PM Healthcare - Summer 2022

PM Healthcare Journal 7 PM Healthcare Journal FACE2FACE Interview - What does the ICS structure mean for Pharmacy? Author Mildred Johnson, Chief Pharmacist/Clinical Director of Pharmacy & Medicines Optimisation at Maidstone & Tunbridge Wells NHS Trust, and Chair of the Kent Surrey & Sussex Chief Pharmacists & Medicines Management Leads Network. In this Q&A interview, Mildred Johnson, Chief Pharmacist and Clinical Director of Pharmacy & Medicines Optimisation at Maidstone & Tunbridge Wells NHS Trust, discusses the effect of integrated care systems (ICSs) on pharmacy services and the wider, local NHS. Mildred, in practical terms – we are talking since 1 July – how would you say things are going in Kent & Medway as we move over to the ICS model of delivering care? So far so good. From a pharmacy perspective, the earlier merger of Kent & Medway’s eight clinical commissioning groups (CCGs) to a single CCG in 2020 helped in the transition to an integrated care board (ICB). Doing this has enabled thinking at scale, which I believe is a necessary stage in preparing for the much larger ICS footprint. There has been great collaborative work with Pharmacy Leads in the ICB, Provider Trusts and Community which started some years ago under the sustainable transformation plan for Kent & Medway. An example of a successful piece of collaborative work in 2017 was the introduction of a Kent & Medway-wide electronic prescribing system in cancer services. I think this was really important – to have planned well in advance and to have tested how scaling up and integration can work in practice. Could you outline some of the challenges that you see in Kent & Medway? The plans and priorities for NHS Kent & Medway are found on the dedicated website, https://www.kentandmedway.icb.nhs.uk . Th e focus will be linked to delivering on the four core purposes of integrated care systems and recovery from Covid-19, which includes reducing the number of people waiting for hospital treatments. Kent and Medway ICB has one of the largest populations (1.8 million people) and services need to be planned in advance to allow for an expected rise in population of almost a quarter by 2031. ”A spend of just £86m (2%) of budget is to support people to stay well and prevent illness, compared to £3.4 billion treating ill-health, so I believe a focus on prevention will be key for the future.” Over 528,000 people live with one or more significant long-term health conditions, including around 12,000 with dementia. Presently, around 1,000 people every day are in a hospital bed when they no longer need to be, and we know that people with a serious mental illness die on average 15 to 20 years earlier than the general population. As far as staffing is concerned, 175 more GPs are required to keep Kent & Medway in line with the national average and over half of practice nurses could retire in 10 years. These challenges pre-existed Covid, and we must now work together as a system to not only recover from the pandemic, but also to address the health inequalities that it highlighted. What major contribution to or change to healthcare (especially for pharmacy) across the region can you foresee as the ICS moves forward? System enablers – strategies employed to improve integration and data sharing – will be central to achieving change. For example, for hospital admissions, using digital tools for virtual wards, the effective sharing of patient records across the interface (including to community pharmacies), digital prescribing systems that are interoperable, and the use of non-medical advanced practitioners to increase capacity for patient care. The ICS, by virtue of its size and the integration ambition that underpins it, provides us with the opportunity of applying these digital solutions to many areas of care. We recently did a (virtual) event with you, about the emerging ICS. Do you think that events like these could help other ICSs take stock of where they are and help planning and delivery? I absolutely think so. The event was very well attended and the feedback we received from the conference is a testament that such a forum allows us to engage fully with the wider workforce, which adds tremendous value to what we are trying to achieve. ”What it facilitated was the means to make wider connections and generate really useful cooperation in real-time. We were able, for example, to obtain information from frontline pharmacy staff, which would help shape and design the best programmes to meet demand in the system. Sharing at this level, potentially across the whole ICS, can be very beneficial.” What are your priorities at the moment in relation to ICS formation and pharmacy? In Kent & Medway we have an Integrated Pharmacy and Medicines Optimisation Board (IPMO) that represents pharmacy professional leadership across the ICS for strategy, planning and advice at all levels. The IMPO Board is working to embed the following priorities into the ICS system architecture: 6