Where does health care policy come from?
- Government
- NHS England
- Professional organisations – GPhC, GMC etc
- Any healthcare organisation
What is the definition of a policy?
‘A course or principal of action adopted or proposed by an organisation or individual’
What is a white paper?
An official government report which sets out the government’s policy on a matter that is or will come before Parliament
What are the 2 main types of white paper?
–> Equity and Excellence: Liberating the NHS (July 2010) - health white paper
–> Healthy Lives, Healthy People (November 2010) - strategy for public health in England
What 5 key priorities is the Equity and excellence white paper focused on?
- Put patients and the public first
- Improve healthcare outcomes
- A more autonomous and accountable system
- Improved public health
- Reforming long-term social care
What benefits do the white papers have on the NHS?
- Greater freedom to the NHS
- Devolve power for commissioning services (CCGs)
- Efficiency savings to be reinvested
- Reduction in management costs
What is the Health and Social Care Bill?
- Introduced to parliament in jan 2011 and now an ACT of parliament
- Primary care trusts ceased April 2013
How do the changed affect pharmacists?
- Working with doctors and other HPs
- Integration into Health and Wellbeing Boards and Local Professional Networks
- Important and expanding role in optimising the use of medicines & supporting better health
INTEGRATION!!!
What is the community pharmacy contract?
• Based on payment by performance
• Give high quality and efficient services
• Increase effectiveness and efficiency in use of medicines
–> through better informed and more involved patients
What is the NHS five year forward view?
- Published by NHS England Oct 2014
* Developed by partner organisations in consultation with patient groups, clinicians and experts
What is included in the NHS five year forward?
Sets out the vision for the NHS and includes
o Need for change
o Prevention – action on smoking, obesity, alcohol
o New models of care
o Integration
o MCPS (multispecialty community providers)
What are the ‘next steps’?
• Published by NHS England March 2017
• Identified key improvements including:
o Increasing no. of clinical pharmacists working in GP practices
o Encourage GP practices to work together as hubs to share community nursing and clinical pharmacy teams and share responsibility
o Work more closely with community pharmacists to make full use of skills
o Get best value out of medicines and pharmacy
What is the NHS long term plan?
• Published by NHS England Jan 2019
•Objectives:
•Making sure everyone gets the best start in life
•Delivering world-care for major health problems –
heart attacks, stroke etc
•Supporting people to age well
What improvements does the NHS long term plan have on the NHS?
- Doing things differently e.g. new structures PCNs and ICSs
- Preventing illness and tackling inequalities
- Backing the workforce e.g. numbers, training, retention
- ->Enough staff - Making better use of data and digital technology
- Getting the most out of taxpayers’ investment in the NHS
What is the NHS mandate?
What we want the NHS to achieve.
What does the mandate do?
- The mandate to NHS England sets the Government’s objectives and any requirements for NHS England.
- The mandate sets the direction for the NHS and helps ensure the NHS is accountable to Parliament and the public.
- Every year, the Secretary of State must publish a mandate to ensure that NHS England’s objectives remain up to date
What objectives is NHS England legally required to seek to achieve?
- Through better commissioning, improve local and national health outcomes, and reduce health inequalities
- To help create the safest, highest quality health and care service.
- To balance the NHS budget and improve efficiency and productivity
- To lead a step change in the NHS in preventing ill health and supporting people to live healthier lives
a. E.g. childhood obesity - To maintain and improve performance against core standards.
- To improve out-of-hospital care
- To support research, innovation and growth and to support the Government’s implementation of EU Exit in regard to health and care
What is ‘Now or never’?
A report commissioned by the RPS on future models of care delivered through pharmacy (Nov 2013)
What are the key findings of the now or never report?
• Need to secure the future of community pharmacy
o Robot dispensers creating worry
• NHS needs to adapt to needs of patients with LTCs and preventable illness- what role can pharmacists play?
• Some development of services throughout the country but progress slow and delivery patchy
• Underutilisation of pharmacists – potential oversupply 11,000-19,000 by 2040
• Advantages of location and opening hours therefore can play major role in out of hours primary and urgent care
• Pharmacy is marginalised
• Lack of public awareness of pharmacy
• Urgent need for outward-looking local and national leadership to work with commissioners & shift service provision from supply to provision of patient care
What are NHS England’s aims for community pharmacy?
• Aims for community pharmacy:
o develop the role of the pharmacy team to provide personalised care
o play an even stronger role at the heart of more integrated out-of-hospital services.
o provide a greater role in healthy living advice, improving health and reducing health inequalities
o deliver excellent patient experience which helps people to get the most from their medicines.
What is the Murray review?
A review of community pharmacy clinical services.
• Undertaken by Richard Murray, Director of Policy, Kings Fund.
• Commissioned by the Chief pharmaceutical Officer and published in Dec 16
• Recommendations
o Make more use of e-repeat prescribing
o MURs evolve into full clinical medication reviews
o Minor ailments scheme locally commissioned
o Greater role in care homes
o New ways of working in which groups of pharmacists can provide clinical services
What is the future of pharmacists?
- PSNC: how community pharmacy will fit into the NHS of the future
- Clinical pharmacists working in teams in primary care-integrating NHS pharmacy and medicines optimisation into STPs and ICS
- Greater involvement in care homes- clinical pharmacist prescribers, pharmacy tech support
- Workforce and education- postgraduate certificates, prescribing qualification, care home training and leadership training
