NMS – effective engagement

and delivery

Leyla Hannbeck Chief Pharmacist

Twitter: @LeylaHannbeck

NMS statistics: 2014/15 and 2015/16

• In the year 2014/15:

775,998 – total number of NMS claimed

9,308 (80%) – number of pharmacies that provided service

83 – average number of NMS per pharmacy

2,366 – eligible pharmacies that did not delivery any NMS

• Between April 2015 and January 2016 (10 months):

603,141 – total number of NMS claimed

NMS: introduction

• NMS aims to provide early support to patients who are newly prescribed a medicine for a long term condition

• Four conditions/therapy covered by NMS include:

Antiplatelet/anticoagulant therapy Asthma and COPD Hypertension Type 2 diabetes

• Involves 3 stages:

Patient engagement

Intervention

Follow-up

Barriers to delivering NMS

.

• Time available: both patients time and pharmacist time

• Capability and availability of support staff

• Lack of staff engagement

• Value and outcomes of the NMS service

• Consultation room uninviting for the patient to enter

• Consultation room being utilised for other services

• Poor consultation styles and skills

• Representatives collecting prescription for housebound patients

• Failure to attend NMS appointments

• Low prescription volume coinciding with low NMS uptake

NMS: current service constraints

• 3 staged process found to be cumbersome and even unnecessary – some patients receive all support by end of intervention stage

• In most cases, payment only received once all three stages are complete - waste of pharmacists time if a patients do not attend at follow-up stage

• NMS cannot be carried out to a carer, guardian or parent– this takes away useful opportunities to help improve medicines adherence amongst certain patient groups

NMS study

• Independent evaluation of NMS conducted by

University of Nottingham and UCL Schools of Pharmacy

• Commissioned by DH in 2012 with final report published in 2014. ‘Understanding and Appraising the New Medicines Service in the NHS in England’

• Key finding: “NMS was effective at improving patients’ adherence to their new medicines by around 10%”

• NMS increased number of patients taking their new medicines from 67 to 78 out of every 100 patients

NMS study: other important findings

• No overall cost to the NHS of providing NMS – the intervention costs were absorbed by reduced subsequent NHS contract costs

• NMS was more successful than other more expensive interventions

• In terms of value, NMS reduced costs for the NHS overall while also improving patient outcomes

• Each NMS saving the NHS on average £21.11

NMS – effective delivery

NMS KPI

• Check34 NMS KPI allows you to:

Manage and monitor NHS services

Understand branch, company performance

Benchmark your pharmacy performance against branches within the same company, other local pharmacies and national averages

Identify root causes for failing to meet targets

Conduct regular training and quality checks to ensure staff are aware of the service

View up to 24 months history and trend analysis

NMS pack New Medicine Service outline Medicines covered by the NMS Anticoagulant or antiplatelet therapy Asthma and chronic obstructive pulmonary disease (COPD) Hypertension Type 2 diabetes Healthy living advice Recruiting and retaining patients Patient consent Communicating with patients Interview schedule The pharmacy team Engaging with GPs Record keeping Payment Access to the Summary Care Record – issues pharmacists should bear in the mind when accessing Ready to provide the NMS – so you can decide whether or not to provide this service Checklist for pharmacies – a checklist to help you ensure that the NMS is running as effectively as possible.

EPBP: overview Assess

SWOT and Gap analysis

Drug Tariff guide

KPIs

Job descriptions

Apprenticeships

GPhC inspections

CPAF

Plan

Achievement plan template

Skills matrix

Action plan template with prioritisation

matrix

Develop

Alternative private services

PGD services

Automated dispensary systems

and pharmacy robots

Benefits of renting out a consultation room

Leadership

Promote

Social media

Review

Improving your pharmacy business

Daily/weekly checklists

SWOT analysis example S – Strengths

Characteristics of the business that give it an

advantage over competitors

W – Weaknesses

Characteristics of the business that put it at a

disadvantage compared to others – potential areas

for improvement

What do you do better than your competition? What additional service(s) does your pharmacy offer

customers/patients compared to other local pharmacy businesses?

Does your pharmacy have any unique selling points?

What does your competition do better than you?

What do they offer that you don’t?

Do you have enough manpower to accommodate

further growth of the business?

O – Opportunities

Opportunities to enhance offering/increase sales

T – Threats

Factors that could cause/enhance issues in future

What other services/products could you offer?

Are there any local pharmaceutical needs that are not

currently being met? This information can be found in the

local Pharmaceutical Needs Assessment (PNA) document

produced by local authority health and wellbeing boards

What do your customers want? Do you have a specific

interest or skills that could be relevant to your local

community? For example, provision of a vaccination

service for Hajj pilgrims

What are your competitors’ vulnerabilities?

Do you know of any plans by local businesses to change the services/products they offer which may put them in competition with you?

Is there a new pharmacy opening in your local area? Do you have much competition from nearby

pharmacies? Do you know of any plans for the local surgery/surgeries

to relocate or close? Do you know of any planned future or ongoing local

road works or car park works which may make your pharmacy less accessible?

Are you aware of internet pharmacies being advertised

locally or providing services in the local area?

objectives – how would you like your pharmacy to perform?

Current performance – how is your pharmacy performing currently?

Steps to achieve business objectives – how to bridge the gap

Timescales (by end of)

Responsibility of (name of person(s) responsible):

For example:

Pharmacist to

carry out x NMS

per financial year

Pharmacist

conducting X NMS

per month

Use delivery drivers

to help promote the

service

Distribute leaflets to

recruit eligible

patients

Use alert stickers to

highlight

prescriptions for

collection belonging

to patients who are

eligible for the

service

NMS leaflets

July

2016

Pharmacy

manager

Responsible

Pharmacist

Gap analysis template

NMS: future suggestions • APPG meeting in 2015 - unanimous in

supporting idea to offer NMS to patients with mental health conditions

• Suggestions to extend service to include patient groups :

Using anti-psychotic medicines

Depression

Gout

Glaucoma