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Pharmacy Year 3 > NHS Structure and Policy > Flashcards

NHS Structure and Policy Flashcards

1
Q

How is the department of health funded?

A

Public funding - Chancellor of the Exchequer

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2
Q

Roughly how much of tax money is used for healthcare?

A

£1 per every £5

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3
Q

Who determines health and social care policy?

A

Secretary of State for Health

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4
Q

Who is responsible for policy and delivery in health and social care?

A

Department of Health

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5
Q

What are the overseeing commissioning groups?

A

Public Health England
NHS England
Regional Teams

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6
Q

Who can provide community pharmacies with funding?

A

NHS England
Local Authorities
Clinical Commissioning Groups

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7
Q

Who negotiates contracts between community pharmacies and NHS England?

A

Pharmaceutical Services Negotiating Committee

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8
Q

How are essential and advanced services funded?

A

NHS England

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9
Q

How are enhanced services funded?

A

NHS England local area teams

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10
Q

Where do social care providers receive funding from?

A

Local Authorities

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11
Q

Who receives funding from CCGs specifically?

A

Commissioning Support Units and Acute Care

Mental Health Trusts

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12
Q

Who commissions Specialised Clinical Services?

A

NHS England

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13
Q

How much of the NHS budget is controlled by NHS England?

A

40%

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14
Q

What are the aims of NHS England?

A

Set our priorities and strategies of NHS
Commissioner for primary care in England
Planning and buying of specialist services
Negotiating partner for PSNC

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15
Q

What are the 5 NHS England Regional Teams?

A 
London
Midlands and East
North
South East
South West
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16
Q

What are the aims of the NHS England Regional Teams?

A

Plans for improving healthcare in their area
Healthcare commissioning and delivery in their area
Working with CGs, LAs, and health and wellbeing boards

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17
Q

What are CCGs made of?

A

GP practices

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18
Q

What are the minimum requirements for the governing body of CCGs?

A

One nurse
One hospital doctor
Two lay persons

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19
Q

What commissions are controlled by CCGs?

A

Planned hospital care
Emergency care
Out of hours care
Prescribing budgets

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20
Q

How many CCGs are there in England?

A

195

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21
Q

What do Commissioning Support Units do?

A

IT, business and management support
Accounting services
Information analysis

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22
Q

What is the purpose of Clinical Senates?

A

Team of healthcare specialists

Share clinical knowledge to inform service commissioning and design

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23
Q

How many clinical senates are there in England?

A

12

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24
Q

What are Local Professional Networks?

A

Provide clinical input in local commissioning decisions
One for pharmacy, dentistry and optometry in each locality
Pharmaceutical Needs Assessments

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25
Q

What are Local Pharmaceutical Committees?

A

Consult on matters affecting local pharmacy contractors
Help plan, negotiate and discuss services with commissioners
Advice to contractors and those wanting to know more about pharmacy

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26
Q

How many Local Pharmaceutical Committees are there in England?

A

80

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27
Q

What is the purpose of the Care Quality Commission?

A

Regulate health and adult social care services

Ensure care from hospitals, dentists, ambulances, care homes and home care agencies meets government standard

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28
Q

What is the NHS improvement regulatory body?

A

Oversee foundation trusts, NHS trusts and independent providers of NHS-funded care

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29
Q

What is the purpose of NHS Improvement?

A

Support providers to give safe, high quality and compassionate care in a financially sustainable way
Support providers to meet areas covered in five year forward view

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30
Q

What is the purpose of Healthwatch England?

A

Gather and represent public views on English health and social care services

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31
Q

What are vanguards?

A

Group of people leading new developments or ideas

Form care models to transform service delivery

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32
Q

How many vanguards are there in England?

A

50

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33
Q

What are the 5 different Vanguard sites?

A 
Integrated Primary and Acute Care Systems
Multispeciality Community Providers
Enhanced Health in Care Homes
Urgent and Emergency Vanguards
Acute Care Collaborations
34
Q

What are the two major health policies?

A

Equity and Excellence: Liberating the NHS

Healthy Lives, Healthy People

35
Q

What are the 5 key priorities of the Equity and Excellence policy?

A 
Patients come first
Improving healthcare outcomes
More autonomous and accountable system
Improving public health
Reform long-term social care
36
Q

What would be the impacts of the equity and excellence policy on pharmacy?

A

Integration of pharmacists - MDTs, health and wellbeing boards, role in medicines optimisation
Payment by performance, incentive for high quality, efficient service

37
Q

What are the key improvements for the NHS five year forward view?

A

Increase the number of GP pharmacists
GP practices to work with community nurses and clinical pharmacy teams
GPs to work closer with community pharmacies to make full use of skills

38
Q

What is the NHS mandate?

A

Objectives and requirements for NHS England

Updated yearly

39
Q

What are the objectives in the NHS mandate?

A

Improve health outcomes and reduce inequalities
Create safest, highest quality healthcare services
Balance budget to improve efficiency and productivity
Prevention of illness and support to lead healthier lives
Maintain and improve performance against core standards
Improve out-of-hospital care
Support research, innovation and growth

40
Q

What is included in the RPS report on future care models?

A

Role of pharmacist in chronic conditions/preventable illness
Improve underutilisation
Improve out of hours and urgent care through pharmacies
Increase public awareness of pharmacy

41
Q

What are the NHS England aims for community pharmacy?

A

Develop team for personalised care
Stronger role in integrated out of hospital services
Bigger role in health advice and improving overall health
Improve patient experience to optimise medicines use

42
Q

What is the Murray Review?

A

Review clinical services offered by pharmacies

43
Q

What are the future views for pharmacists?

A

Work in primary care teams
Increased care home/A&E involvement
Read-write access to Summary Care Records

44
Q

What is determined by NHS legislation?

A

Products prescribable under NHS

Patient charges for drugs dispensed under NHS and grounds for exemption

45
Q

What is the quality payment scheme?

A

Payments to community pharmacy contractors meeting certain criteria

46
Q

What are the four gateway criteria for quality payments?

A

Provision of at least one advanced service
NHS UK entry up to date
Staff can send and receive NHS mail
Can link to NHS digital systems

47
Q

What are the extra domains in quality payment criteria?

How many have to be met?

A 
Patient safety
Public Health
Digital/Urgent care
Clinical effectiveness
Workforce

One or more

48
Q

What is the Pharmacy Integration Fund?

A

Support development of clinical pharmacy practice in a wider range of primary care settings
More integrated and effective NHS primary care pathway

49
Q

What are the aims of the pharmacy integration fund?

A

Make better use of community pharmacy, pharmacists and technicians
Improve patient access
Relieve pressure on GPs and A&E
Contribute to delivering a 7-day service

50
Q

What is the basis of approval for community pharmacy contracts?
Who undertakes this?

A

Pharmaceutical Needs Assessment done by LA health and wellbeing board

51
Q

Which services are nationally agreed and commissioned by NHS England?

A

Essential and advanced services

52
Q

What are commissioned by LAs, CCGs and NHS England local offices?

A

Locally commissioned services

53
Q

What are the roles of health and wellbeing boards, local pharmaceutical networks and NHSE local offices in enhanced services?

A

Pharmaceutical needs assessment done by boards and networks

NHSE local offices commission

54
Q

What are the seven essential services?

A 
Dispensing
Repeat dispensing
Disposal of unwanted medicines
Public health - 6 campaigns a year
Signposting
Self care support
Clinical governance - HCP accountable for quality of services
55
Q

How are the patient/public involved in clinical governance?

A

Notify of services provided
Patient satisfaction questionnaires
Monitor medicines owed/put of stock
Establish complaints system

56
Q

What are other terms of service for clinical governance?

A 
Clinical audits
Risk management programme
Staff training and management
Whistle blowing policy
Premise standards
Data protection
57
Q

What are the six advanced services?

A 
MURs
NMS
Urgent Medicine Supply Advanced Service
Flu vaccine
Appliance Use Review
Stoma Application Customisation
58
Q

What is the aim of medicines use reviews and when are they offered?

A

Improve patient’s knowledge, concordance and use of prescribed medicines
After dispensing prescription for previous 3 months

59
Q

What are the MUR target groups?

A 
If taking high risk medications
If recently discharged and medication is changed
Respiratory diseases
At risk of or diagnosed with CVD
On multiple medicines
60
Q

What are the aims of the new medicines service?

A 
Improve adherence
Increase engagement with condition and medicines to support them in decision making
Reduce wastage
Reduce hospital admissions from ADRs
Increase ADR reporting
61
Q

Give some examples of conditions targeted by NMS

A

Asthma/COPD
T2DM
Antiplatelet/anticoagulant therapy
Hypertension

62
Q

What were the positives identified of the NMS?

A

Increased adherence by ~10%
Saved money
Patients were positive and supportive of service

63
Q

What is the Urgent Medicine Supply Advanced Service?

A

Patients calling 111 with urgent requirement for repeat medicines referred directly to community pharmacy instead of GP

64
Q

Who is offered the flu vaccine service?

A

Patients in high risk groups

65
Q

What are the pre-requisites for locally commissioned services?

A

Suitable premises
Trained and qualified staff
Appropriate equipment
Aligned with national guidelines and local needs

66
Q

What are the six enhanced services?

A 
Anticoagulant monitoring
Minor ailments scheme
PGD service
Needle and syringe exchange service
Care home service
Home delivery
67
Q

What are the three locally commissioned services?

A

Vascular risk assessments
Weight management schemes
Sexual health

68
Q

What is remuneration?

A

Payment for NHS services, determined by Department of Health

69
Q

What is reimbursement?

A

Arrangements for repayment of costs of medicines dispensed against NHS prescriptions, determined by Department of Health

70
Q

Where are the reimbursement amounts found?

A

Branded products - Manufacturer’s NHS list price

Generic products - Drug tariff price

71
Q

How do drug tariff prices work?

A

Price for each product is fixed regardless of how much individual community pharmacy paid
Updated monthly

72
Q

Where is the profit made on import/export of medicines currently?

A

Export medicines as import medicines are not much cheaper due to exchange rate

73
Q

What is the negative of exporting medicines for profit?

A

Shortage of medicines in UK

74
Q

Why is there a discount deduction scale for reimbursements?

A

Medicines cost less than list price through wholesaler discounts, bulk buying and parallel importing
DoH estimates difference

75
Q

How frequent is reimbursement for dispensed medicines?

A

Monthly

76
Q

What is the downside of NHS cost control mechanisms?

A

Attempting to purchase cheaper medicines
Attempt to increase level of discount beyond NHS scale
Minimise stock to reduce waste - problems with availability

77
Q

What are the costs involved in running a community pharmacy?

A 
Staff
Training
Rent and bills
Deliveries
Stock loss, incorrect claims
Equipment
78
Q

How do community pharmacies make their profits?

A 
Number of dispensed prescriptions
Payment for services
Accurate remuneration and reimbursement
Cost containment
Quality payments
79
Q

What problems arise from stock shortages?

A 
Decreased patient satisfaction
Patient confusion from swaps
Increased workload
Inconvenience to patient
Reduced compliance
80
Q

How do hospital pharmacies receive income?

A

National tariff reflecting national average prices for hospital procedures
Achievement of ‘commissioning for quality and innovation’ indicators
Non-profit

81
Q

How are costs controlled in hospital pharmacies?

A

Efficient and rational use of medicines
Encourage patients to use own drugs
Home care services

Pharmacy Year 3 (15 decks)

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