Background

The COVID-19 pandemic has introduced unprecedented rapid change in the NHS resulting in:

• A widespread shift to remote management, reducing face-to-face appointments

• Surging clinical demand linked to coronavirus infection

• Severe disruption to routine practice in all clinical areas, e.g. cancer and long-term conditions.

• Problematic access to medicines, that would normally be prescribed and dispensed by the hospital outpatient pharmacy

Although the pandemic has been challenging, it has also been a catalyst for change, particularly in the transformation of outpatients’ management.  For example, since March 2020, UCLH has implemented video and telephone clinics for about 50% of its outpatient clinics.  This has prompted the publication of the UCLH Outpatient Transformation Strategy 2021-2026: An integrated future for outpatients.  The ambition is to design integrated ways of working collaboratively, to overcome these challenges, e.g. one stop clinics.  One of the aims of this strategy is ‘to identify a way for hospital doctors…to prescribe from community pharmacies’.  

This issue is affecting all hospitals nationally, not just within UCLPartners geography.  
 

Project

The overarching collaboration
UCLPartners will collaborate with Pfizer & Alliance Healthcare in a two-phased approach to explore and develop a new outpatient hospital medicines provision model:

• Phase 1 – Will involve local engagement and stakeholder roundtables over a period of 6 months, allowing for system input, co-design and sourcing of partners interested in piloting alternative medicines provision models.

• If a Provider is found, we may initiate phase 2 (separate to this agreement) where alternative medicines provision models would be tested in a real-world setting.  

For Phase 1
Pfizer will provide £49,200 to support funding for UCLPartners to employ a part time Senior Pharmacist to run the project. In addition, 63 hours of Pfizer colleagues’ time will also be provided to support the project through all stages of delivery from planning to evaluation.

Alliance Healthcare will provide £7,500 to support funding for UCLPartners to employ a part time Senior Pharmacist to run the project. In addition, 63 hours of Alliance Healthcare colleagues’ time will also be provided to support the project through all stages of delivery from planning to evaluation.

UCLPartners will provide 985 hours of UCLPartners colleagues’ time to support the project through all stages of delivery from planning to evaluation. UCLPartners will also employ a Senior Pharmacist to run the project.
 

Benefits

Benefits for Patients/Population/User Groups

• Better access to medicines and treatments

• Healthcare support at a local level

• Continuity of care from hospital into primary care

• Reduction of unnecessary hospital visits

• Improved equity of access (e.g. lower cost barriers to access care in community settings)

• Improved adherence to medicines through new model of care

Benefits for the NHS

• A widespread shift to remote management, reducing face-to-face appointments

• Surging clinical demand linked to coronavirus infection

• Severe disruption to routine practice in all clinical areas, e.g. cancer and long-term conditions.

• Problematic access to medicines, that would normally be prescribed and dispensed by the hospital outpatient pharmacy

• Prioritisation of equity of access and need to address cost and other barriers

Benefits for Pfizer

• Understanding new patient pathways for accessing hospital only medicines in the community

• Understanding of how we improve access to our medicines

• Understanding which channels to distribute our medicines through to get them to patients in a safe, robust and convenient way.

Benefits for Alliance Healthcare

• Understanding skills and processes community pharmacy must develop to support patients using hospital only medicines in the community

• Understanding how wholesale services might adapt to enable community dispensing points to access hospital only medicines

• Understanding how homecare services might adapt to support community pharmacies in the management of patients using complex hospital medicines and in the variation of homecare services to improve access to treatment in the community, e.g. community infusion clinics

Outcomes

A summary of the outcomes from Phase 1 can be downloaded here.
This project has now moved onto a second phase.