AHP Medicines Project - Improving quality and productivity
AHP Medicines Project Improving quality and productivity www.dh.gov.uk Shelagh Morris Allied Health Professions Officer
High Quality Care for All Improving Quality Improving Productivity Enabled by Innovation Quality, Innovation, Productivity & Prevention (QIPP) Prevention The quality and productivity challenge
The QIPP programme Supporting commissioners to commission for quality and efficiency – e.g. through improved clinical pathways, decommissioning poor value care, tariff reforms Provider efficiency – supporting providers to respond to the commissioning changes and efficiency pressures by transforming their businesses Shaping national policy and using system levers to support and drive change e.g. tariff rules, primary care contracting & commissioning Care closer to home More standardisation Earlier intervention Empowered patients Fewer acute beds Reduced unit costs Characteristics of a sustainable system: Areas covered by QIPP programme
Andrew Lansley - Five priorities <ul><li>1. A patient-led NHS – ensuring it responds to people’s needs and their wishes when it comes to managing their own care. </li></ul><ul><li>2. Shifting focus and resources towards better health outcomes – targets that have no clinical justification will be removed and healthcare professionals will be given control over the running of day-to-day services, with a focus on outcomes for patients. </li></ul><ul><li>3. Empowering professionals throughout the NHS – giving them more power and responsibilities, replacing the top-down approach from central government. </li></ul><ul><li>4. Improving our public health services – the NHS will have to work with a range of partners focusing strongly on improving people's health through preventive measures. </li></ul><ul><li>5. Reforming long-term care – improving accessibility of, and options for, long-term social care by focusing on prevention, personalisation and partnership delivery. </li></ul>
AHP Prescribing and medicines Supply Scoping Project <ul><li>Phase 1- Further work should be undertaken to establish: </li></ul><ul><li>Independent Prescribing: physiotherapists, podiatrists </li></ul><ul><li>Supplementary Prescribing: dietitians </li></ul><ul><li>Exemptions: dietitians, orthoptists </li></ul><ul><li>Phase 2- Further work when appropriate, to consider the need for: </li></ul><ul><li>Independent Prescribing: radiographers </li></ul><ul><li>Supplementary Prescribing: occupational therapists </li></ul><ul><li>speech and language therapists, </li></ul><ul><li>orthoptists, </li></ul>► Allied health professions prescribing and medicines supply mechanisms scoping project report http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_103948
Patient Specific Directions <ul><li>A written instruction from an independent prescriber for a medicine or appliance to be supplied or administered to a named patient. </li></ul>In primary care, this might be a simple instruction in the patient’s notes. Examples in secondary care include interactions on a patient’s ward drug chart. ► PATIENT SPECIFIC DIRECTIONS - BRIEF Q and A ON THEIR USE Alison Dale – Non-medical Prescribing Lead, Yorkshire & The Humber SHA Patient_Specific_Directions_Q_and_A_March_2009_Version_2.pdf
Patient Group Directions <ul><li>A written instruction for the supply or administration of a licensed medicine (or medicines) in an identified clinical situation, where the patient may not be individually identified before presentation for treatment. </li></ul>► TO PGD OR NOT TO PGD? – That is the question. A guide to choosing the best option for individual situations www.pgd.nhs.uk Example Rheumatology for administration of corticosteroid injections.
Exemptions <ul><li>A number of health professions have specific exemptions in medicines legislation to supply or administer medicines </li></ul>► Ref: Medicines Matters (2006) http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_064325 Example Podiatrists have exemptions under medicines legislation for: - sale/supply of a number of prescription only medicines (POMs), including erythromycin and topical hydrocortisone - parenteral administration of a number of POMs, including bupivacaine and lignocaine.
Supplementary Prescribing <ul><li>A voluntary prescribing partnership between the independent prescriber and supplementary prescriber, to implement an agreed patient-specific Clinical Management Plan (CMP) with the patient’s agreement. </li></ul>Supplementary prescribing is intended for use between medical reviews in the management of long term conditions. Examples: Physiotherapists: Musculosketal conditions and pain management Podiatrists: Diabetes and peripheral arterial disease Therapeutic radiographers: to manage pain and other side-effects of radiotherapy
Independent Prescribing <ul><li>The independent prescriber takes responsibility for the clinical assessment of the patient establishing a diagnosis and the clinical management required as well as responsibility for prescribing where necessary and the appropriateness of any prescription. </li></ul>Prescribing, supply and administration of medicines: Meeting patient need Developing a flexible workforce Locally determined service improvement
Today <ul><li>Post – its </li></ul><ul><ul><li>Examples of how you are or could use the existing mechanisms available to occupational therapists </li></ul></ul><ul><li>Flipcharts </li></ul><ul><ul><li>Examples of how occupational therapists might redesign services using prescribing, supply and administration of medicines </li></ul></ul><ul><li>Improving clinical outcomes </li></ul><ul><ul><li>Improving the patient experience </li></ul></ul>
And remember…. <ul><li>“ Learn the past, watch the present, and create the future.” </li></ul><ul><li> Anonymous </li></ul>
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