Briefing Note: Specialist Pharmacy Service (SPS)
All England Chief Pharmacists’ Group (AECP), 6th October 2017
Dr Justine Scanlan
- Specialist Pharmacy Service (SPS)
1.1Service Overview & Specification Update
Previous discussions have outlined the requirement for a collaborative approach to the delivery of SPS and this remains a key priority in bringing this together as a single national service for England.
The proposal is to create a virtual SPS hub within each of the proposed regions in line with an agreed national specification. Each of the 4 SPS functional groups of medicines information (MI), procurement, quality assurance (QA) and medicines use and safety (MUS) have produced individual outline specifications for service provision. In line with these specifications, the functional areas of QA, MI and MUS have produced annual reports on outcomes for the year 2016/17. Specific key performance indicators to measure the degree of service delivery have been developed. The mechanism of the commissioning process which will agree and monitor the associated specifications is to be finalised in due course.
- Management and Oversight
The structure as proposed in The Review of the Specialist Pharmacy Services in England (May 2014) is now in place. The assistant head posts have been taken from the existing service structure as outlined in the report with the titles of these positions updated to reflect the current NHS landscape. The management structure for SPS is outline in figure 1.
Figure 1: Management Structure for SPS
Oversight of SPS has been written into the terms of reference of the Medicines Optimisation Oversight Group which is formed to oversee the development and delivery of the Regional Medicines Optimisation Committees.
2.2Finance
SPS has been subject to equal scrutiny within NHSE for cost improvement payment (CIP). The proposed CIP level within NHSE is 10%. Papers have been put forward round to ensure ongoing funding at the existing level and without a CIP. To date the service has been successful in maintaining the current level of budget. Rationale for this is taken from the safety case for SPS as outlined in the review paper of May, 2014 and thedirect support SPS will give to the Regional Medicines Optimisation Committees. It should be noted that SPS providesthe infrastructure support to these committees with the MI service being integral to this.
- Functional Groups Key Priorities
3.1Medicines Information
A hub and spoke model for MI in line with the proposals in the review paper has been developed and the service is working towards operationalizing this from April 2018. The core service deliverables for MI are outlined in Table 1.
Table 1: Core Service Deliverables for Medicines Information Service in England
RMOC1 national coordinator plus 4 hub structure / Clinical enquiry answering
1 national coordinator plus 3 hub structure / Information and Resources
Newcastle, Leicester, Bristol and Northwick Park Centres to provide the secretariat to the RMOCs
Newcastle Centre to provide the secretariat to the Medicines Optimisation Priorities Panel (MOPP) which supports the workplan for the RMOCs.
Liverpool Unit to provide the new drug Horizon Scanning and Prescribing Outlook publication
All to develop the clinical governance standards for RMOC activities / 4 centres led by the Southampton Centre to provide the regional service for enquiry answering
One single number which directs callers to their nearest centre for enquiries.
MiDatabank development support to enable sharing of national enquiries
Development of a national English standard for enquiry answering (with UKMI). To include a standardised method of enquiry classification.
Clinical Governance standards for enquiry answering activities (includes Incident Reporting in Medicines Information Services (IRMIS)) and QA of regional enquiry answering centres / Product Safety Risk assessments
Lactation Data
Patent Databases
Fridge Data Base
Medicines Compliance Aid information
Drug monitoring in primary care
High risk injectables
Loading doses
Medicines Q&As
Omitted & delayed doses
Clinical Governance standards for information and resources activities
NICE Bites
INFRASTRUCTURE SUPPORT Website development and co-ordination, medicines shortages content. MSO support (WebEx, work to enhance / develop national guidance in support of alerts and local meetings
In addition to this, SPS has commissioned a piece of work to review the current arrangements for the delivery of the injectable medicines guide. This work will confirm ownership of the guide and determine the appropriate funding model to ensure the long term sustainability of this important resource for the NHS.
3.2Quality Assurance
Work has been undertaken which considers the variation in the delivery of the EL 97(52) Audit programme across England. A revised procedure has been put together which standardises the reporting mechanism. Trust reports are collated centrally by the Head of SPS, which enables an overview of gives a centralised mechanism of reporting the status of aseptic units operating under section 10 exemptions.
An appointment of a Regional QA specialist to the Yorkshire and the Humber footprint following a vacancy of some years was achieved earlier this year. Linda Hardy has been appointed to this post.
Alison Beaney retired as RQA for the NE and the vacant position has been filled by Anne Black who brings considerable experience in the Advanced Technology Medicinal Products (ATMPs).
Alison Beaney will continue to support SPS as the subject matter expert for NHSI’s review of Aseptic Services.
3.3Procurement
As highlighted at the last meeting of the AECP, SPS has commissioned a piece of work to scope the requirement for a centralised shortages resource to be hosted on the SPS website. This piece of work is underway and a plan of implementation will be in place by the end of this year.
There have been a number of key discussions undertaken over the summer with the development of some documents for chief pharmacists including a position statement on non-disclosure agreements (see separate paper), and a way forward for the generic tendering model.
3.4Medicines Use and Safety
Discussions are under way with the Patient Safety team at NHSI to consolidate the work of MUS to develop the work with the medication safety officer’s network and the WHO proposals around medication error. Recruitment has been difficult for this team and chief pharmacists are asked to encourage their staff to apply for the posts when advertised. They can be located in any base hospital across England and are appointed on a secondment basis.