transfer of care to pharmacy - hassan argomandkhah, chair of pharmacy local professional network...
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Pharmacy LPN Chair (Merseyside) NHS England
Hassan Argomandkhah FRPharmS IPresc
Transfer of Care to Pharmacy
Transfer of Care to Pharmacy
Patient admitted to & discharged
from hospital
Key objectives1. To create a fully Integrated system which
enables hospitals to transfer relevant clinical information between care settings and improve medicines optimisation.
2. To enhance communications between care settings thus delivering timely, positive and measurable patient outcomes and experiences.
Transfer of Care to Pharmacy
Key objectives3. Link with with Cheshire & Merseyside Sustainability and Transformation
Plan (STP) objectives. Reducing emergency bed days and length of stay*.Reducing hospital re-admissions*. Early identification and intervention. Delivery of care in alternative settings. Optimise direct patient care through forging links with
community pharmacy.Improve the health of the C&M population through
medicines optimisation.Reduced drug waste and impact on primary care
medicines spend*. Improved patient satisfaction*
✴ These are the project objectives that would be measured as part of the academic evaluation.
Transfer of Care to Pharmacy
Project outlineThe project aims will establish the following patient eTCP pathways
• Hospital admission notification to community pharmacies.
• Hospital admission notification to GP practices.• Hospital discharge notification to community
pharmacies. • Hospital discharge information to community
pharmacies.• Anonymised monitoring of messages via a secure
‘hub’
Transfer of Care to Pharmacy
✦ Hospital pharmacy needs to deliver more services to increase patient safety.
✦ A transfer of care to pharmacy pathway can deliver the desired outcome.
✦ Seamless delivery requires a more efficient delivery platform
✦ electronic Transfer of Care to Pharmacy (eTCP) will provide the efficiency
✦ eTCP will deliver optimal use of medicines, technology and workforce.
✦ eTCP will create a fully automated transfer of admission and discharge information to encourage collaboration between secondary and primary care and remove unnecessary variation in services.
✦ This will deliver value for money for the taxpayer and good clinical outcomes for all patients seven days a week.
Transfer of Care to Pharmacy
Reference1. Keeping patients safe when they transfer between care providers – getting the medicines right, July 2011:
http://www.rpharms.com/current-campaigns-pdfs/1303
Cheshire and Merseyside Overview
Key Features• Hospital admission notification to
1. community pharmacies 2. GP Practices
• Hospital discharge notification & information Providing pharmacies with a copy of the relevant patient discharge information
• anonymised monitoring of eTCP messages through a secure hub
Key System ObjectiveFully Integrated system to enable hospitals to transfer relevant clinical information between care settings to improve medicines optimisation NHS England Funding
To fully develop and implement software solution in all Cheshire and Merseyside NHS Acute Hospital Trusts
Electronic Transfer of Care to Pharmacy (eTCP)
Electronic Transfer of Care to Pharmacy (eTCP)
On Patient Admission to Hospital
1. Hospital pharmacy team assesses risk of meds changes2. Automated notification
Community Pharmacy Team
Practice Admin Team
1. Suspend medication supply2. Add notes to PMR3. Await discharge information
Anonymised monitoring HUB [SAM] Secure
Allocation Management
1. Suspend Rx2. Add notes to clinical system3. Await discharge information
Monitors eTCP actions
Admission notification Patient selection
✦ Non-elective✦ 4 meds or more✦ MDS (blister packs)✦ CVD event
Electronic Transfer of Care to Pharmacy (eTCP)On Patient Discharge from
Hospital
Automated notification & transfer of discharge
information
Community Pharmacy Team
Monitors eTCP actions 1. Reviews discharge information2. Reviews any outstanding Rx3. Cancel unwanted Rx & query new Rx
Anonymised monitoring HUB [SAM] Secure Allocation
Management
1. Adds note to clinical system2. Post discharge meds reconciliation 3. Act on any new Rx query
Discharge information
Practice Team
continues to receive discharge information through existing channels
Electronic Transfer of Care to Pharmacy (eTCP)
Patient admitted to & discharged
from hospital
Admission notification plus Discharge notification & information is sent to the Community pharmacy
Secure Allocation Manager (SAM) Anonymised monitoring of eTCP
messages
Full pathway
Enhanced pt. safety• Reduced
medication errors
• Support on concordance
• Less likelihood of re-admission
Patients
Electronic Transfer of Care to Pharmacy (eTCP)
HospitalIncreased efficiency• Smoother
discharge • Reduced 30d
re-admission• Better links
to primary care
benefits of eTCP - admission & discharge notifications
PharmacySafer for pts. & reduces waste• Access to
timely information
• Better use of clinical skills
• Less medicines dispensed and wasted
GP PracticeBetter pt. safety & reduces waste• Targets
“revolving door” pts.
• Identifies pt’s. meds adherence issues
• Less medicines wasted
NHS/CCG/
Social Care
GPs / Commissioners would see a reduction in hospital admissions due to an improvement in medicines adherence. Community pharmacists have the opportunity to be an integral part of a patient pathway which allows them to utilise their inherent skills, and to build professional relationships with patients and fellow health professionals.
Key benefits to eTCP partner come from the benefits to their patients
More productivity• Fewer re-
admissions• Better meds
optimisation• Less med
waste• Better
management of resources
Electronic Transfer of Care to Pharmacy (eTCP)Potential Savings
4Liverpool Heart & ChestThomas Drive, Liverpool, Merseyside, L14 3PE
1Aintree University HospitalLower Lane, Liverpool, Merseyside, L9 7AL
6Royal Liverpool HospitalPrescot Street , Liverpool, Merseyside, L7 8XP
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Arrowe Park HospitalUpton, Wirral, Merseyside, CH49 5PE
7Southport and OrmskirkTown Lane, Southport, PR8 6PN
8Whiston HospitalWarrington Rd, Prescot L35 5DR
3Macclesfield GeneralEast Cheshire NHS Trust Macclesfield, SK10 3BL
2Countess Of ChesterHealth Park, Chester, Cheshire, CH2 1UL
5Leighton HospitalMid Cheshire NHS Foundation Trust, Crewe, CW1 4QJ
9Warrington HospitalLovely Lane , Warrington, Cheshire, WA5 1QG
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Bowmere Hospital MHTHealth Park, Liverpool Road, Chester, CH2 1BQ
eTCP EOI - Hospital Trusts
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Alder Hey Children's HospitalEast Prescot Rd, West Derby, Liverpool, L14 5AB
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eTCP EOI - Hospital Trusts
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Electronic Transfer of Care to Pharmacy (eTCP)
Project implementation • STP Board engagement• Patient engagement • Clinician engagement• Innovation Agency• CPPE • Project Roll-out
Electronic Transfer of Care to Pharmacy (eTCP)
Hospital Trust system selection.• We are supporting each hospital Trust to choose their
preferred system supplier which meets our joint project objectives based on system compatibilities including any third party IT solutions
Partnership arrangements. The following organisations have agreed to support NHS
England / PLPN to deliver elements of eTCP. These will be managed through Service Level Agreements.
• The NHS Innovation Agency / Academic Health Sciences Network (AHSN North West Coast).
• Centre for Post Graduate Pharmacy Education (CPPE).
Governance arrangements
Electronic Transfer of Care to Pharmacy (eTCP)Governance arrangements
• Governance for the complete project falls under NHS England (Cheshire and Merseyside) through pharmacy Local Professional Network (Merseyside) - PLPN
• NHS England / PLPN Merseyside through a SLA with IA (Innovation Agency / AHSN) will deliver eTCP in 12 C&M Trusts
• Each site will establish a footprint steering group and use a common reporting framework and will be accountable to the PLPN steering group
• All eTCP meetings with project partners fall under the same governance arrangements
Electronic Transfer of Care to Pharmacy (eTCP)
System provider selection • Due to the unique nature of this project there are
only two system providers that can currently deliver this service specification.
• The two are Webstar and Pinnacle Health.• Each system provider shall enter into a SLA with
the IA with a commitment to meet the outline service as described in this proposal within an agreed financial envelope.
Any Questions?
Hassan Argomandkhah FRPharmS IPrescChair of Pharmacy Local Professional Network NHS England (Merseyside)
Electronic Transfer of Care to Pharmacy (eTCP)