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Sweetening the pill on Medicines Optimisation

NHS England’s National Pharmacy Adviser for RightCare gives the first in a series of updates to the pharmacy frontline:

The intention of these blogs is to provide an overview of information on what is new and relevant to medicines optimisation and pharmacy colleagues.

For those not familiar with NHS RightCare, it is a national, NHS England supported programme committed to delivering the best care to patients, making the NHS’s money go as far as possible and improving patient outcomes.

You can see an overview of our work, projects and resources on the RightCare website including information and resources on medicines optimisation.

The main points to note from the last few months are that with the introduction of the Pharmacy Adviser role to NHS RightCare, an engagement exercise has been carried out with pharmacists across England, to find out how familiar they were with the RightCare resources, how they were using them and how they could be improved.

A number of welcome comments were received, including positive suggestions on how the medicines optimisation aspects could be improved. A big thank you to all those that took part.

Having looked at the feedback we received, a programme of work has been put into place within NHS RightCare’s Intelligence programme. You will hopefully see some of these changes emerge in new resources that are published over the next year or so.

We received some very helpful suggestions from people on how the Intelligence resources could be enhanced in relation to medicines optimisation. Some of the changes that we will take on board over the coming months include:

  • Using terminology that is more familiar to pharmacists
  • Making comparator drug lists as explicit as possible, so that it is clear what is and isn’t included within the metrics
  • Making drug selections that are based on the BNF sub-sections
  • Making prescribing data as current and up-to-date as possible
  • Using appropriate measures and metrics depending on what drugs are being considered (such as only using ASTRO-PU where appropriate)
  • Seeking specialist pharmacist input on specific clinical topics

We have given presentations at various pharmacy forums and conferences over the last few months to raise awareness of the NHS RightCare approach and how the principles of medicines optimisation relate to NHS RightCare. The slide presentations are available upon request.

There are already a plethora of medicines optimisation resources that have expert input. Examples include the medicines optimisation dashboard; key therapeutic topics from NICE; and open prescribing. We are also aware that health economies have their own local sources of intelligence and local dashboards.

The idea is for NHS RightCare resources to signpost people towards these other sources of information where relevant, rather than duplicate effort and attempt to produce similar products. In future resources from NHS RightCare, you will see increased references to these other sources of information where they exist.

They will include information along the lines of:

“NHS RightCare provides us with resources that help raise questions. These resources enable us to identify variation and question whether it is warranted or unwarranted. The resources and data are not there to provide definitive answers, but rather to help generate discussion within local health economies. The information provided by NHS RightCare is not intended to be used in isolation. There may be caveats to the data provided that need to be taken into consideration, and local intelligence and interpretation is required before any final conclusions are drawn from any of the data.

“From a pharmacy and medicines optimisation perspective, the idea is to provide pharmacists with an opportunity to look at medicines as part of a whole pathway rather than looking at medicines in isolation. We realise that pharmacists are the experts on medicines and may already have a vast amount of data available on medicines either nationally or locally. We hope that the NHS RightCare data will help provide some of those links for medicines in relation to pathways and clinical outcomes. We advise health economies to interpret any medicines-related data from NHS Right Care in consultation with their local medicines optimisation team within their CCG.”

Within the next few weeks we hope to record a webinar to explain how NHS RightCare information can be used by pharmacists. This will be particularly useful for those who have not been able to attend any of the NHS RightCare workshops where we have provided information on this. Recordings of the webinar will be available on the NHS RightCare website.

We will also try to share examples of best practice whenever we can, so if you have examples of any good projects  – and in particular where you may have used NHS RightCare resources to help inform your project – then please let us know. We would be happy to help you write it up as a case study that can be used to help and educate others.

Jas Khambh

Jasbinder Khambh is an experienced pharmacist who has worked in the NHS for 20 years as a pharmacist and a senior manager. Jas has led on various initiatives and programmes of work across London to help deliver the objectives of the strategic QIPP programme and other medicines optimisation initiatives. More recently, she has been working at NHS England as the National Pharmacy Adviser for NHS RightCare, focusing on the national initiatives for medicines optimisation within NHS RightCare.

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