What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

The COVID-19 pandemic required rapid and unprecedented changes to procedures across the system. Community pharmacy was an important NHS service. Many of the population became vulnerable due to freedom of movement restrictions. Those with pre-existing medical conditions often require a consistent supply of their medications, many of which due to COVID-19, suddenly required their medications and healthcare advice and information to be provided differently to safeguard them. This was achieved by:

• Collaboration across Primary Care Networks (PCNs) so the patient is seen in the right place at the right time
• Alignment with the Pharmacy Quality Scheme, agreed as part of the response and recovery from COVID-19 – https://psnc.org.uk/services-commissioning/pharmacy-quality-scheme/
  Supporting GPs to see more seriously unwell and move acute self-limiting conditions to community pharmacy
• Triaging patients through the pharmacy and escalating to GPs if required
• Working together to deliver online patient consultations where appropriate

What does your project aim to achieve?

General Practice is frequently a first-point of call for people with acute healthcare needs. Pharmacists demonstrated during COVID-19 they are a valuable first contact for patients.

90% of community pharmacists time is currently spent dispensing medicines. The vision is to free pharmacists so they can spend over 50% of their time consulting with patients; without damaging the ability to accurately and safely dispense medicines in a timely fashion.

Hypothesis:
If pharmacists spend more time consulting with patients, less patients are visiting their GPs and possibly getting quicker input or earlier clinical triage. This aligns with the new five-year pharmacy contract and the aim for patients to see pharmacists first, reducing pressure elsewhere in the NHS system

Proposed Solution:
Remodel the pharmacist’s working day to identify tasks only the pharmacist can undertake. All other colleagues fill in the gaps, freeing up the pharmacist. Quality Improvement (QI) approaches will be central to this solution.

How will the project be delivered?

The Project will be carried out in collaboration between the West of England AHSN and Avon Local Pharmaceutical Committee (LPC). If successful, the project funding will be used to engage a change management expert to lead and support the LPC and community pharmacy colleagues with processes to support service re-modelling.  The West of England AHSN will provide QI expertise and project management support to the project.  The intention is to engage up to ten community pharmacies to participate in this project and will be delivered through:

• Frequent inter-organisation project planning and review meetings
• Face-to-face group meetings (hosted on virtual platforms if the COVID-19 restrictions prevent face-to-face)
• 121 training in the pharmacy
• QI methodologies to support pharmacists remodel their working day
• Online training sessions in QI methodologies
• Sharing best practice across the pilot sites and PCNs
• Publication and dissemination of the project findings will be carried out collaboratively between the two organisations.

How is your project going to share learning?

• The learning from the 10 project pharmacies will be shared and replicated across the Avon LPC geographic footprint (open to all 225 pharmacies) during the year
• The project will have a dedicated page on the West of England AHSN and Avon LPC website with the intention of sharing multi-media resources for wider adoption and spread i.e. recorded webinars, QI resource templates etc.
• Learning will be shared through member organisations of West of England AHSNs Medicines Safety Steering Group, covering three STP regions in the West of England.
• The learning will also be shared, where appropriate, with the National AHSN Medicines Optimisation Network and the South West Regional Pharmacy Network.
• The project learning could have national implications and shared across pharmacy networks across the county
• The West of England AHSN host an evidence repository for small research projects; the findings will also be shared on this platform.