboration with partner organisations, has launched an initiative to encourage better medicines support for people who are receiving social care services in their homes.
Involved & informed: good community medicines support aims to ensure the safe and effective use of medicines in the community, so people get the best possible outcomes with a reduced risk of medicine related harm. The campaign encourages health commissioners and local authorities to have a written agreement that sets out clear responsibilities for home-based medicines support.
The campaign also urges home care providers to ensure their medicines policies are robust and based on NICE guidance. The campaign focuses on NICE’s guideline and quality standard on managing medicines in the community, and comprises of action-orientated stand-alone messages, that speak to specific key audiences.
These key audiences are: local authority and clinical commissioning group (CCG) commissioners; social workers and other adult Care Act assessors; home care providers; people accessing medicines support (and their families and carers); Care Quality Commission (CQC) inspectors; GPs; pharmacists; and NHS Acute Trusts.
A series of indicators to inform safer prescribing practice, helping pharmacists, clinicians and patients to review prescribed medication and prevent avoidable harm | Department of Health and Social Care
The Department of Health and Social Care is introducing prescribing indicators to inform safer prescribing practice. The experimental indicators link prescribing data from primary care with hospital admissions for the first time. The purpose is to identify prescribing that could potentially increase the risk of harm and that may be associated with hospital admission. The first indicators focus on how different medicines may be contributing to people being admitted to hospital with gastro-intestinal bleeding. The programme will cover more medicines and associated conditions later in the year.
The transformative electronic prescription service (EPS) has managed to save the NHS £130 million over three years | NHS Digital
By allowing GP surgeries to send prescriptions directly to pharmacies, the EPS system, which has been developed by NHS Digital, has helped to save patients time and money when collecting their medications.
An audit of patients using the system found that 72 per cent said their medicines were ready and waiting for them when they arrived at their pharmacy, with the average prescription collection around 20 minutes quicker under the EPS system.
Over the past three years the system has saved patients almost £75 million and has meant patients need to make fewer return trips to pharmacies as a result of their medications being out of stock.
The time savings that EPS offers the average GP practice, allows staff to have more time to care for patients, particularly during the winter months when there is more demand for their services.
Additionally with more people falling ill over the winter period, EPS can help patients get their medication quickly and reduce the need for pharmacists to ring the GP about prescription queries.
The biggest savings were recorded by prescribers who saved around £327 million between 2013 and 2016, while dispensers saved nearly £60 million.
GP practices on average also saved an hour and 20 minutes each day by signing electronic repeat prescriptions compared to paper versions and an average of an hour and 13 minute a day by producing electronic repeat prescriptions compared to paper ones.
Other time savings for prescribers include:
Practices save an average of 43 minutes per day by not having to locate paper prescriptions within the practice.
Practices save an average of 31 minutes every day by not having to re-print lost paper prescriptions.
Practice staff save an average of 39 minutes every day by not having to wait for GPs to sign urgent paper prescriptions.
Practices save an average of 27 minutes every day by cancelling prescriptions electronically versus paper.
The Pharmaceutical Services Negotiating Committee has published a case study on Bath and North East Somerset CCG medicines optimisation service.
To reduce excessive prescribing BANES CCG commissioned community pharmacy to actively review their patients medication and to look for opportunities to optimise their care. The community pharmacists identified items to either not dispense or optimise and then worked with the CCG employed practice support pharmacists to make the changes permanent on a patient’s record.
In the first eight weeks of the service (18th May 2017 – 12 July 2017) the five initial pilot pharmacies have identified £15,421 of annualised savings of which £9,396 have been actioned by the surgery, with £2,498 rejected and £3,528 awaiting resolution in the surgery. Currently 120 medicines optimisation opportunities have been identified by the community pharmacies with 69 being actioned by the CCG pharmacists.
The average annual saving per actioned suggestion is £136 (£9,396 / 69). The £30 professional fee is only paid to the community pharmacist once the change has been actioned by the surgery. The 69 approved changes resulted in £2,070 being paid in a professional fee, which represents a return on investment of 1 : 4.5 (£2,070 : £9,396). In year two, the CCG will continue to gain the benefits of these savings with no additional professional fee.
Objectives: Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care.
Conclusions: Successful implementation of information technology interventions for medicine optimisation will depend on a combination of the infrastructure within primary care, social structures embedded in the technology and the conventions, norms and dispositions of those utilising it. Future interventions, using electronic audit and feedback tools to improve medication safety, should consider the complexity of the social and organisational contexts and how internal and external structures can affect the use of the technology in order to support effective implementation.
The improved platform aims to make it easier to see uptake of pharmaceutical products and medical innovations within the NHS | NHS Efficiency
The scorecard reports on the use of medicines and medical technologies in the NHS in England, specifically those which have been positively appraised by the National Institute for Health and Care Excellence (NICE) since 2012.
The site now provides greater transparency and is easier to use.
Users can now:
compare commissioning organisations’ uptake of medicines
view information without having to download data
share results more easily and securely
look at overall levels of prescribing by medicine
The Innovation Scorecard is part of the government’s broader goal of supporting open data and transparency.
Prescribing by suitably-trained pharmacists and nurses offers similar outcomes to prescribing by doctors, at least in the management of chronic conditions.
This Cochrane review pooled clinical outcomes and patient satisfaction across 45 studies of nurse or pharmacist prescribing compared with doctor prescribing.
Most studies were of chronic disease management in primary care settings in high income countries (25 from the US and six from the UK).
Independent and supplementary prescribers in the NHS include not only the nurses and pharmacists, as covered in this review, but also other professions such as podiatrists, optometrists, and physiotherapists. At a time of high demand for NHS resources, with shortages of doctors in some specialties, prescribing by other professionals may help ease the workload, but safety, time and costs of training need to be considered.