MUR AND NMS RESPIRATORY TOOLKIT. Sian Retallick (C) Devon LPC 20/01/2017
WHAT IS IMPORTANT TO KNOW? • The Quality Payment Scheme is the new addition to the pharmacy contract • It is a voluntary self assessment covering a number of areas: Patient safety, Patient experience, Public Health, Digital, Clinical effectiveness, and Workforce • If pharmacy can achieve good results in the Quality Scheme it will benefit the sector in moving toward a service lead future • Asthma is an area where community pharmacy can a huge difference to good patient care • The Clinical effectiveness Quality Payment – ‘over use of asthma (reliever)treatments’ is likely to be worth circa £1,700 (C) Devon LPC 20/01/2017
WHY IS ASTHMA BEING TARGETED FOR MUR’S AND NMS ? 5.4 million people in the UK are currently receiving • treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12). Asthma prevalence is thought to have plateaued • since the late 1990s, although the UK still has some of the highest rates in Europe and on average 3 people a day die from asthma. In 2014 (the most recent data available) 1216 • people died from asthma. The NHS spends around 1 billion a year treating and • caring for people with asthma. Chronic obstructive pulmonary disease (COPD) is the • name for a collection of lung diseases, including chronic bronchitis, emphysema and chronic obstructive airways disease. It affects an estimated 3 million people in the UK. • (C) Devon LPC 20/01/2017
BENEFITS OF MUR’S / NMS • improve medicines adherence • increase patient engagement with their condition and medicines, which will support them in making decisions about their treatment and self management • reduce medicines wastage • reduce hospital admissions due to adverse events associated with medicines • increase reporting of medicine adverse reactions by pharmacists and patients • positive patient assessments • provide evidence base on the effectiveness of the service • enable the development of outcome and/or quality measures for community pharmacy • For MUR’s limited to 400 per year can generate £11200. • NMS is unlimited range £20 - £28 per intervention. (C) Devon LPC 20/01/2017
WHY FOCUS ON ASTHMA AND COPD FOR MUR’S AND NMS ? • To access Quality payments the contractor must be offering MUR’s or NMS or be registered for NHS Urgent Medicines Supply. • Over 90% of pharmacies provide Mur’s and NMS. • Results of a Independent academic evaluation (2014) gave a positive reinforcement for the service with improved patient outcomes and reduced cost for the NHS. (C) Devon LPC 20/01/2017
PART OF THE QUALITY PAYMENTS ! • Asthma patients dispensed more than 6 short acting bronchodilator inhalers without any corticosteroid inhaler within a 6-month period are referred to an appropriate health care professional for an asthma review. • There are two review points for this criterion: • · Friday 28th April 2017; and · Friday 24th November 2017. • At each review point, meeting this criterion is worth 10 points (£640), therefore a total of 20 points (£1,280) can be claimed in 2017 for achieving this criterion. (C) Devon LPC 20/01/2017
CHALLENGES FACING THE PHARMACY TEAM • How will we monitor "reliever " overuse is Asthmatic patients. • How will our referral pathway to GP's be made to ensure a clinical review is undertaken. • How will we keep to targets and deadlines. • How will this information be recorded in our Pharmacies. (C) Devon LPC 20/01/2017
PP PHARMACY ASTHMA REFERRALS
PSNC P RESOURCES
CPPE SUPPORT . • The Centre for Pharmacy Postgraduate Education (CPPE) has a distance learning course and e-assessment on asthma, as well as inhaler technique training e- learning and videos, which pharmacists or pharmacy technicians may find useful to complete before incorporating the QP criterion into their daily practice. (C) Devon LPC 20/01/2017
ASTHMA BTS GUIDELINES. While you would normally recommend the • NICE COPD guideline over the GOLD guideline, the NICE COPD guideline is out of date, having not been updated since 2010. NICE undertakes a more comprehensive review of • the evidence and prepares their guidance in the context of the English/Welsh NHS. NICE also involves GPs and nurses in developing their • guideline. The next review of the NICE guideline was scheduled • to start in May 2016 , so we cannot expect a revised version until late 2017 or early 2018. Clearly there have been many new treatment • options introduced since 2010, which are therefore not covered by NICE currently. (C) Devon LPC 20/01/2017
ASTHMA RESOURCES • BTS ( New British Guidelines for the management of asthma) • Devon Formulary ( Inhaler technique videos and checklists) • Asthma UK (Asthma Action Plans) • In-Check Inspiratory Flow Measurement Device • Inhaler technique training videos / CPPE Online • Teva Respiratory Resources (C) Devon LPC 20/01/2017
COPD RESOURCES. • Devon Formulary (Formulary choices, Inhaler technique videos and checklists, COPD self management plans and rescue packs • British Lung Foundation (COPD Passport) • Cat COPD Assessment Test • PCRS - (MRC Dyspnoea scale) • COPD /CPPE Online learning • COPD – new medicines /CPPE Online learning • Teva Respiratory Resources (C) Devon LPC 20/01/2017
SAFEGUARDING . • Safeguarding training is a staff training requirement for many locally commissioned services, such as emergency hormonal contraception. • The General Pharmaceutical Council has also stated that pharmacy professionals and the pharmacy team working in community pharmacies are well placed to identify people who may be vulnerable. • Level 2 safeguarding training may be available to pharmacy staff via local training sessions organised by Clinical Commissioning Groups, NHS England, local authorities or other providers, including in-house training. • Alternatively, the CPPE Safeguarding children and vulnerable adults e- learning and e-assessment meets the level 2 requirements. (C) Devon LPC 20/01/2017
ONE LAST THING ? • One of the Quality Payment criteria is: • ‘On the day of the review 80% of registered pharmacy professionals working at the pharmacy have achieved level 2 safeguarding status for children and vulnerable adults in the last two years.’ (C) Devon LPC 20/01/2017
GO FOR IT ! • Any Questions ! (C) Devon LPC 20/01/2017
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