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Pharmacy Year 3 > NHS Structure and Policy > Flashcards

NHS Structure and Policy Flashcards

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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
What are Local Pharmaceutical Committees?
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
26
How many Local Pharmaceutical Committees are there in England?
80
27
What is the purpose of the Care Quality Commission?
Regulate health and adult social care services | Ensure care from hospitals, dentists, ambulances, care homes and home care agencies meets government standard
28
What is the NHS improvement regulatory body?
Oversee foundation trusts, NHS trusts and independent providers of NHS-funded care
29
What is the purpose of NHS Improvement?
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
30
What is the purpose of Healthwatch England?
Gather and represent public views on English health and social care services
31
What are vanguards?
Group of people leading new developments or ideas | Form care models to transform service delivery
32
How many vanguards are there in England?
50
33
What are the 5 different Vanguard sites?
``` Integrated Primary and Acute Care Systems Multispeciality Community Providers Enhanced Health in Care Homes Urgent and Emergency Vanguards Acute Care Collaborations ```
34
What are the two major health policies?
Equity and Excellence: Liberating the NHS | Healthy Lives, Healthy People
35
What are the 5 key priorities of the Equity and Excellence policy?
``` Patients come first Improving healthcare outcomes More autonomous and accountable system Improving public health Reform long-term social care ```
36
What would be the impacts of the equity and excellence policy on pharmacy?
Integration of pharmacists - MDTs, health and wellbeing boards, role in medicines optimisation Payment by performance, incentive for high quality, efficient service
37
What are the key improvements for the NHS five year forward view?
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
What is the NHS mandate?
Objectives and requirements for NHS England | Updated yearly
39
What are the objectives in the NHS mandate?
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
What is included in the RPS report on future care models?
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
What are the NHS England aims for community pharmacy?
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
What is the Murray Review?
Review clinical services offered by pharmacies
43
What are the future views for pharmacists?
Work in primary care teams Increased care home/A&E involvement Read-write access to Summary Care Records
44
What is determined by NHS legislation?
Products prescribable under NHS | Patient charges for drugs dispensed under NHS and grounds for exemption
45
What is the quality payment scheme?
Payments to community pharmacy contractors meeting certain criteria
46
What are the four gateway criteria for quality payments?
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
What are the extra domains in quality payment criteria? | How many have to be met?
``` Patient safety Public Health Digital/Urgent care Clinical effectiveness Workforce ``` One or more
48
What is the Pharmacy Integration Fund?
Support development of clinical pharmacy practice in a wider range of primary care settings More integrated and effective NHS primary care pathway
49
What are the aims of the pharmacy integration fund?
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
What is the basis of approval for community pharmacy contracts? Who undertakes this?
Pharmaceutical Needs Assessment done by LA health and wellbeing board
51
Which services are nationally agreed and commissioned by NHS England?
Essential and advanced services
52
What are commissioned by LAs, CCGs and NHS England local offices?
Locally commissioned services
53
What are the roles of health and wellbeing boards, local pharmaceutical networks and NHSE local offices in enhanced services?
Pharmaceutical needs assessment done by boards and networks | NHSE local offices commission
54
What are the seven essential services?
``` 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
How are the patient/public involved in clinical governance?
Notify of services provided Patient satisfaction questionnaires Monitor medicines owed/put of stock Establish complaints system
56
What are other terms of service for clinical governance?
``` Clinical audits Risk management programme Staff training and management Whistle blowing policy Premise standards Data protection ```
57
What are the six advanced services?
``` MURs NMS Urgent Medicine Supply Advanced Service Flu vaccine Appliance Use Review Stoma Application Customisation ```
58
What is the aim of medicines use reviews and when are they offered?
Improve patient's knowledge, concordance and use of prescribed medicines After dispensing prescription for previous 3 months
59
What are the MUR target groups?
``` 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
What are the aims of the new medicines service?
``` 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
Give some examples of conditions targeted by NMS
Asthma/COPD T2DM Antiplatelet/anticoagulant therapy Hypertension
62
What were the positives identified of the NMS?
Increased adherence by ~10% Saved money Patients were positive and supportive of service
63
What is the Urgent Medicine Supply Advanced Service?
Patients calling 111 with urgent requirement for repeat medicines referred directly to community pharmacy instead of GP
64
Who is offered the flu vaccine service?
Patients in high risk groups
65
What are the pre-requisites for locally commissioned services?
Suitable premises Trained and qualified staff Appropriate equipment Aligned with national guidelines and local needs
66
What are the six enhanced services?
``` Anticoagulant monitoring Minor ailments scheme PGD service Needle and syringe exchange service Care home service Home delivery ```
67
What are the three locally commissioned services?
Vascular risk assessments Weight management schemes Sexual health
68
What is remuneration?
Payment for NHS services, determined by Department of Health
69
What is reimbursement?
Arrangements for repayment of costs of medicines dispensed against NHS prescriptions, determined by Department of Health
70
Where are the reimbursement amounts found?
Branded products - Manufacturer's NHS list price | Generic products - Drug tariff price
71
How do drug tariff prices work?
Price for each product is fixed regardless of how much individual community pharmacy paid Updated monthly
72
Where is the profit made on import/export of medicines currently?
Export medicines as import medicines are not much cheaper due to exchange rate
73
What is the negative of exporting medicines for profit?
Shortage of medicines in UK
74
Why is there a discount deduction scale for reimbursements?
Medicines cost less than list price through wholesaler discounts, bulk buying and parallel importing DoH estimates difference
75
How frequent is reimbursement for dispensed medicines?
Monthly
76
What is the downside of NHS cost control mechanisms?
Attempting to purchase cheaper medicines Attempt to increase level of discount beyond NHS scale Minimise stock to reduce waste - problems with availability
77
What are the costs involved in running a community pharmacy?
``` Staff Training Rent and bills Deliveries Stock loss, incorrect claims Equipment ```
78
How do community pharmacies make their profits?
``` Number of dispensed prescriptions Payment for services Accurate remuneration and reimbursement Cost containment Quality payments ```
79
What problems arise from stock shortages?
``` Decreased patient satisfaction Patient confusion from swaps Increased workload Inconvenience to patient Reduced compliance ```
80
How do hospital pharmacies receive income?
National tariff reflecting national average prices for hospital procedures Achievement of 'commissioning for quality and innovation' indicators Non-profit
81
How are costs controlled in hospital pharmacies?
Efficient and rational use of medicines Encourage patients to use own drugs Home care services

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