Chemist and Druggist Award Finalist 2016
Chemist and Druggist Award Finalist 2016
May 26, 2016
Demonstrating a new model of care:
This ambitious, city wide programme of Community Pharmacists, working with GPs at scale across Sheffield is successfully demonstrating a new model of care. Community Pharmacists are making a huge impact on reducing GP workload, improving medicines optimisation and driving the patient-centred care agenda. Facilitated by Primary Care Sheffield and Sheffield Clinical Commissioning Group, funded by the Prime Ministers Challenge Fund and supported by Community Pharmacy Sheffield, this is the first example of large scale collaborative working between General Practice and Community Pharmacy.
Reduction in GP workload:
This programme which is the largest of it’s kind in the UK, has 57 pharmacists working within their local GP practice 1-2 sessions a week, with another 17 ready to get started, performing a variety of work including; domiciliary visits, reconciliation of hospital discharge and repeat medicines, education, medication reviews and solving ad-hoc medication queries. 7383 provisions of work have been recorded since the project began in October 2015, the majority being reconciling of hospital discharge medicines and medication reviews. In 87% of cases the pharmacists completed the work/resolved the issue without referring to a GP. Ninety-five percent of the work would have been dealt with by a GP in the pharmacists’ absence.
Improved joint working, communication and patient care:
Community pharmacists have worked with GP’s and their staff and now have a mutual understanding of each others capabilities, roles and workloads. This has resulted in greater understanding and co-operation between pharmacies and practices, more joint-working and improved communication, improving patient care within pharmacies and practices.
This partnership project deserves to win because it is successfully demonstrating a fantastic new model of care on a city wide scale, demonstrating the role of community pharmacists as primary care clinicians, and an integral part of the primary care team.
More timely resolution of patient problems:
With closer partnership working and improved communication between practices and pharmacies patient’s problems can be sorted in a more timely manner.
More efficient patient access to advice/treatment:
With practice staff having a better understanding of the role and skills of the community pharmacist more patients requesting urgent GP appointments are being signposted to their local pharmacies where they can be seen straight away and triaged/treated under the Minor Ailments Scheme, improving access to advice and treatment, at the same time reducing GP appointments.
Improved patient satisfaction and reduction in waste:
Performing medicines reconciliation of repeat prescriptions and dealing with patient requests, has helped reduce waste through reducing incorrect prescribing and improved patient satisfaction as the correct item is prescribed when requested.
Improved patient awareness of pharmacists’ skills:
“By performing medication reviews patients are more aware of your abilities and likely to call into the pharmacy and ask my opinion prior to booking an appointment with the Doctor…”. Community Pharmacist
Improved medicines optimisation in vulnerable patient groups:
Over 50% of pharmacist interactions have been with patients aged 65 and over. This population often have multiple co-morbidities and complex medication regimes. By performing hospital discharge medicines reconciliation and medication reviews the pharmacists are reducing the risk of prescribing errors and rationalising prescribing.
Housebound patients can be difficult for GPs to reach; pharmacists providing domiciliary visits are improving medicines optimisation and removing waste medicines.
With different clinicians working in partnership, learning from and complimenting each others skill set, this new model of care is driving the patient-centred care agenda.
“Pharmacists see medication issues from a different perspective and provide a more holistic view of patients” GP.
This more holistic/patient-centred approach to medicine use and review can improve patient understanding and improve compliance with their medicines.
Improved resolution of prescription issues:
“The closer working relationship with the surgery allows us to sort out minor problems such as repeats with the incorrect quantity or spurious dosages as we can tackle these problems directly which makes things easier for the Pharmacy staff.” Community Pharmacist
“Pharmacy understands who does what in the Surgery & who best to talk to about different issues”. Community Pharmacist
Improved patient perception and use of the pharmacy:
“…The patients see you as being more of a resource from the point of view of health information, medication usage and your ability to triage patients effectively. They also tend once you have built a rapport to come to you first if they need a prescription sorting out…”. Community Pharmacist
Increased practice staff awareness of the skills of the pharmacist and the services community pharmacies offer has led to increased signposting/referral of patients from practices to pharmacies.
Seamless patient care:
“It is critical for pharmacists and GPs to work closely together if patients are going to get optimal outcomes from their medicines. This initiative is a good example of that and will help develop a genuine multidisciplinary and seamless approach to patient care which plays to the strengths of GPs and community pharmacists alike”. Dr Keith Ridge, Chief Pharmaceutical Officer, NHS England.
Community pharmacists are not only improving patient care by working with GPs within the practices, freeing GP time and dealing with vulnerable patients, those pharmacists with access to the GP system within their community pharmacy can continue to work with GPs
providing medication reviews and dealing with patient queries directly from their pharmacy. The project is enabling the partnership working to extend beyond the funded practice sessions and become part of the community pharmacists fulltime practice, a seamless approach to patient care.
Pharmacists learning new skills:
The project has enabled pharmacists to undergo training in the use of GP IT systems and to update their clinical knowledge:
“Being part of the Project encourages you to look at the latest local and national guidelines as you start to look at things from the prescribing perspective and have more information concerning the diagnosis and physical health of the patient…” Community Pharmacist
Enhanced role of the Community Pharmacist:
The project has empowered community pharmacists to use their clinical skills e.g. to perform medication reviews with access to patient notes and test results. It has also given them an opportunity to enhance their communication and collaborative working skills.
Utilisation of Pharmacist knowledge:
As the practice staff have become familiar with their pharmacists they have become a vital source of information to solve medication, prescribing and stock related queries.
Each pharmacist has been flexible to the needs of their practice, performing tasks that the practice feels are a priority and then building on this list of tasks as the pharmacists become an integral part of the practice team.
Pharmacist motivation with expanded job role:
“It allows you to sort out minor problems that occur, and allow you to take a fuller role in looking after the health of the GP’s patients and your customers. This gives greater variety and therefore job satisfaction”. Community Pharmacist
More motivated pharmacists with increased job satisfaction has led to more motivated community pharmacy teams and improved patient experience.
GPs sharing their workload:
“The project has led to GPs waking up to how they can share their workload with Pharmacists and they want the initiative to continue” GP.
GPs are more aware of the skills and capabilities of community pharmacists and are seeing the benefits of this new collaborative model of care.
Pharmacists becoming an integral part of the primary care team:
Pharmacists are becoming more of a resource to other healthcare professionals:
“Because you are spending regular time at the Surgery, staff and other Health Professionals are used to you being around but also have a greater understanding of your abilities…Nurses might ask your advice or wish to discuss an item of medication. GP’s might ask your opinion for alternatives for medication discontinued or out of stock.” Community Pharmacist
GP Practices asking for access to their IT system within the Community Pharmacy:
Enthusiasm from pharmacists and GPs has been huge and the project is being expanded in a number of practices across the city to allow community pharmacist access to the GP computer system from within the community pharmacy so that the Pharmacist can continue to benefit from having access to full patient records to deal with queries or perform medication reviews when working within their community pharmacy.
The pharmacists can also send direct instant messages to GPs on the system and make notes on the patients record which can free up both pharmacist and GP time in making unnecessary telephone calls, as well as improve patient care.
“Because of the access I have to the Surgery Patient records I can annotate the records according to my interaction with the Patient and this can give the Doctor vital information sometimes prior to an appointment. This is especially useful if we wish to highlight concerns over possible signs of Alzheimer’s or inappropriate medication use which generally means the patient gets the correct treatment earlier.” Community Pharmacist.