Medicines Optimisation Advisory Service to support NHS England North-West Health & Justice Team

Background

The North-West (NW) Health & Justice team asked Midlands and Lancashire CSU (NHSML) to support three key workstreams over a two-year contract, one of the workstreams was an advisory Medicine Optimisation service.

In 2017 Professional standards for optimising medicines for people in secure environments were published and there is also a national H&J MMO strategy.

There was a recognised need to support prisons in the NW region to achieve these standards and provide assurance to commissioners. A national job description for a Regional H&J Pharmaceutical Adviser was developed and formed the basis for the NHSML Medicines support service.

Action

Following discussions with commissioning leads and identification of compliance variation across prison sites, the priority focus for NHSML support was agreed as:

• NW implementation of the national H&J MMO strategy 
• Commissioning, contract management and procurement of relevant MMO / pharmacy services
• Integration of H&J MMO/pharmacy services with pharmacy and ICSs
• Increase capacity and capability for delivering clinical pharmacy services and medicines governance in H&J practices.
• Ensure equivalence of pharmacy services and medicines access for people receiving H&J services.
• Driving the inclusion of H&J practice and career pathways within NW & ICS pharmacy workforce planning

Impact

NHSML supported providers to deliver national standards, provide assurance to commissioners, safer use of medicines and improve  patient care across NW Health and Justice settings.

Outcomes included:

• Improvement in medicines governance and adherence to national standards for medicines and controlled drugs
• Developed a programme of site visits, along with the NHSE Quality Team, to evaluate standards within prisons, allow sharing of good practice and support improvement when required
• Regional and national relationships developed, with specialist advice provided to commissioners and providers
• NW H&J Pharmacy forum established with NHSE and ICB attendees
• Expert medicines advice provided to improve safer use of medicines e.g. sodium valproate project
• Evaluation scoring of medicines management and pharmacy sections of contract bids
• Increased inclusion of H&J pharmacy teams with ICB and wider healthcare teams
• Supporting NW sites with planning and readiness for national requirements e.g. SMRs, intra-nasal naloxone
• Representing H&J at regional pharmacy workforce planning group
• Events were organised to bring teams from across all NW prisons to network, share good practice, challenges and liaise with ICB colleagues