Better Sooner More Convenient Primary Care - New Zealand Doctor
Better Sooner More Convenient Primary Care - New Zealand Doctor Better Sooner More Convenient Primary Care - New Zealand Doctor
8 Effect on inequalities It is anticipated that more effective and efficient clinical pathways in both laboratory referred services and pharmacy services will lead to a reduction in resource wastage (both time and money) enabling more attention and resources to identify and target those most in need in order meet their health needs in a better sooner more convenient way. 9 Evidence for this initiative In 2009 West Coast Primary Health Organisation commissioned a report 51 to investigate ways in which the PHO could, and community pharmacies would, work together more closely to advance its goal of achieving better health for people on the West Coast. This report identified the following from evidence in the literature: “Medication has the ability to enhance the quality of life and reduce the manifestations of diseases that would normally lead to suffering and premature death. There is also a growing awareness of the potential for these same drugs to cause a significant amount of morbidity and mortality. Underpinning nearly all innovative, cognitive services that might be provided by pharmacists is the issue of drug-related morbidity and mortality. Drug-related morbidity and mortality represents a serious medical problem that requires expert interdisciplinary attention. Unrecognised and unresolved drug therapy problems may result in extra primary care visits, hospitalisations, long term care facility admissions and premature death. The literature suggests that a large proportion of drug-related morbidity is preventable. Potentially pharmacists have the skills to ameliorate this problem by identifying existing and potential drug therapy problems likely to cause harm, a reduction in the quality of life, or death. “ It went on to say that: “Clinical advisory pharmacists are recognised as having the qualifications, skills and abilities to work in a variety of specialist roles. The services provided focus on optimising medicines-related health outcomes for individual patients and working to reduce existing and potential drug therapy problems from a population based health perspective, These roles may include: • Pharmacist facilitation • Comprehensive medication management (clinical medication reviews) • Medicines therapy assessment (eg. in rest homes, residential care) 51 Linda Bryant and John Dunlop. Opening the Door on Community Pharmacy, , June 2009) Business case appendices V12 AC 25Feb2010 Page 84
• Provision of patient specific medicines information • Undertaking clinical audits at practice level • Working with community pharmacists • Review of medicines for high-risk people discharged from hospital • PHO Performance Management • Undertaking or assisting with research initiatives • Collaborative Prescribing” In 2007 DHBNZ published the “New Zealand National Pharmacists Framework” 52 . The executive summary of this document reads as follows: “Ministerial strategic documents highlight an opportunity for pharmacists to add value in the primary health care sector. The final framework describes existing dispensing services and five new services in two main themes: 1. Information services comprised of: Health Education to patients. Medicines and Clinical Information Support to practitioners (this includes Clinical Advisory Pharmacist and Pharmacist Facilitation roles). 2. Medicines review services. Medicines Use Review and Adherence Support (MUR), a four part review assessing the patient‟s use, understanding and adherence to their medication regimen. This service has been aligned with the NZ Pharmacy Council competency standards and titles. Medicines Therapy Assessment (MTA), a comprehensive clinical review of an individual patient‟s medication as part of a multidisciplinary team. Comprehensive Medicines Management (CMM), case based active management of changes and (future) pharmacist prescribing activities, as part of a multidisciplinary team. These new services aim to: Enable flexible implementation, eg. via District Health Boards (DHBs), or Primary Health Organisations (PHOs), in line with available resources Promote optimal medicine related outcomes from medicines. Encourage multidisciplinary work practices, primary-primary and primary-secondary integration. Provide the prime tools in managing and ensuring value from pharmaceutical expenditure apart from PHARMAC supply and demand initiatives. Utilise the opportunity for enhanced access that community pharmacy offers for the promotion of public health and well-being and the encouragement of self-care. 52 Elizabeth Plant & Ruth Rhodes. New Zealand National Pharmacist Services Framework, DHBNZ Pharmacy Advisory Group, 2007 Business case appendices V12 AC 25Feb2010 Page 85
- Page 103 and 104: Year three Continued joint plan
- Page 105 and 106: extending health promotion activiti
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- Page 143 and 144: to easily access by telephone). Oth
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- Page 153: Identify patients that would benefi
- Page 157 and 158: 12 Organisational accountabilities
- Page 159 and 160: emain under the care and management
- Page 161 and 162: Service user pathways in an optimal
- Page 163 and 164: Model for shared care pathways deve
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- Page 193 and 194: This option is effectively a Greenf
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- Page 197 and 198: Year two Substantive-IFHC in Greymo
- Page 199 and 200: 12 Costs Capital costs Greymouth IF
- Page 201 and 202: utilize MedTech, but via their own
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• Provision of patient specific medicines information<br />
• Undertaking clinical audits at practice level<br />
• Working with community pharmacists<br />
• Review of medicines for high-risk people discharged from hospital<br />
• PHO Performance Management<br />
• Undertaking or assisting with research initiatives<br />
• Collaborative Prescribing”<br />
In 2007 DHBNZ published the “<strong>New</strong> <strong>Zealand</strong> National Pharmacists Framework” 52 . The<br />
executive summary of this document reads as follows:<br />
“Ministerial strategic documents highlight an opportunity for pharmacists to add value in the<br />
primary health care sector. The final framework describes existing dispensing services and five<br />
new services in two main themes:<br />
1. Information services comprised of:<br />
Health Education to patients.<br />
Medicines and Clinical Information Support to practitioners (this includes Clinical<br />
Advisory Pharmacist and Pharmacist Facilitation roles).<br />
2. Medicines review services.<br />
Medicines Use Review and Adherence Support (MUR), a four part review assessing<br />
the patient‟s use, understanding and adherence to their medication regimen. This<br />
service has been aligned with the NZ Pharmacy Council competency standards and<br />
titles.<br />
Medicines Therapy Assessment (MTA), a comprehensive clinical review of an<br />
individual patient‟s medication as part of a multidisciplinary team.<br />
Comprehensive Medicines Management (CMM), case based active management of<br />
changes and (future) pharmacist prescribing activities, as part of a multidisciplinary<br />
team.<br />
These new services aim to:<br />
Enable flexible implementation, eg. via District Health Boards (DHBs), or <strong>Primary</strong><br />
Health Organisations (PHOs), in line with available resources<br />
Promote optimal medicine related outcomes from medicines.<br />
Encourage multidisciplinary work practices, primary-primary and primary-secondary<br />
integration.<br />
Provide the prime tools in managing and ensuring value from pharmaceutical<br />
expenditure apart from PHARMAC supply and demand initiatives.<br />
Utilise the opportunity for enhanced access that community pharmacy offers for<br />
the promotion of public health and well-being and the encouragement of self-care.<br />
52 Elizabeth Plant & Ruth Rhodes. <strong>New</strong> <strong>Zealand</strong> National Pharmacist Services Framework, DHBNZ Pharmacy Advisory<br />
Group, 2007<br />
Business case appendices V12 AC 25Feb2010 Page 85
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