We provided a tailored package of strategic and operational support to a newly formed pharmacy team at a primary care network, helping them increase the rate of structured medication reviews.

Background

When a newly established Primary Care Network (PCN) covering thirteen GP Practices in the Northwest of England approached NHS Midlands and Lancashire (NHS ML) for strategic and clinical support, NHS ML responded by developing a tailored package of year-long support that included clinical supervision, joined-up work planning and strategy development. NHS ML aimed to ensure the PCN achieved its Network Contract Direct Enhanced Services (DES) and Investment & Impact Fund (IIF) targets.

Action

An initial workforce survey highlighted learning needs. We provided senior pharmacist expertise in workforce development, outcome reporting methods, training and clinical supervision:

• Training and clinical supervision – monthly sessions with supported discussions forums to review any clinical issues
• Expert support and peer review – monthly one to one’s with senior NHS ML lead pharmacists and individual development plans with agreed objectives for the next 12 months
• Strategy and workplan development – structured workplan developed in line with DES and IIF requirements
• Operational support – a suite of standardised clinical system searches and tools were shared with the team to help them to identify patients for priority Structured Medication Reviews (SMRs).

Impact

The tailored package of support we developed included training on SMRs, the Community Pharmacy Consultation Service, Antimicrobial Stewardship, Area Prescribing Committees (APCs), Chronic pain, Opioids and medicines related safety. Local speakers were brought in to provide expert advice including the North West regional antimicrobial resistance lead, the local Controlled Drug Accountable Officer and the pan Mersey APC Secretariat.

Clinical supervision sessions provided a safe space for team discussions and interaction with experienced leads for mentorship and support. Group discussions often focussed on how work could be standardised. The team have now successfully implemented a scalable, hub-based model and operate as part of an agreed workplan and wider primary care strategy. Six extended training & clinical supervision sessions were held for the PCN Pharmacy team with a forum for team discussions, with mentorship and expertise provided by experienced NHS ML leads. This was complemented by monthly one to ones for all six clinical staff within the PCN.

Outcomes

• The PCN rated the NHS ML sessions as excellent, delivering improved pharmacist competencies through the use of NHS ML resources to meet their learning needs.
• The PCN progressed from 41 to 437 SMRs during the year with an additional 2,462 medication reviews undertaken.

“I really value [MLCSU’s] input and support. I would definitely like to see them support us for at least the next year.

“I enjoy the clinical supervision sessions, and really value the 1:1 support with the team. I hope that our Pharmacy Team relationship with NHS ML can continue as they support the direction of our growing and developing team.”

Pharmacist, St Helens South Primary Care Network

“I would like to say thank you to NHS ML for the service provided to date. I have seen an improvement in the pharmacy team and would like to continue on this trajectory.”

Dr Chibuzo Orjiekwe, St Helens South Primary Care Network