Policy & Structure Flashcards
What year was the NHS created?
July 1948
Who was the health secretary at the time of the conception of the NHS?
Aneurin Bevan
What is NHS England?
An independent body that commissions primary care in England and sets NHS priorities
What is a CCG?
Clinical Commissioning Group whose members are GP practices
What are CCGs responsible for?
Responsible for two thirds of the NHS England prescribing budget and ensures quality of commissioning
Who is on the CCG governing body?
At least one doctor, one nurse and two lay persons
How many CCGs are there in England?
195
What are commissioning support units?
Paid for commercial service
Provide, IT, business, management and accounting support
What are clinical senates?
Team of healthcare specialists sharing knowledge to inform commissioning and design
Links with professionals and royal bodies
What are local professional networks?
Provide clinical input to local commissioning decisions, hosted by NHS regional teams
What is the main role of the pharmacy local professional networks?
Undertaking of pharmaceutical needs assessments
What are local pharmaceutical committees?
Represent all NHS pharmacy contractors in defined locality, negotiates pharmacy services with commissioners
What is the Care Quality Commission?
Independent regulator of health and adult social care services
What is NHS Improvement?
Regulator that oversees foundation trusts, NHS trusts and independent providers of NHS funded care
What is Healthwatch England?
Independent consumer champion
Gathers and represents public views on health and social care services
What are sustainability and transformation partnerships?
NHS organisations and local councils developing shared proposals
What is a Vanguard?
A group of people leading the way in new developments to overcome divides between primary care, community and hospital services
What are the 5 types of Vanguard site?
Integrated primary and acute care systems Multi-specialty community providers Enhanced health in care homes Urgent and emergency Acute care collaborations
What are PACS?
Integrated primary and acute care systems based around GP registered list providing most or all local hospital services
What are MCPs?
Population based new care model but based on smaller population than PACS
What is the Murray Review?
2016 review of community pharmacy clinical services
What are the key recommendations of the Murray Review?
Make more use of e-repeat prescribing
MURs evolve into full clinical medication reviews
Minor ailments schemes locally commissioned
Greater role in care homes
Groups of pharmacists aiming to provide clinical services
What is the NHS mandate?
Set’s objectives and requirements for NHS England and ensures NHS is accountable to parliament and the public
What is a white paper?
Report setting out government pliicy to come before parliament
Major health policy statements
What is the role of NHS legislation in pharmacy practice?
Does not determine the right to practise of pharmacists, establishment of pharmacies or arrangements for private prescription dispensing
Determines prescribable products, patient charges, grounds for exemption
What are the 3 main contractual arrangements in the pharmacy contract?
Award of NHS pharmaceutical contracts
Supply of medicines
Provision of services
What is the quality payment scheme?
Part of the 2017/18 contractual framework
Payments to be made to community pharmacy contractors meeting certain quality criteria
What four gateway criteria must be met to claim quality payments?
Provision of at least one advanced service
NHS UK entry up to date including opening hours and patient questionnaire results
Ability for staff to send and receive NHS mail
Link to NHS digital systems such as EPS and SCR
Upon meeting gateway criteria, what criteria can be met to receive quality payments?
Patient safety Public health Digital/urgent care Clincial effectiveness Workforce
What is the purpose of the pharmacy integration fund?
Aims to make better use of community pharmacies and pharmacy staff to improve patient access and relieve pressure on GP/A&E
What are the criteria for market entry?
Applications for new, additional or relocated premises made to NHS England local offices
Base approval decisions on pharmaceutical needs assessment
What are the 3 tiers of commissioners?
NHS England
CCGs/Local authorities
Health & Wellbeing boards/LPNs
What is the main responsibility of Health & Wellbeing boards?
Develop and publish pharmaceutical needs assessments
What is the main responsibility of LPNs?
Negotiate with CCGs to win contracts on behalf of their members
What are the essential pharmacy services?
Dispensiing medicines/appliances Repeat dispensing and advice on its benefits Disposal of unwanted medicines Public health- 6 campaigns per year Signposting Support for self-care Clinical governance
What is clinical governance?
A system through which healthcare providers are accountable for continuously improving the quality of their services and safeguarding high standards of care
What are the 7 key ares of clinical governance?
Public/patient involvement Clincial audit Risk management programme Staff management programme Raising concerns Premises standards Data protection
What are the 6 main advanced services?
MURs NMR Urgent medicine supply advanced service Flu vaccination Appliance use reviews Stoma application customisation
What is the purpose of locally commissioned services?
Allows for innovation to meet local needs
Give some reasons for the drastic increase in the drugs bill over the last 10 years.
Increased availability of treatments New & expensive treatments Increase in preventative medicines Publication of treatment guideliines Larger, more ageing population Rise in obesity, alcohol consumption and lifestyle related disease Improvement in diagnosis
What is the pharmaceutical price regulation scheme?
Indirectly controls prices of branded products dispensed under the NHS, limits % of income allowed as profit from total UK sales of medicines to NHS
What are the 3 types of cost control on supply side of NHS?
Profit control on manufacturers
Price fixing of retailers’ reimbursement
Discount adjustment scale (clawback)
What are the 4 main sources of prescriber guidance?
NICE
National service frameworks
Formularies
Generic prescribing
What are the 7 NHS prescription exemption groups?
Age <16 Age >60 16-18 in full time education Pregnant or up to 12 months post natal Medical exemption Low income Free provision of oral contraceptives
What is CQUIN?
Commissioning for Quality and Innovation
What are the benefits of parallel import/export?
Trading of medicines within EU, due to recent weakening of the GBP, profitable to sell medicines from UK to other EU member states
What is the Royal Pharmaceutical Society?
Professional membership body of pharmacists and pharmacy in the UK
What is the Pharmaceutical Services Negotiating Committee?
Promotes interests of NHS community pharmacies in England
What is the National Pharmacy Association?
Association for independent UK community pharmacies providing business support
What is the Guild of Healthcare Pharmacists?
Defends the interests of its members, supporting individuals within the workplace
What is the Pharmacists’ Defence Association?
Supports the needs of the individual pharmacists and defends their reputation
What is CPPE?
Centre for Pharmacy Postgraduate Education provides pathways for further learning
What is the Healthy Lives, Healthy People Strategy?
2010
Places local communities at the heart of public health by giving local governments freedom and funding
What role do Local Authorities play in public health?
Have responsibility to improve locally health and wellbeing
Allocated ring fenced budgets
Establish health and wellbeing boards to co-ordinate
What is Public Health England?
Established as executive agency of DoH in 2013 to provide evidence based professional support
Give examples of Public Health commissioned pharmacy services.
Weight management Smoking cessation Alcohol interventions Sexual health Vascular screening Cancer screening Immunisations
What is the aim of healthy living pharmacies?
Demonstrate high quality delivery of a range of services to increase productivity
What is a Quality Adjusted Life Year?
Generic measure of disease burden, including both the quality and the quantity of life lived
Used in economic evaluation to assess the value for money of medical interventions
One QALY equates to one year in perfect health
What is the Cancer Drugs Fund?
Established in order to provide a means by which NHS patients in England could get cancerdrugs rejected by National Institute for Health and Care Excellence because they were not cost effective
Can give access to promising new treatments, via managed access arrangement, while further evidence is collected to address clinical uncertainty
Interim funding for all newly recommended cancer drugs, giving patients access to these treatments many months earlier than before
What is Value Based Pricing?
A pricing strategy which sets prices according to the estimated value of a product to the customer
Rather than according to the cost of the product or historical prices
