Realising the potential of community pharmacy
How can we maximise the public’s experience when interacting with community pharmacists?
With a specific focus on:
  • polypharmacy
  • improved health outcomes in the local population
  • shared decision making tools
  • generating significant savings for local NHS organisations through reducing wastage and preventing avoidable emergency hospital admissions.  

Ideas (Education, training and future workforce)

Innovation 'Elevator Pitch':
PharmacyFace matches community pharmacy services to the needs of their community to encourage medicine adherence and heathy lifestyles. 

 prevents illness, manages long term conditions, promotes healthy living and effective self-care whilst reduc
Overview of Innovation:
PharmacyFace uses search engine marketing and online booking to make gaining healthcare support from a pharmacy easier.  As many pharmacies are becoming more aware of the need to be 'more service' rather than dispensary-driven, PharmacyFace makes this process easier for the business and patient.

This offers an alternative solution to the increasing pressures on GP surgeries capacity and a viable option to out-of-hours hubs to direct relevant customers to community pharmacy.

The PharmacyFace online booking widget is easy to implement on the pharmacies website with one line of code. We can also develop websites for pharmacies which do not yet have one.  Any service provided by that particular pharmacy can be added to their booking widget, with private / NHS services clearly labelled.

Further plans include the ability for the pharmacist to send an MUR proposed booking time out to their patient through their preferred channel (text or email); ability for a patient to cancel and reappoint a booking through their mobile/online; integration with popular PMR systems; an app which enables the public to locate and book in with the pharmacy convenient to them based on location.

The pharmacy gains insights on how well their current offerings are matched to public need, eg whether staffing levels/appointment capacity is correct at peak times and whether they are losing any customers as a reult of this. Pharmacist can easily locate, cancel and move a booking, create linked bookings rapidly (eg. smoking cessation or weight management courses).

The PharmacyFace system will also deliver open-ended questioning techniques / training videos which can help pharmacists to gain better customer 'buy in' to medicine adherence. Evidence-based guidance to NICE guidelines.
Eg. Suggested questions to parents of a child with asthma ‘how is your child sleeping’ and ‘how are you sleeping as a result’.  This opens up a different conversation instead of focusing solely on the technical aspects of taking the medication. How much exercise does the child get?  Has he/she ever felt excluded from exercise or social activities he/she would like to do as a result of the condition?  It is proposed that linking these real-life priorities can lead to the patient and parents of the patient understanding the specific benefits to them of medication adherence. The pharmacy then sends an online review request to the parents to receive feedback which could be posted via NHS Choices, social media etc. 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
57 million GP appointments/annum are taken up with minor ailments in England. 1 in 6 hospital visits could be prevented with correct adherence to medication, with 30-50% medications estimated to be taken sub-optimally (costing £1.42Billion/annum - R Pharm Soc.)  GP’s would like to spend more time with patients with complex physical and/or mental health conditions but capacity is an issue.
 
Greater 24/7 access for patients to an alternative to GP surgeries for minor ailments, leading to cost savings and greater capacity. Faster access to a community healthcare professional for appropriate signposting which can prevent health conditions worsening and resulting in costly hospitalisations (by improving digital access to community pharmacy).  Potential to connect community pharmacy and community health trainers who could deliver healthy lifestyle support within pharmacy branches which have less capacity to offer servcies beyond dispensing at present and have under-utilised consultancy rooms. (Initial discussions have taken place with healthcare trainers.)  

An opportunity to show community pharmacists that helping support customers to make healthy lifestyle choices will benefit their reputation commercially through customer loyalty, word of mouth and OTC sales, improve job satisfaction and staff retention, creating longer term buy-in.  This long-term buy in with community pharmacy can help to unlock pharmacy as an 'untapped resource' in the prevention of LTC through healthy lifestyle and better medicine optimisation. Training support for on effective questioning (during MURs) for speciific conditions (following NICE guidelines and evidence-based) will help to build confidence and community pharmacies capacity to unlock better medicine adherence amongst their customers who may have felt they have their condition under control (e.g. asthma) when behavioural evidence suggests otherwise (eg. high use of reliever inhalers, low use of preventer inhalers).

We also have plans to increase awareness via schools etc.  Enabling lead nurses the time to book phone time online (and eventually face to face screen time) with a pharmacist enables them to collate questions from their colleagues regarding patients medications and get them answered by the pharmacy they have an existing relationship with in a more efficient manner, promoting better medication adherence and reducing risk of more complex and costly problems later on.
Initial Review Rating
3.80 (2 ratings)
Benefit to WM population:
Better access 24/7 to advice on medications,  Self-employed who have avoided blood tests, blood pressure checks etc.as they do not want to 'lose a days work' can book in for an appointment with the pharmacy able to provide the service they require.
 
Expansion of PharmacyFace sales and pharmacy support staff will increase employment and wealth creation within the area. We also use local printing, graphic design and web development personnel to maximise the economic benefit in the region whrn commercially viable to do so.
Current and planned activity: 
We have had meetings with pharmacies in Coventry, Solihull and Birmingham who have expressed a desire to have the PharmacyFace widget implemented on their website. Tested training staff in a pharmacy showed very few problems with using the PharmacyFace system.  We are also developing websites currently for two pharmacies who wish to use PharmacyFace. Two pharmacies wish to use the system for their travel vaccinations initially whilst they bring in other services. Having had initial conversations with community pharmacies in Walsall we are now starting to gain personal referrals to other pharmacies in that area.  All pharmacy websites using PharmacyFace to have SSL certificates to improve security of any emails customers choose to send the pharmacy. The majority of community pharmacy websites do not currently have this.
Build network of pharmacies using the system in the region through email marketing combined with useful content to build awareness, direct contact/sales. 
 
What is the intellectual property status of your innovation?:
Currently under advisement.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
2
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Jason Lyndon 11/04/2017 - 11:15 Sign Posted Login or Register to post comments
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Innovation 'Elevator Pitch':
The Sound Doctor has over 250 high quality short educational films. Evaluations show they work by changing behaviours and improving outcomes to help people get the best out of life with long term conditions.
Overview of Innovation:
The Sound Doctor is the leading provider of film and audio content for patients in the UK. Our content is thought to be unmatched in quality, range and production values and evaluations show it works by changing behaviours and improving outcomes to help people get the best out of life with long term conditions.

With 1.6m people daily attending a community pharmacy and 89.2% of the population within 20 minutes walking distance of a community pharmacy, scope to increase engagement is high.
 
Our films are endorsed by leading charities and adhere to NICE guidelines.
Conditions covered are COPD, Diabetes, back pain, dementia and weight management surgery.  
There are over 250 films in our library so far and it is constantly growing. We have a range of health and wellness short animations which are now being used in pharmacies and GP surgeries around the country. 
In addition, the team also devised and produce Health Today, a national radio programme for NHS England – nhs.uk/healthtodayradio
 
We have evidence that patients with diabetes, for example, have changed their attitudes towards diet and exercise as a result of watching our films. People with COPD are more confident about dealing with exacerbations at home. We also know that across all conditions they are considered a valuable part of people’s health care and improve patient experience.
 
The aims of TSD, and there is evidence of this as well, are:
 
1. To reduce the number of avoidable admissions (and readmissions) to hospital
2. To reduce the need for face to face contact with consultants, physicians, nurses, physiotherapists and others (and to improve the quality of meetings which do take place)
3. To address the issue of co-morbidities by creating a multi-condition library
4. To improve medicines management and compliance with medications
5. To improve the quality of care for patients (and patient experience of their care)
6. To help people get the most out of life through effective self-management
   
About us:
TSD was founded by Dominic Arkwright and Rosie Runciman and is a registered social enterprise.
Dominic worked as a reporter at the BBC for more than 20 years, mostly on Radio 4 's Today Programme as well as Newsnight and PM. He also presented discussion programme 'Off the Page' and 'The Call' on Radio 4.
Rosie Runciman also worked at the BBC for more than 20 years on Radio 4's Today programme, Newsnight, Radio 5 Live and at The World Service. She was Editor of Newshour and Assistant Editor at Five Live.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
  • For clinicians  
    • Complements and supports sessions
    • Sessions more focused and efficient to achieve better health outcomes
    • Reduces appointments, admissions and DNAs
  • For providers  
    • More efficient caseloads, better outcomes for patients, reduced waiting lists
    • Money saved through reduced numbers of GP appointments, hospital admissions and DNAs
Return On Investment (GPs)
Cost of TSD per patient per annum = £5.00
 
Average number of GP visits pre TSD = 3.7 appointments Average number of GP visits post TSD = 0.42 appointments
 
3 fewer appointments per TSD user x payment for each appointment of
£23.50 (NHS tariffs) = £70.50 per patient; an ROI of 1:14
 
Average number of GP DNAs pre TSD = 2.5 appointments Average number of GP DNAs post TSD = 0.5 appointments
 
2 fewer DNAs per TSD user x cost of each DNA of £36 (Kings Fund) = £72 per patient; an ROI of 1:14
Initial Review Rating
3.80 (1 ratings)
Benefit to WM population:
Benefits for patients
  
  • Empowers and encourages people’s engagement with their condition
  
  • Improves medicines adherence
  
  • Improves overall quality of care
  
  • Improves people’s experience of and satisafaction with their care
Current and planned activity: 
Who’s using The Sound Doctor
•  CCGs 
  • Barnsley, Gloucestershire, West Leicester, Wirral, Newcastle, Central London Community Health Trust
  
  • Hospital Trusts  
    • Guy’s and Tommy’s NHS Trust
    • Liverpool Heart and Chest Hospital
  
  • Other  
    • Philips Healthcare
    • All South London pharmacies
    • Jhoots Pharmacies
    • NAPC Practice Innovation Network
What is the intellectual property status of your innovation?:
We own the IP on all our content
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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Dominic Arkwright 26/09/2016 - 16:31 Sign Posted Login or Register to post comments
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Innovation 'Elevator Pitch':
Evaluation of near patient testing within community pharmacy to help reduce inappropriate antibiotic prescribing associated with respiratory and urinary tract infections.
Overview of Innovation:
Inappropriate antibiotic prescribing can lead to higher rates of antimicrobial resistance. Taking steps to reduce the number of inappropriate antibiotics prescribed will help delay the emergence of resistant organisms and prevent harm by reducing the incidents of Clostridium Difficile. 

GP practices are often the first port of call for infections such as such as sore throats. It is estimated that 50-95% of sore throats in adults and 70% in children are caused by respiratory viruses which could potentially be managed safely within community pharmacy without the need for antibiotics.

Patients presenting with sore throats to GP practices fall into three groups namely, those with clear bacterial infection, those with viral infection and those where there is a degree of diagnostic uncertainty. In the latter group, a near patient test to aid diagnosis may help reduce diagnostic uncertainty and may prevent inappropriate antibiotic prescribing. 

Near patient testing is well established in general practice e.g. urine test strips for urinary tract infections. Recently, other devices have been introduced which look at CRP, Strep A, RSV, Flu.  These devices have been shown to aid diagnosis rates. 

However, conducting near patient tests in GP practice does not help address the current workload and capacity issues experienced by GPs. It is therefore proposed that such tests could be conducted in the Community Pharmacy.

Patients with diagnostic uncertainty could be referred by the GP to their community pharmacist to have a diagnostic test and dependent upon the results have the most appropriate treatment dispensed. Community pharmacists could supply antibiotics in line with local formularies if the test results were positive or self advice / over the counter medicines if the results were negative. 

By developing and evaluating this care pathway, we aim to evaluate whether this helps reduce overall antibiotic prescribing in primary care. We would also evaluate patient satisfaction, the impact of GP workload as well as pharmacy satisfaction with near patient testing. 

Initially we would like to evaluate one device but this patient pathway could be applied to other near patient tests. If successful, ear patient tests could be incorporated in common ailment schemes whereby patients approach their "pharmacy first" rather than their GP practice for sore throats or urinary tract infections. This would help reduce demand on GP services.  



 
Stage of Development:
Trial stage - Trial stage to prove that the idea actually works as intended
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Education, training and future workforce / Patient and medicines safety / Person centred care
Benefit to NHS:
The NHS would benefit on a number of fronts. 

1. Reduce inappropriate antibiotic volume. This will help delay the emergence of of antimicrobial resistance which in turn help prevent incidents of C Difficile and related multi-resistant infections in the future. 

2. A reduction of unplanned admissions associated with C Diff will help reduce pressure of the acute sector. Similarly, any reduction in hospital admissions will help the NHS save money. 

3. Introduction of a new care pathway involving near patient testing within community pharmacy will help reduce workload pressure on GP practices. A recent survey of GP surgeries has shown that GP waiting times have increased from an average of 9 days in April 2014  to 13 days in APril 2015. Near patient tests can take from a couple of minutes to 10 minutes. By doing these tests during a  GP consultation will add time which could be potentially be avoided if done elsewhere.

4. New ways of working between GPs and community pharmacists are part of the Five Year Forward View. A clear and robust pathway will help utilise existing capacity in community pharmacy to support other primary acre contractors such as GPs. This also strengths the links between community pharmacy and GP practices and will foster closer working between the two primary care contractors. 


 
Return on Investment (£ Value): 
N/A
Return on Investment (Timescale): 
N/A
Ease of scalability: 
N/A
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Manir Hussain 20/05/2016 - 18:18 Archived Login or Register to post comments
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