South Yorkshire LPCs’ joint Respiratory Service
South Yorkshire LPCs’ joint Respiratory Service
The PSNC Evidence Awards, which were supported by the Health Education Foundation, were held during the 2013 LPC Conference to further enhance the evidence base for locally commissioned services. From the many submissions, nine entries were shortlisted based on the evidence submitted, and LPC Conference delegates voted for the five winners from the shortlist.
One of the winners was the South Yorkshire LPCs who won an award for their Respiratory Service, which was commissioned across the five South Yorkshire LPCs. Nick Hunter, Secretary of Doncaster and Rotherham LPCs, was interviewed after the awards to find out more about the Respiratory Service.
When money became available for community pharmacy across ﬁve LPC areas, South Yorkshire’s LPCs decided that the most effective way of utilising this money would be to work together to bid for one service which would span the entire region. “[South Yorkshire] already had a forum [where we] share ideas and ways of doing things… so we utilised that to take the idea forward,” Nick Hunter, Secretary of Doncaster and Rotherham LPCs, explains; but this project took these links a step further.
These strong ties across South Yorkshire helped the LPCs to get the money for their Respiratory Service in June 2012, but they were put on a tight schedule as the South Yorkshire Strategic Health Authority wanted an evaluation completed by the end of the following March.
So Nick and Matt Auckland (then Head of Medicines Management at Barnsley PCT) looked to other areas for help, in the end being guided by a similar scheme that had run on the Isle of Wight. Of course the unique geography of the island was a cause for concern, but in the end South Yorkshire has proved that the success could be replicated in other areas of the country. Carried out in conjunction with an MUR or NMS consultation, the Respiratory Service, which saw pharmacies giving advice on inhaler technique, was shown to have helped 98% of asthma patients using inhalers improve their Inspiration Rate Change in just one session (see The Respiratory Service in ﬁgures box).
The Respiratory Service in figures
1,616 consultations took place between September 2012 and March 2013
83% of respiratory service consultations took place as part of an MUR
Nearly 80% of service users were aged 45 or over
11% of people with inhalers were unsure of their diagnosis
98% of asthma patients using inhalers showed improvement in their Inspiration Rate Change after their consultation
More than 1,000 patients met their target Inspiration Rate during one consultation
Over half of patients used reliever inhalers at least once a day
Almost 80% of patients were given at least one intervention by the pharmacist
The biggest challenge the LPCs came up against was the re-organisation of the NHS, because just at the time they were trying to get the service up and running and needed the PCTs to back it to ensure other health professionals were conﬁdent in it and could refer to it, the PCTs were winding down their activities. But relying on the strong links the LPCs already had with PCT contacts and through other local health networks, they were able to manage this.
One of the key aims for the Respiratory Service was to improve patients’ management of their own condition to help reduce avoidable hospital admissions. However, whilst teaching patients effective inhaler technique and symptom control can go a long way towards achieving this aim, proving the link to hospital admission reduction can be a difficult process, and some are still yet to be convinced about it.
This need for clear evidence that health services are effective is particularly important at the moment as savings need to be made. Fortunately, South Yorkshire’s LPCs did manage to produce a very effective evidence case for their Respiratory Service, meaning that they not only won a PSNC Evidence Award but were also asked to present their work at the leading UK conference for pharmacy practice researchers called “Health Services Research in Pharmacy Practice” (HSRPP).
They also won over at least some of the doctors, as both Nick and Doncaster CCG are keen to continue the Respiratory Service. Again it comes down to money though, as the CCG must ﬁnd a budget for it.
If you would like to help get the ball rolling for this or any other services in your area, your LPC’s contact details can be found via the LPC Portal at: lpc-online.org.uk
Nick Hunter on…
… the decision to base service payments on data collection
“It’s human nature… if you’ve got no incentive to do something, then you get on with the things where you have got an incentive to do them… [so] the fees were a ‘no data, no payment’ system.”
… the benefits of data collection
“[The data] has been vital to bring to discussions with new commissioners… there is a much bigger pot now available to [the Respiratory Service]. Had we not got that report, then we wouldn’t have got the commissioners’ interest in re-commissioning the service.”
… the future of pharmacy services
“See if you can take what we’ve done [in South Yorkshire] and make it ﬁt in with other areas.”