Leading integrated pharmacy and medicines optimisation Guidance for ICSs and STPs on transformation and improvement opportunities to benefit patients through integrated pharmacy and medicines optimisation
September 2020
1 | Contents
Contents
Foreword ........................................................................................ 2
Introduction .................................................................................... 3
Building future clinical pharmacy services ..................................... 5
Annex A: System leadership for pharmacy .................................. 10
Annex B: Priorities for workforce, medicines value and safety ..... 15
Annex C: IPMO transformation plan ............................................ 19
2 | Foreword
Foreword
Alongside the deeply challenging experiences of the COVID-19 pandemic, the NHS
has found a greater need for and openness to teamwork across professional,
organisational and system boundaries. It is striking to hear the many reports of
progress health and social care services have made in bringing about positive
changes to practice, pathways or systems through working as teams in the widest
sense during the last few months.
It is paramount that we keep up the momentum as we move to ‘system by default’
working and ‘lock in’ the beneficial changes that we’ve collectively brought about.
This includes backing local initiative and flexibility; enhanced local system working;
strong clinical leadership; and the rapid scaling of new technology-enabled service
delivery.
In pharmacy, there have been many examples of innovative practice and
collaborative working; something we must all strive to retain. It feels positive that
pharmacy teams have been able to make change happen nationally, regionally and
locally in collaboration with health and social care colleagues.
This guidance is about how to build on this refreshing teamwork more
systematically to help improve and transform pharmacy and medicines optimisation.
Building on the expansion of the pharmacy workforce into primary care networks to
capture the innovation and ensure we use the resources available to us to address
health inequalities and improve health outcomes for people who use medicines and
pharmacy services. Collaborative leadership at system level will be vital in the
months and years ahead as we learn to live with and beyond COVID-19. Pharmacy
leaders, professionals and teams must be particularly attentive to the stark health
inequalities that have been exposed again, in particular with respect to Black, Asian
and minority ethnic people and deprived communities.
Much good work is underway including the approaches to collaborative system
leadership we’ve been exploring with the support of the Pharmacy Integration Fund.
This guidance contains the learning and coincides with the appointment of Regional
Chief Pharmacist colleagues – bringing the full complement to seven – who will
lead this work.
I’m grateful to our pilot sites and teams up and down the country for all they have
done to spearhead this work.
Dr Keith Ridge CBE, Chief Pharmaceutical Officer for England
3 | Introduction
Introduction
1. The NHS Operational Planning and Contracting Guidance 2020/21 sets out a
timetable for every part of the country to move towards becoming an Integrated
Care System (ICS) by April 2021. Local systems are asked to use their system-
wide strategic plans developed in 2019 to deliver the commitments of the NHS
Long Term Plan and achieve a ‘system by default’ approach to delivering care.
2. ICSs will undertake two core roles: system transformation and collective
management of system performance. This document sets out the principles
and approach to the development of a pharmacy and medicines optimisation
transformation plan in each ICS and a system-wide pharmacy professional
leadership model to bring about collective management of system performance.
3. The NHS pharmacy profession’s collaborative, system-wide working established
in response to the COVID-19 pandemic has accelerated the regional and local
framework needed to secure these changes for the future. The deliberate
tripartite working bringing together pharmacy professionals across secondary,
primary and community care has stimulated local innovation recognising that the
urgent need of the population requires valued solutions that are integrated
across health and social care regardless of the setting.
4. Implementing the ambition for integrated care detailed in the NHS Long Term
Plan requires the continued development of an integrated pharmacy workforce
at all levels to maximise the clinical contribution of the third largest workforce
group and ensure the safe use of and best value for money from the more than
£18 billion1 the NHS invests in medicines each year.
5. The pharmacy and medicines optimisation plans will be co-ordinated and
supported by the NHS England and NHS Improvement regional chief
pharmacists and pharmacy leadership teams within the seven English regions to
ensure consistency in the plans and coherence in the use of pan regional
1 https://digital.nhs.uk/data-and-information/publications/statistical/prescribing-costs-in-hospitals-and-the-community/2018-2019
4 | Introduction
resources such as education and training, medicines information services, the
recovery planning in response to COVID-19, and medicines procurement.
5 | Building future clinical pharmacy services
Building future clinical pharmacy services
What are our ambitions for pharmacy and medicines optimisation under the NHS Long Term Plan?
6. Medicines remain the most common therapeutic intervention in the NHS, with
48% of adults having taken a prescription medicine each week.2 As ICSs
develop, it is essential therefore that pharmacy workforce and medicines
optimisation are considered from the outset. The scope and scale of the
challenges mean that we need to transform the way that services are both
developed and delivered. This will require effective planning and strong and
effective local leadership to ensure that services are appropriately resourced, fit-
for-purpose, resilient and sustainable.
7. Post COVID-19, the NHS has been asked to take this opportunity to ‘lock in’
beneficial changes that have been brought about. This includes local initiatives
and flexibility; enhanced local system working; strong clinical leadership; flexible
and remote working where appropriate; and rapid scaling of new technology-
enabled service delivery options such as digital consultations. Patients should
only be required to attend hospital where clinically necessary meaning staff
must continue to work flexibly to see or support patients through remote or
virtual consultations for the foreseeable future. Pharmacy has a key role to play
in safe and effective services, ensuring the public get the best from their
medicines, and in improving the public’s health.
Pharmacy professional workforce
8. Our vision builds on the ambitions of the NHS Long Term Plan and earlier work
delivered through the Five Year Forward View vanguards and new care models
which introduced new roles such as clinical pharmacists in general practice,
pharmacists in integrated urgent care (IUC) pathways and pharmacists and
pharmacy technicians in care homes. Pharmacist prescribers, advanced
2 https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/health-survey-for-england-2016
6 | Building future clinical pharmacy services
practice and consultant pharmacists work autonomously with patients and within
multidisciplinary teams to treat and support patients across health and care
settings. These roles need to be developed at scale across systems. Where
they do exist evidence of their success has been demonstrated by the COVID-
19 response and ensured that these roles have now become firmly established
and are the basis for how services will operate in the ICS and the newly
established primary care networks (PCNs).
9. Pharmacy and medicines optimisation will be critical in supporting the expected
increase in the need for community and mental health services to deal with post
COVID-19 complications and rehabilitation including the increase in long-term
conditions and the need to support patients to be cared for in their own homes.
It will be essential to upskill pharmacy technicians and pharmacists to take on
wider roles to ensure safe medicines practice when there may be stretched
resources and workforce pressures for other healthcare professionals.
10. The pharmacy workforce is the third largest single staff group in the NHS.
Alongside clinical patient-facing roles, this specialist workforce also ensures a
resilient medicine supply chain (including procurement, manufacture and
compounding of aseptic products, quality assurance and medicines information
services) and supports national strategic priorities such as antimicrobial
stewardship and medicines safety.
11. In January 2019, the General Pharmaceutical Council (GPhC) consulted on new
initial education and training (IE&T) outcomes for pharmacists. The proposed
outcomes were broadly accepted and the reforms are now being implemented,
including the provision of greater opportunities for workplace experience in
clinical settings. The NHS needs to introduce a standard foundation training
programme as a priority to support pharmacists in the early stages of their
careers through a structured work-based approach that embeds knowledge,
skills, abilities, values, attitudes and beliefs in their practice. As the new GPhC
IE&T standards are implemented, then it is proposed to orientate IE&T
requirements to provide registered, independent prescribing pharmacists at the
end of the five-year period. As stated in the People Plan, this would include the
replacement of the current pre-registration pharmacist year by a new, one-year
foundation curriculum, which, led by the GPhC, could commence from
September 2021, subject to consultation, if all the relevant organisations work in
partnership to deliver to this timescale.
7 | Building future clinical pharmacy services
12. Pharmacists remain the guardians of safe, effective and legal use of medicines.
The UK has extremely high standards of safety in the production and supply of
medicines with strict legal and regulatory frameworks. Expertise in this area
should not be taken for granted, although the primary function of the pharmacy
workforce will increasingly be the safe and effective use of medicines and
reducing health inequalities. The scope of medicines optimisation is widening
from the historical emphasis on prescribing and medicines supply to holistic,
integrated, person-centred services including deprescribing and personalised
care. The combination of clinical, scientific, operational design, technical and
engineering skills that are unique to the pharmacy professional provide the
strong foundations for ensuring patients will benefit from the many new
innovations in medicines. Annex B sets out key priorities for the pharmacy
professional workforce.
Medicines safety and value
13. The Overprescribing Review into problematic polypharmacy commissioned in
December 2018 by the Secretary of State for Health is expected to report later
this year. The initial rapid evidence review undertaken by the EEPRU
highlighted that: “Taking many medicines is related to having a greater risk of
death. This might be because people who have poorer health take more
medicines and, due to their poorer health, are also at greater risk of death”.
There are specific actions aimed at reducing that risk that require strong
pharmacy professional leadership to implement across systems. Ensuring
medicines safety and optimising use, while delivering good value for money for
the NHS are essential.
14. Similarly, the report published by Public Health England about addiction to
prescribed medicines highlights the harm that some medicines can cause if they
are not initiated, reviewed and used appropriately. The report recommendations
expect clinical pharmacists to play a major part in supporting patients to become
less dependent on these medicines and to make sure they are only initiated
when really needed.
15. Baroness Cumberlege’s Independent Medicines and Medical Devices Safety
Review report First Do No Harm highlights how sodium valproate, an effective
antiepileptic medicine, but with a known high level of teratogenicity, continues to
cause harm to unborn children, leaving them with lifelong disabilities. Clinical
8 | Building future clinical pharmacy services
pharmacists will again play an important role in helping to minimise its use, and
when it is used to make sure it is prescribed and used safely and reviewed
regularly.
16. In key areas specific medicines use is expected to rise, as a result of the
COVID-19 pandemic and as the NHS Long Term Plan commitments for cancer,
respiratory and cardiovascular disease and mental health services are
developed. In other areas, the reduction of antimicrobial prescribing requires
local clinical leadership to bring about change through collaborative
multidisciplinary working as part of the Antimicrobial Resistance National Action
Plan. This will be particularly important while there is no vaccine available for
COVID-19. A renewed emphasis on de-prescribing and avoiding overprescribing
means more structured medication reviews (SMRs) for those patients taking
several medicines for multiple conditions. Sharing information – both personal
and virtual – between care settings before starting, changing or stopping
medicines becomes ever more important.
17. The operating model for the regional medicines optimisation committees
(RMOCs) outlines how the committees work at national and regional level to
help patients get the most from their medicines, while ensuring taxpayers get
the best value from the annual medicines bill. The necessary leadership through
national and regional oversight is aimed at supporting and optimising local
prescribing practice and reduce unwarranted variation. The role of the RMOCs
is to promote collaboration and help reduce duplication on issues related to
medicines across the healthcare system.
18. STP/ICS financial planning will need to take account of how the medicines
budget can be balanced across the system while acknowledging that the legal
responsibilities still sit within secondary and primary care commissioning.
Savings and efficiencies will need to be built into system plans. The COVID-19
pandemic has highlighted the significant pharmaceutical expertise required to
inform future service design and financial modelling to support a secure
medicine supply chain and deliver safe systems. Pharmacy leadership will be
essential as part of the emergency preparedness, response and resilience
arrangements at STP/ICS level to manage medicines supply and pharmacy
services during incidents such as the pandemic and in preparation for EU Exit.
9 | Building future clinical pharmacy services
19. The Medicines Safety Improvement Programme (MedSIP) has established a
number of key initiatives to drive system wide medicines safety and gather
opinion about the most important priorities for: high risk drugs; high risk parts of
the medicines use process as set out by the short life working group on
medication errors and to protect patients with the highest vulnerabilities.
20. System-wide metrics will be an essential tool to facilitate collective management
of system performance. A move towards measuring health outcomes needs to
be built into pathways and addressing prescribing priorities for funding. The
system priorities for delivering medicines safety and value are set out in Annex
B.
10 | Annex A: System leadership for pharmacy
Annex A: System leadership for pharmacy
Learning from the integrating pharmacy and medicines optimisation (IPMO) pilots
1. Since September 2018, pilot sites in each of the seven NHS England and
NHS Improvement regions have been working on developing a Pharmacy and
Medicines Optimisation Framework within an existing STP/ICS footprint. The
focus for the work has been to develop the leadership model, workforce
planning tools and medicine optimisation measures that can be used to
ensure efficient use of medicines in line with national priorities and NHS Long
Term Plan commitments. An important driver has been to set up and test
models of leadership and integrated governance for pharmacy and medicines
optimisation. The use of pharmacy and medicines optimisation metrics has
been identified as a priority for each ICS to develop and agree to inform
performance management recognising the expertise of professional pharmacy
leadership to establish and deliver them.
2. Through a series of national action learning sets, local workshops and access
to organisational development support, the seven pilots have identified the
scope and key responsibilities for an ICS pharmacy system leadership model.
The pilot evaluation Phase 1 and 2 reports are available from NHS Futures
collaboration platform.3
3. The overriding message from the evaluation is that the success and progress
of local medicines optimisation programmes has been dependent on the
existence of a named system-wide lead supported by a collaborative senior
leadership group and where the pharmacy professional lead role sits in the
STP/ICS structure and the strength of their pharmacy and wider system
relationships and consequent ability to influence and engage within and
across the system. The key factors that influenced the ability for systems to
deliver pharmacy and medicines optimisation were identified as the availability
3 South Central and West Commissioning Support Unit, Leadership development evaluation for the IPMO pilots; Phase 1 report, March 2019 and Phase 2 report January 2020.
11 | Annex A: System leadership for pharmacy
of a professional and sustainable workforce, the system background maturity,
system challenges, governance structures and the influence of and
engagement with the leadership model.
4. The system maturity index for integrated care systems published in July 2019
provides the reference to describe system maturity. The pilot STP/ICS
localities were either described as emerging or developing in their maturity.
The most mature pilot sites have been able to demonstrate the most progress
in securing a pharmacy and medicines optimisation plan that was developed
through a collaborative approach and a process of collective decision making
led by a professional pharmacy lead. Case studies for each pilot are available
from the NHS Futures platform.
5. The key factors identified by the pilots that influenced the delivery of an
integrated system-wide pharmacy and medicines optimisation programme are
set out in Table 1.
Table 1: Key factors for achieving a system-wide pharmacy and medicines optimisation model identified by the IPMO pilots
Influencing factors of system-wide pharmacy and medicine optimisation
Workforce • A single system-wide workforce vision that has been communicated and secures engagement with commitment to review and re-shape as the system matures;
• Establishment of a named pharmacy workforce workstream lead to ensure momentum in implementation of the strategy;
• Establishment of cross -sector working for individuals and teams;
• Access to system leadership development and training for the system leader and leadership team.
System background
• Commitment and support from the host organisation for the pharmacy leadership role;
• Existing system maturity within integrated care providers/places (ICPs) and across sectors;
• Existing system leadership, partnerships and change capability;
• Existing system architecture and strong financial and management planning.
System challenges
• Collaboration and collective decision making perceived as a positive enabler to finding solutions to system-wide operational problems;
• Agreed metrics for programmes of work essential to clarify objectives and secure stakeholder support;
• Merging available funding to support integrated delivery models and creating new funding models to support new ways of working;
• Using “business as usual” meetings and projects to develop system-wide collaboration and ways of working and move to
12 | Annex A: System leadership for pharmacy
formal structured processes to increase pace in decision making across interfaces/sectors.
Governance structure
• Securing executive level sponsorship and senior level support for the pharmacy and medicines optimisation programme;
• Creating links through to finance, commissioning, quality and clinical workstreams as a priority as the system matures;
• Ensuring the meetings supporting the governance structure include transparent decision making and not just information sharing;
• Defining workstreams with named pharmacy leads that can be linked to accountable leaders within the system;
• Investing in the pharmacy leadership team with support and training in system thinking;
• Piloting workstreams and testing structures through an iterative process to inform an effective and efficient system-wide leadership model;
• Reducing duplication and consolidate governance across the system as it matures.
Influence and engagement
• Access to professional communications expertise to inform strategic plan and ensure integration with the whole system approach;
• Focussing on initial relationship building across all sectors and build consensus on the priorities for each identified workstream;
• Utilising existing communications and stakeholder events for the whole system to articulate the pharmacy and medicines optimisation priorities;
• Enlisting support from regional and national pharmacy leadership to support the delivery of the transformation plan.
6. As localities move towards a ‘system by default’ during the period of recovery
and restoration as a result of the COVID-19 pandemic, it is proposed that
each STP/ICS establishes a pharmacy and medicines optimisation
governance framework using the learning from the IPMO pilots and the
COVID-19 tripartite leadership adopting a system pharmacy leadership model.
This leadership model is expected to have collective responsibility through
senior decision makers across the system and take responsibility for
developing an ICS transformation plan for pharmacy and medicines
optimisation. The leadership group will be drawn from senior pharmacy
leaders across acute, mental health and community services NHS Trusts,
CCGs and community pharmacy. Senior pharmacists from PCNs such as
those in clinical director roles or taking a leadership role within a GP
federation may also form part of this group as the system matures.
7. Through the regional pharmacy and medicines optimisation team, support will
be provided in developing the plan and in a coordinating role between national
13 | Annex A: System leadership for pharmacy
programmes including the Medicines Value Programme, NHS Right Care and
Getting It Right First Time medicines optimisation workstream. Their focus will
be to optimise the contribution clinical pharmacy plays in improving clinical
productivity with respect to medication safety, reduction in medication errors,
reduction in prescribing of low value medicines and increasing the use of
technology to drive best practice and remove duplication. The RMOCs,
regional directors of primary care, NHS Specialist Pharmacy Services, Health
Education England pharmacy deans and regional medicines procurement
leads will be able to co-ordinate and provide support across their region. Other
organisations such as the academic health science networks (AHSNs), NHS
Digital, NHSX and Public Health England, as well as professional bodies and
regulators, are national resources able to support system working.
8. Once the group is established it is expected that where affordable, systems
should use the transformation plan to establish an ICS chief pharmacist role
to take forward a programme of work to support the integration of the
pharmacy workforce and deliver medicines optimisation across the system.
We will work with systems to identify an appropriate funding resource where
useful. It is anticipated the leadership group will also identify workstream leads
from across the ICS to specifically take a leadership role for priority areas,
including workforce training and education; clinical pharmacy; digital
medicines, safety and governance; improvement; aseptic and specialist
medicines. The workstreams will develop over time as the ICS matures and
needs of the system develop.
9. It is anticipated that the ICS chief pharmacist role and workstream leads will
be provider-based or hosted through the commissioning CCG aligned with the
ICS boundaries. Consideration may be given to the role being jointly shared to
achieve the senior leadership required across a whole system. The ICS
pharmacy leadership group will work with place-based clinical and
multidisciplinary teams to support the integration of pharmacy and medicines
optimisation across health and social care.
14 | Annex A: System leadership for pharmacy
Figure 1: Example ICS pharmacy leadership system leadership model within the system4
4 Specific examples of governance structures developed by the pilots are available through the NHS Futures website.
15 | Annex B: Priorities for workforce, medicines value and safety
Annex B: Priorities for workforce, medicines value and safety
System priorities for the pharmacy and medicines optimisation workforce
1. The creation of ICS chief pharmacist roles to provide senior system-wide
leadership and co-ordination of resources for the delivery and implementation
of integrated pharmacy and medicines optimisation plans and services across
the local health system.
2. Develop cross-system leadership teams (eg senior managers network
comprising of community services, community pharmacy, secondary and
primary care).
3. Provide a focus for pharmacy workforce planning and deployment in line with
the workforce operational model emerging from the Interim NHS People Plan.
4. Support the development and delivery of workplace-based foundation training
across all settings for all pharmacists, replacing the existing pre-registration
year, subject to consultation, that equips them to work clinically across
healthcare settings while leading to independent prescribing pharmacists on
registration.
5. Pharmacy technicians to have access to placed-based pre-registration training
across secondary, community and primary care leading to foundation
development to be able to provide a pipeline for a sustainable pharmacy
technician workforce across PCNs, community pharmacy and hospital trusts.
6. Support access to education and training resources to enable the pharmacy
workforce to use digital tools such as robotics, health related apps and
develop skills in health informatics as highlighted by the Topol Review.
7. The pharmacy workforce confidently using shared decision-making to agree
with patients that they need prescribed medicines, through careful initiation,
16 | Annex B: Priorities for workforce, medicines value and safety
monitoring and review, and through offering alternative interventions, such as
mental health support or social prescribing.
8. Pharmacists trained to consultant level and supporting system-wide delivery of
evidenced-based, clinical and cost-effective patient care. In addition,
increasing advanced clinical practice and consultant pharmacist roles across
care settings to provide clinical leadership across systems.
9. By 2023/24 new clinical pharmacists in each primary care network based in
general practice and working directly with patients so that each PCN will have
access to a team of clinical pharmacists building on the initial roles already in
place. These roles will be working as part of a multidisciplinary team along
with pharmacy technicians, care home pharmacy teams, integrated urgent
care clinical pharmacists, community services and mental health pharmacy
teams as well as community pharmacy and acute care:
i) delivering structured medication reviews for key group of patients to
improve quality of care, reduce medicines related harm and improve
efficiency (eg less medicines waste)
ii) supporting medicines optimisation specifically through reducing addiction
to prescribed medicines including opiates, reducing overprescribing and
polypharmacy, and improving clinical research with medicines in primary
care.
10. Community pharmacy as the first port of call for self-care, prevention and
minor illness consultation, working closely with general practices and within
primary care networks, and always working to reduce health inequalities,
including in people from Black, Asian and minority ethnic communities
11. Additional specialist mental health pharmacists across all local areas to
support delivery of the Mental Health Implementation Plan.
12. Integration of clinical pharmacists within community mental health teams
supporting the delivery of community mental health for adults and older adults.
13. Pharmaceutical public health pharmacists working within local authorities and
across the system to plan and deliver population health approaches to
17 | Annex B: Priorities for workforce, medicines value and safety
medicines optimisation and pharmacy services, and linking into emergency
planning, resilience and response activities.
14. Pharmacists working within newly forming NHS Genomic Medicine Service
(GMS) Alliances and across the system to deliver pharmacy workforce
transformation and embed genomics and personalised medicine into clinical
care in the form of pharmacogenomics, gene therapies and targeted
treatments for cancer and rare disease.
15. Making health services and clinical research across all sectors a priority for
the pharmacy workforce, including through clinical academic careers
supported by the National Institute for Health Research.
System priorities for medicines value and safety
16. Deliver pharmaceutical advice to senior ICS colleagues, including establishing
and leading an ICS medicines optimisation committee that will link through to
the regional medicines optimisation committee, reducing the duplication of
work created by local area prescribing committees.
17. Consolidate and rationalise vital NHS pharmacy support functions such as
procurement, medicines governance, education and training, medicines
information services and aseptic production to free pharmacist and pharmacy
technician time for patient-facing roles.
18. Link robustly to regional and national priorities through the regional chief
pharmacists, and through them the regional medicines optimisation
committees, and onwards to the Office of the Chief Pharmaceutical Officer
and national policy directors.
i) Deliver the government five-year anti-microbial strategy across care
settings to ensure antimicrobial stewardship across systems.
ii) Support and delver against the national medicines safety agenda.
iii) Extend the STOMP/STAMP reviews of medicines use for people with
learning disability and mental illness.
18 | Annex B: Priorities for workforce, medicines value and safety
iv) Increase the resilience, standardisation and efficiency of the NHS
medicines supply chain for all medicines including elective surgery,
aseptically produced products particularly for critical care and cancer
treatments.
v) Develop system wide metrics that focus on pathways and prescribing that
demonstrate the impact on health outcomes
19. Use population health approaches to promote medicines safety and reduce
medication errors, over medication and waste.
i) Use population data to identify those patients who would benefit most
from targeted medicines, structured medicines use reviews and support
and prevention services.
ii) Develop meaningful ICS/STP pharmacy and medicines metrics through
the use of cross-system datasets, digital medicines systems including
integrated electronic prescribing systems and electronic rostering
iii) Support the implementation of the community pharmacy Discharge
Medicines Service, building on the AHSN Transfers of Care Around
Medicines (TCAM) programme to ensure patients are prioritised for
support with their medicines at discharge from hospital.
20. Provide professional leadership for the pharmacy quality scheme and clinical
services delivered through the Community Pharmacy Contractual Framework
2019 to 2024 (eg NHS Community Pharmacist Consultation Service and the
New Medicines Service).
19 | Annex C: IPMO transformation plan
Annex C: IPMO transformation plan
IPMO transformation plan timeline
1. Indicative timeline showing key dates in the IPMO planning process is shown
below:
2. Each STP/ICS is asked to deliver an IPMO transformation plan setting out
how the opportunities of collaboration and transformation across the local
health system can support the creation of a flexible and sustainable workforce,
supporting patients across care settings and into their homes. It will focus
explicitly on the need to develop professional pharmacy leadership and the
local and regional infrastructure for medicines optimisation and pharmacy in
health and social care systems.
3. The aim is to develop a draft plan by November 2020 building on strategic
system plans for the STP/ICS as they come together to serve communities
through a partnership board, using existing work in the hospital pharmacy
transformation programmes and the learning from the IPMO pilots in the
seven ICS pilot areas.
4. A final IPMO transformation plan should be submitted to the STP/ICS board
by February 2021. Key elements of the IPMO transformation plan include:
September
2020
Guidance issued
Webinars for pharmacy leaders
November
2020
Draft plans submitted to
NHSE&I Regional Pharmacy leadership team for feedback
Nov 2020-Jan 2021
Feedback on draft plans
Revise plans if necessary
February 2021
IPMO plan presented to
STP/ICS board with BC for the
ICS Chief Pharmacist
From April 2021
Final IPMO transformation
plans implemented
20 | Annex C: IPMO transformation plan
(i) a business case to create an ICS chief pharmacist role that would attract
highly experienced staff to provide professional leadership on behalf of all
the NHS organisations and supporting the delivery of NHS commissioned
services within each geographic footprint to deliver the IPMO transformation
plan from April 2021 as part of the ICS plans for workforce, efficiency and
effectiveness
(ii) NHS Long Term Plan pharmacy and medicines optimisation priorities
incorporating the COVID-19 restoration and recovery priorities for the ICS
explicitly linked to approved strategic system plans and balanced to ensure
that quality and finance are given equal prominence
(iii) a credible and costed ICS pharmacy workforce strategy incorporating a
cross system governance framework
(iv) quality indicators to ensure that health outcomes and quality improvements
can be monitored and delivered with respect to medicines value and safety.
An action planning tool and resources will be shared through the NHS
England and NHS Improvement regional pharmacy leadership team to
support development of the plan and coordinating support through the
regional directors of primary care, medicines procurement leads, and Health
Education England pharmacy deans within their geographies.
NHS England and NHS Improvement
Skipton House 80 London Road London SE1 6LH This publication can be made available in a number of other formats on request.
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