Welcome and introductions London Region NUMSAS workshop 9 th March - - PowerPoint PPT Presentation

NHS Urgent Medicines Supply Advanced Service (NUMSAS) Pilot Implementation Workshop Welcome and introductions

London Region NUMSAS workshop 9th March 2017 Liz Wize Director of Primary Care Commissioning – NHS England (London Region) & Programme Director - Transforming Primary Care, Healthy London Partnership Healthy London Partnership – “Transforming London’s health and care together”

Primary Care Update – Commissioning Activities

3 Scope of Service Financial Information

• Commission and co-commission Primary Medical

Services (1365), Optometry (c.2000) and Dental (c.1400) contracts throughout London

• Manage market entry of Pharmacy (c.1900) activity
• Support definition of and implementation of new contracts
• Define operational processes to work effectively with

CCGs in Joint and Delegated Co-Commissioning arrangements

• Support co-commissioning arrangements
• Budget value; £1.17bn GP / £0.6m primary DOP /

£0.17m secondary dental

• In year; On plan
• Expected out-turn; £25m reduction in Pharmacy budget

– dependent on national re-negotiation of contract Achievements to Date Next Steps

• Implementation of co-commissioning and delegated

commissioning arrangements: of 32 London CCGs - 20 level 2 CCGs 11 level 3 CCGs

• Restructuring to one single team for London from the

Commissioning Function and the Contract Team

• Support CCGs to take on further delegated Primary

Care responsibilities

• Final implementation of PMS review – contracts to be

implemented in 2017

• Organisation Design Review of Primary Care

Commissioning staffing to support move to place-based commissioning

• Implementation of General Practice Forward View and
• f the Strategic Commissioning Framework for

London

• Implementation of National Pharmacy Contract changes

Primary Care Delivery in London is a large scale challenge

GP commissioning delegation is currently at various levels across London

Bromley Croydon Barking and Dagenham Barnet Bexley Brent Camden Ealing Enfield Greenwich H&F Haringey Harrow Havering Hounslow Islington West London Lambeth Lewisham Newham Redbridge Richmond Waltham Forest Wandsworth Central London Southwark Hillingdon Kingston Merton Sutton Sutton Croydon Tower Hamlets City & Hackney

Already fully delegated (11 CCGs)

Croydon

Level 2 delegation (20 CCGs) Level 1 delegation (1 CCG) 4

But is expected to be fully delegated in 17/18

Bromley Croydon Barking and Dagenham Barnet Bexley Brent Camden Ealing Enfield Greenwich H&F Haringey Harrow Havering Hounslow Islington West London Lambeth Lewisham Newham Redbridge Richmond Waltham Forest Wandsworth Central London Southwark Hillingdon Kingston Merton Sutton Sutton Croydon Tower Hamlets City & Hackney

Already delegated (11 CCGs)

Croydon

Expected to be delegated from April 2017 (21 CCGs)

We expect all CCGs to be at delegated by Apr 17 (pending membership Votes)

It is important to note that NWL, C&H and Camden do not expect to have completed membership voting/ sign off until February 2017 5

The practice environment is changing, with practices closing and merging

6

0.5 1 1.5 2 2.5 3 3.5 4 4.5 North Central London North East London South West London South East London

Practice closure

Practice closure

Between April 2015 – March 2016 11 practice closed across London Between April 2015 – March 2016 22 practice merged across London

2 4 6 8 10 12 North Central London North East London North West London South West London

Practice merges

Practice merges

By the end of 2017/18, we will have extended access throughout London

2016/17 Over 6m (65%*) of London will have access as per the London definition of extended access by the end of 2016/17

* Current plans received in December outline that this is tracking for greater than 65% - and further assurance of plans is underway to confirm

Other areas of London (35%) would be providing partial delivery/ setup etc. 2017/18

9.2m (97%) of London will have access as per the

London definition of extended access by the end of 2017/18 3% of London would be providing partial delivery (City and Hackney are currently scoping opportunity to deliver some extended access via the hub model in 17/18, ahead of becoming a GPAF scheme in 18/19)

We have now had plans in from 31/32 areas of London, outlining their plans for this delivery:

7

And increasing the workforce is a key aim of the GPFV

8

The GPFV outlines ambitions for more resource and investment

5,000 GPs 5,000 extra by 2020 National Resource Increase Additional Funding Clinical Pharmacy Funding

£143m

Nurse development

£15m

Reception & clerical staff training

£45m

Practice Manager Development

£6m

Pharmacy integration

£100m*

5,000 other roles, including 3,000 extra MH therapists 1,500 more clinical pharmacists

• Further work to deliver the 10 point action plan
• Major national and international recruitment campaigns
• Bursaries for the areas which have struggled the most to

attract into GP training

• Induction and refresher courses for those looking to return

to work

• Support for flexible working
• Support for practices to be more resilient
• Review of best ways of working to manage outpatient

demand

• Reduction in CQC inspections for the best rated practices
• Programme to release time for patients through
• Better automation of tasks where possible

Workforce improvement activities Workload Improvement activites 9

• What are your biggest workforce concerns?
• As employers what would you like to input into the

National workforce debate ? Key discussion questions Supporting Activities

PHARMACY IN PRIMARY CARE

Pharmacists in General Practice

10

NHS England London Region is now taking forward the Pharmacist in GP Practice work Programme.

• Part of the GP Five Year Forward View.
• The Application are made through GP Practices and Federations.
• In February 2017 more applications were received from GP practices and GP

federations for pharmacists to work clinically in GP practices.

• The application process will be on a rolling basis throughout 2017.
• London has to achieve recruitment of 84 pharmacists/year over the next 3 years.

It will be important to establish links between Community pharmacy and GP based pharmacists particularly around medicines optimisation, supporting referrals into MURs and NMS, and discharge planning. More joint working supports and reinforces the role of the pharmacy profession in Primary Care.

PHARMACY IN PRIMARY CARE

Community Pharmacy reforms

11

The following contractual changes came into effect from 1st December 2016:- The reforms are a mixture of contractual efficiencies , changes to pharmacy regulations and new innovations. Some of innovations include the

• Introduction of a Pharmacy Access Scheme.
• Introduction of a Quality Payments Scheme.
• A new national Pharmaceutical advanced Service for Urgent Repeat

Medicines supply

• Introduction of a Pharmacy Integration fund.

Pharmacy in primary care

Integrating pharmacy into urgent care

12

NHS England is working to embed pharmacy into the urgent care pathway by expanding the services already provided by community pharmacies in England. This will include:-

• treatment for urgent minor ailments and common conditions.
• who need urgent repeat prescriptions - NUMSAS is a very good example of this.

London currently has a Pharmacy Urgent repeat medication service, set up in December 2014., which is being transitioned to NUMSAS There is a review taking place on how London can consistently commission community pharmacies to provide extended hours over the Public holiday period.

www.england.nhs.uk

NHS Urgent Medicine Supply Advanced Service Pilot

Overview of service

www.england.nhs.uk

Urgent Care

• Pressures will be familiar to all
• Five Year Forward View:
• “need to redesign urgent and emergency care services

in England for people of all ages with physical and mental health problems”

• Urgent and Emergency Care Review:
• “a fundamental shift in the way urgent and emergency

care services are provided to all ages, improving out-of- hospital services so that we deliver more care closer to home and reduce hospital attendances and admissions”

www.england.nhs.uk

Urgent and Emergency Care Review

• The vision of the review is simple:
• For adults and children with urgent care needs, we

should provide a highly responsive service that delivers care as close to home as possible, minimising disruption and inconvenience for patients, carers and families.

• For those people with more serious or life-

threatening emergency care needs, we should ensure they are treated in centres with the right expertise, processes and facilities to maximise the prospects of survival and a good recovery.

www.england.nhs.uk

Urgent and Emergency Care Review

• The review proposes that five key changes need to take place in order for

this to be achieved. These are:

• Providing better support for people and their families to self-care or care

for their dependents.

• Helping people who need urgent care to get the right advice in the right

place, first time.

• Providing responsive, urgent physical and mental health services
• utside of hospital every day of the week, so people no longer choose

to queue in hospital emergency departments.

• Ensuring that adults and children with more serious or life threatening

emergency needs receive treatment in centres with the right facilities, processes and expertise in order to maximise their chances of survival and a good recovery.

• Connecting all urgent and emergency care services together so the
• verall physical and mental health and social care system becomes

more than just the sum of its parts.

www.england.nhs.uk

Urgent and Emergency Care Review

• Key themes:
• Balance capacity and demand
• Keep flow going
• Reduce variation
• Manage interfaces and handovers
• Reducing acute hospital admissions
• Supporting people to manage long-term conditions
• Managing seasonal pressures
• Balancing elective and emergency care

www.england.nhs.uk

Urgent and Emergency Care Review

• “Commissioners and providers should minimise the

number of ‘hand-offs’ between different people to avoid unnecessary re-work"

• “Community pharmacies can make valuable

contributions to local health communities’ urgent care

• programmes. They can enhance patient safety and

reduce pressure on other parts of the local health community, particularly general practice, thus creating headroom for the management of patients with more serious problems”

www.england.nhs.uk

• https://www.youtube.com/watch?v=FIZZu4R6yEU&fe

ature=youtu.be

www.england.nhs.uk

1 What does the service do? 2 Why is the service needed? 3 Why commission community pharmacy? 4 Evidence for the service 5 Why a pilot? 6 Key requirements 7 NHSmail 8 Registration for service 9 NHS 111 10 Pharmacy Steps 11 Payment Structure 12 Some Key Points

NUMSAS

20

www.england.nhs.uk

• The Service will allow community pharmacies to

supply a repeat medicine at NHS expense, following a referral from NHS111 and where the pharmacist identifies that the patient has an immediate need for the medicine and that it is impractical to obtain a prescription without undue delay.

21

What does the service do?

www.england.nhs.uk

• In an emergency, a pharmacist can supply prescription
• nly medicines (POM) to a patient (who has previously

been prescribed the requested POM) without a prescription at the request of the patient under the provisions and requirements of Regulations 225, 253 and Schedules 18 and 23 of the Human Medicines Regulations 2012 (HMR). The pilot is using these existing regulations to enable the supply to be made as an NHS transaction.

• These regulations are set out in Annex A of the service

specification.

• The Royal Pharmaceutical Society has published guidance
• n making supplies under these regulations.

22

Legal basis

www.england.nhs.uk

• Requests for medicines needed urgently account for about

2% of all completed NHS 111 calls – rising to 30% at peak times in some areas.

• These calls normally default to GP out of hours to arrange

an urgent prescription and as a result can block access to GP appointments for patients with greater clinical need.

• Saturdays generate the highest demand for emergency

medicines, followed by Sundays and Public Holidays.

• There is also demand at other times, in particular in

evenings.

23

Why is the service needed?

www.england.nhs.uk

Why is the service needed?

• Over the period there were on average 408 referrals per

week, of which 144 (25%) went to a PURM pharmacy

• Provides support to 111/IUC at peak periods (GP OOH capacity) – 88%
• f London 111 urgent repeat prescription activity occurs out of hours
• Provides support to the wider UEC system (ED capacity) – patients may

present as an emergency if they don’t get timely support

• Improves the patient experience (cost, timeliness and convenience)

www.england.nhs.uk

• Community pharmacy is ideally placed to receive referrals

from NHS111, for patients who have a need for a repeat medicine out of hours.

• A pharmacist can, in many such situations, legally provide

emergency supplies of prescription only medicines at the request of the patient without a prescription.

• Community pharmacies are often open at weekends and in

the evenings, when calls to NHS111 are at their peak.

• Community pharmacists are experts in medicines and can

assist patients with their immediate needs and provide advice and support to help patients to avoid future issues with repeat medicines.

25

Why commission community pharmacies to provide the service?

www.england.nhs.uk

What is the evidence for the service?

• Prior learning:
• Long history of community pharmacy supporting

patients, e.g. via emergency supply legislation

• Experiences with pharmacists in NHS Direct
• Experiences of pharmacists deployed within GP

Out of Hours Services

• NHS 111 Learning and Development pilots

examining role of pharmacists within the service

www.england.nhs.uk

• NHS England published guidance to commissioners on the

benefits of setting up such services in 2014, and this was updated in 2015.

• A number of local areas have been commissioning a

similar service since 2014.

• These found that 80 % of all callers can be supplied with

urgent medication directly by the pharmacist with only about 2 % requiring a prescription from a GP.

• The rest of the referrals resulted in patients being

signposted back to their own GP to obtain a routine prescription because the pharmacist considered this clinically appropriate.

• 27

What is the evidence for the service?

www.england.nhs.uk

• This service is not like other community pharmacy

advanced services in that it requires a number of key stakeholders to collaborate to enable it.

• Therefore although it is being commissioned as a

national service it requires local implementation and management.

• A key element of the pilot is to evaluate it to inform

key elements that need to be developed to ensure integration of pharmacy into the wider NHS to support existing urgent care and general practice.

28

Why is it a pilot?

www.england.nhs.uk

• Consultation room – not all consultations need to be held in it,

but it must be available for when it is appropriate to do so.

• A Standard Operating Procedure for the service.
• EPS enabled.
• Have a premises specific shared NHSmail box and linked

personal NHSmail addresses.

• Successfully registered on NHSBSA website to provide the

service.

• Read the service specification (https://www.england.nhs.uk/wp-

content/uploads/2016/11/numsas-service-specification.pdf).

• As with all advanced services, must be satisfactorily providing

essential services and have an acceptable system of clinical governance in place.

29

Key requirements for the service

www.england.nhs.uk

• A premises specific shared NHSmail address is one which

is:

• Specific to that pharmacy premises
• Is accessed through an individual’s nhs.net address
• From December 2016 has the following naming

structure: nhspharmacy.Town/Village/Area.tradingnameofpharma cyODScode@nhs.net

• Shared NHSmail accounts issued prior to December

2016 will be transition to new naming convention by end of 2017

• Personal NHSmail addresses MUST not be used for the

service.

30

NHSmail

www.england.nhs.uk NHS England Engagement

• National NHS England team to send through to local teams details of pharmacies requesting new NHSmail

accounts up to and including 1st February 2017.

• Local NHS England team to send targeted communications to Pharmacies requesting new NHSmail, up to and

including 1st February, asking if they want to be NUMSAS enabled.

• If yes, local NHS England to send the Pharmacy a local area URL to Citizen Space for the Pharmacy to complete

their online registration. The registration includes the Pharmacy identifying their shared mailbox owner, providing a smartcard number for the shared mailbox owner, current email address and current mobile phone number, BSA communication CPCF email, along with details for the other individuals who require a personal NHSmail account.

NHS Digital Engagement (IPACS Programme)

• NHS Digital (IPACS) to collate registration information and validate to populate the manual processing dataset.
• NHS Digital (IPACS) to send complete dataset to the NHSmail Programme on a daily basis.

NHS Digital Email Processing (NHSmail and Accenture)

• NHSmail to send Pharmacy dataset onto Accenture for processing.
• Accenture to process the Pharmacy requests.
• Accenture to confirm to the authenticated email address for the Pharmacy mailbox owner, their login credentials for

their NHSmail account.

• Once the Pharmacy user (Shared mailbox owner) has activated their account, Accenture to confirm login credentials

for up to the other 3 individuals account details.

• NHSmail to provide a regular report on the allocation of emial for each local area to be shared with NHS England

Manual process for Pharmacy NHSmail accounts: March 2017.

V0.2 28/02/17

A centralised solution will be in place to replace the manual process April 2017

www.england.nhs.uk

• Register at www.nhsbsa.nhs.uk/UMS
• Uses the same tool as that used for Seasonal Flu Vaccination

Service and CPCF Assurance

• Requires NHSmail address – PERSONAL NHSmail address must

not be used

• Automatically generates a confirmation email within 2 hours – if not

received, contact NHSBSA (after checking junk box!)

• Number of bouncebacks to these due to errors in the NHSmail

address that has been entered.

• NHSBSA staff will telephone the pharmacy to explain the claims

process.

• Information from the website is then sent to NHS 111 Directory of

Services leads to add the pharmacy details to the DoS as a provider of NUMSAS, so important that the information - especially email – is correct.

• Information is also sent to NHS England local teams.

32

Registration on NHSBSA website

www.england.nhs.uk

NHS 111 Receives call from patient Explain and confirm NUMSAS is an NHS service, is free of charge and the usual prescription charges apply, up to 30 days supply or equivalent can be made, requires patient to provide evidence of ongoing treatment. GP will be informed of supply and information will be shared with NHS organisations in line with the usual prescription process. Patient should call the pharmacy within 30 minutes to discuss requirements. Action Provide patient with pharmacy telephone number and email referral to pharmacy. Patient to call pharmacy within 30 minutes

33

What happens at NHS 111

www.england.nhs.uk

Pharmacy Step 1 Patient calls pharmacy

Action Check nhs.net email for referral details from NHS 111 Identify Confirm patient identity using information provide by NHS

• 111. If no information received from NHS 111, contact local

NHS 111 service to confirm referral has been made and take details by telephone. Explain and confirm NUMSAS is an NHS service, is free of charge and that usual prescription charges apply, local CCG GP out of hours prescribing guidelines apply (NOTE: any local restrictions for certain medicines, e.g. benzodiazepines, pregabalin and duration of supply), requires patient to provide evidence. GP will be informed of supply . Check Identify medicine or item required Emergency supply criteria are met (see service specification) Patient/carer can attend pharmacy Medication/items are available in the pharmacy

34

Pharmacy Step 1 (a)

www.england.nhs.uk

Action Action if supply can be made Ask patient or representative to attend the pharmacy to obtain supply Action if supply cannot be made Provide advice and/or refer to GP out of hours using access telephone number to organise an assessment and/or prescription. If medicine/item is out of stock, telephone another NUMSAS pharmacy in their locality and if appropriate make a referral. Send email with NHS 111 referral data to the pharmacy receiving the referral. Action if patient does NOT make contact with pharmacy Make 3 attempts to contact patient using referral details. After 3rd attempt close referral and leave a message to the same effect for the patient

35

Pharmacy Step 1 (b)

www.england.nhs.uk

Pharmacy Step 2 Patient or representative attends pharmacy Identify Confirm patients identity Explain and confirm Review information provided so far Confirm if Emergency Supply is appropriate Check Evidence of previous supply (if provided) – may include access to patient’s PMR and SCR Emergency supply criteria are met (see service specification) If an electronic RX is already in system via EPS Tracker Action (if supply can be made) Make supply and/or provide advice Advise patient about repeat dispensing services from a local pharmacy Collect prescription charge (if applicable) Ask patient/representative to sign declaration on EPS token Ask patient/representative to complete survey for feedback Action (if supply cannot be made) Provide advice and/or refer patient to GP out of hours using access telephone number to organise an assessment and/or a prescription

36

Pharmacy Step 2

www.england.nhs.uk

Pharmacy Step 3 Administration Record and submit for payment Complete and send GP notification Record supply details including reason codes for non-supply on EPS token and complete details for payment Submit to NHSBSA along with the NUMSAS claim form Participate in Evaluation Will be contacted to complete and submit some additional information during the pilot.

37

Pharmacy Step 3

www.england.nhs.uk

• Pharmacy will be able to claim payment for ANY

referral received from NHS 111 whether or not there is a supply as long as FP10 DT dispensing token filled in with all information.

• This payment will be £10 consultation fee and £2.50

administration fee

• A supply fee of £1.50 for initial item
• An additional supply fee of £0.50 per item for

subsequent items supplied to the same patient

• Cost of medicines in normal way

38

Payment structure

www.england.nhs.uk

• If pharmacy A refers to pharmacy B (e.g. as out of

stock) BOTH will be able to claim consultation and administration fees (but only the pharmacy making the supply will be able to claim the other fees)

• Where a pharmacy receives a referral but can meet

the patient’s need by using an EPS prescription downloaded via the EPS Tracker, they will still be able to claim the consultation and administration fees

• Where the pharmacy cannot contact the patient after

three attempts they will still be able to claim the consultation and administration fees

39

Payment structure

www.england.nhs.uk

• The service is being added as an additional option in

the existing NHS 111 pathway.

• Pharmacies must not advertise the service to the

public.

• Pharmacies should continue to manage requests for

urgent supplies from patients as they currently do.

• Calls for urgent medication to NHS 111 will be
• monitored. In areas which have commissioned similar

services locally there has not been an increase in calls.

40

Only for NHS 111 referral

www.england.nhs.uk

• Expectation is that the pharmacy manages all referrals.
• Where a supply cannot be made because of legal reasons

– e.g. a CD – the pharmacy must contact the GPOOH (will have the private health professional phone number) and discuss next steps and if appropriate send on the referral.

• Note that the NHS 111 call handler is not a clinician and is

not able to identify if a patient is requesting a CD.

• No patient should be referred back to NHS 111.
• Part of the evaluation will be to identify how successfully

pharmacies can manage all referrals.

41

Pharmacy to manage all referrals

www.england.nhs.uk

• NUMSAS is being commissioned as a fully integrated

service and therefore requires a number of key elements to be in place before it can go live.

• To support efficient roll-out for the referral from NHS 111 to

community pharmacy a phased introduction will take place from December 2016 to March 2017 with the pilot running until March 2018.

• London Region was chosen as a Phase 4 site.
• Five NHS 111/Integrated Urgent Care providers cover the

whole of London, supported by three DOS teams.

42

Phased Implementation

www.england.nhs.uk

• Directory of Services (DoS) profiles and testing
• Message to GP after the episode of care
• Access / contact details for:
• NHS 111
• GP Out of Hours service.
• Other local NUMSAS pharmacies
• Go live decision

43

Local details

www.england.nhs.uk

• Decision to use Pharmacy system e.g. London

Anenta

• In place in some pharmacies
• Already in use and familiar
• GP practices receiving messages (e.g. flu)
• Modules being developed that will streamline the

process for pharmacies

44

Message to GP

www.england.nhs.uk

• Suggested content:
• Patient name, date of birth, NHS number, address and postcode
• Pharmacy name, address and telephone number
• Name and GPhC number of pharmacist
• GP practice name and address
• Date and time of episode
• Outcome of assessment
• Whether EPS Tracker and/or Summary Care Record accessed
• Details of each item supplied (drug/appliance name, form,

strength, dose, quantity)

• Free text space for comments
• Pre-populated statements describing core aspects of the service

and intervention

• A template is to be developed that will enable this

45

Message to GP

www.england.nhs.uk 46

Discussion and Q&A

www.england.nhs.uk

• Continue communication and work together
• Pharmacies:
• Sign up for NHSmail
• Register to provide the service
• In sufficient numbers to make it viable
• Commissioners:
• Complete preparations (e.g. Anenta )
• DoS profiling and testing
• Inform local GPs and GPOOHs
• Determine when local coverage is sufficient to go live
• Agree local reporting/monitoring

47

Next steps

NHS Urgent Medicines Supply Advanced Service (NUMSAS) Pilot Implementation Workshop Refreshments

PURM to NUMSAS

Key differences & similarities Local transition plan 09.03.2017

www.england.nhs.uk

Background and Rationale for the PURM Service

50

The NHS has a requirement to achieve savings while improving the care provided to patients.

• PURM fulfils this by facilitating appropriate access to urgent repeat medication

OOH through NHS 111, enabling access promptly to urgent supply of prescription medicines

• If not in place, the patient may have to pay the full cost of their medication

through a conventional community pharmacy route, thereby forcing patient’s to access OOH, A&E or Walk in centres increasing demand on these services

• Recent reports have shown that up to:-
• 15% of calls to NHS 111 are for emergency repeat medication at busy times

at the weekends

• 3-4% of Bank Holiday out-of-hours appointments with a doctor are taken up

by requests for a prescription for repeat medicines.

• This clearly indicates there is a need for a PURM service to address these

emergency medication requests.

www.england.nhs.uk

PURM cost Effectiveness

51

£317,824.00 £174,192.00 £174,192.00 £66,024.50 £344,032.76 £200,400.76 £200,400.76 £92,233.26

GP OOH via NHS111 Walk-in Urgent Care Centre A&E (Type 3) PURMs

Comparison of costs per service type on 3056 referrals 1 April 2015 - 31 March 2016

Cost total ex Drugs Cost Total incl Drugs

www.england.nhs.uk

PURM cost effectiveness

52

The key finding is that the service is extremely cost effective, for urgent repeat medication supplies

• 73% cheaper than using GP out of Hours Services which would cost

£344,032.76

• 57% cheaper than using Accident & Emergency or walk in centre services

which would each cost £200,400.76.

• (note tariffs quoted A&E, WIC were outside London)

Takes pressure off the other services Use of the cost effective community pharmacy route to manage repeat emergency medication route

www.england.nhs.uk

PURM coverage London 03.03.2017

53

www.england.nhs.uk

PURM to NUMSAS Transition

54

PURM NUMSAS

Service Type London Enhanced service National Advanced service Funding source Funding with pharmacy enhanced floor Integration fund , drug costs recharge to CCGS Time limited pilot 1st December 2016 – 31st March 2018 Payment process IT platform , data sent to Capita/ PSCE Paid through BSA Fees £12.50 consultation fee for advice only £12.50 consultation fee + medicine costs A Consultation fee of £10, AND

• II. An Administration fee of £2.50 per

consultation

• b. Where a medicine or appliance has

been supplied, a supply fee of £1.50 will be made for the first item and an additional £0.50 will be paid for each additional item supplied. Registration Through Regional Team; factoring in opening hours and location. Registration managed centrally through NHSBSA. NHS Net emails Yes. Yes - NHS net email access will be controlled centrally through BSA. Recording and documentation All entries are made on the IT

• platform. irrespective of whether

A blank FP10DT EPS dispensing token will be used to document all referrals

www.england.nhs.uk

Referrals – Comparison of PURM & NUMSAS

55

Referral Referral from NHS 111 via NHS net Aims and intended

• utcomes of the

service

Y Y Y Y

• patient’s
• patients’

Consultation

. Patient advice on ordering medication in a timely way.

Training, premises and

• ther

requirements

Accreditation not specified. No consultation room standards- face to face consultation. Safeguarding awareness.

www.england.nhs.uk

Project management of PURM to NUMSAS transition

56

• Project group established in January 2017
• Representation from: NHS England – Primary Care, Medical Directorate,

Communications; NHS 111/Integrated Urgent Care; DOS leads; U&EC Networks; Healthy London Partnership; LPCs; IT Provider

• Detailed project plan and risk assessment
• Regular meetings and reporting schedule
• Pathway and information flow mapping
• Mapping exercise to assess coverage across London
• Working with NHSE national pharmacy team to ensure processes are aligned
• Ensure good coverage of NUMSAS registered pharmacies across London
• Critical point – ensure sufficient service provision is in place for Easter

bank holidays.

www.england.nhs.uk

Key milestones

57

• IM&T solution – plan developed and implemented including token printing
• Communications/stakeholder engagement strategy
• Contract management/commissioning to support transition
• All national team/service plans confirmed; issues clarified and factored into

London transition plan

• NUMSAS Workshop held
• Appropriate NHS Mail accounts set up for all prospective providers
• Registration/deregistration of pharmacy providers
• DOP team briefed and trained to deal with any issues
• NHS 111 DoS Lead and NHS 111 Commissioners checklist for go live completed
• NHS 111 call handlers briefed and trained to direct calls appropriately
• Pharmacy Contractor checklist for go live completed
• NHS 111 Provider go live checklist completed
• New claims and payment process implemented

NHS Urgent Medicines Supply Advanced Service (NUMSAS) Pilot Implementation Workshop Graham Flynn

NHS Urgent Medicines Supply Advanced Service (NUMSAS) Pilot Implementation Workshop Lunch

NHS Urgent Medicines Supply Advanced Service (NUMSAS) Pilot Implementation Workshop Interim planning workshop

NHS Urgent Medicines Supply Advanced Service (NUMSAS) Pilot Implementation Workshop Next steps

NHS Urgent Medicines Supply Advanced Service (NUMSAS) Pilot Implementation Workshop Thank you for attending Please leave your badge and completed evaluation form on the table for collection