Developing Services to Meet Local Needs
There are many examples of medicines management services available. Browsing
any journal may detail dozens of different services - minor ailments, smoking
cessation, medication review, chronic disease monitoring. These are all
examples of excellent services, but with limited resources how do you know
which service will have the greatest impact for your local patient population?
Needs Assessment
Before designing or implementing any major medicines management service, it is
a good idea to perform a local needs assessment. A needs assessment can take
many different shapes and forms. It may include surveys / interviews of
targeted populations (patients, GPs, community pharmacists, etc.),
geodemographic analysis and/or assessment of PCT prescribing data. You can
approach a needs assessment with a particular service in mind or with a blank
sheet of paper. Some approaches will obviously cost more than others and take
more time but may be appropriate depending upon your plans.
Whichever approach you decide to take, make sure you can answer some basic
questions regarding the service before you begin fleshing out the details.
- Q: Who is my target audience?
- Q: How many patients locally comprise my target audience?
- Q: How do my patients receive the service today?
- Q: Why is this new service needed?
The answers to these questions will guide you to determine which services will
have the greatest impact on your local patient populations.
Designing the Service
Once you have chosen your medicines management service, the details of
implementing the service might become overwhelming. As a first step you might
find it helpful to create a high-level process map following the patient
through his/her journey. This will immediately require you to make decisions
about the service or consult others with questions.
When you have finished designing your service, you should be able to answer the
following questions.
- Q: How much will your service cost to implement? And to maintain?
- Q: Who will pay for the service?
- Q: How will the service be evaluated?
- Q: How will communication between healthcare providers be coordinated?
- Q: Has patient confidentiality been addressed?
- Q: Have you built in clinical governance?
Occasionally choice will not be possible - the services may be mandated by the
national contract. The new pharmacy contract looks to detail essential
services such as minor ailments and health promotion services. Where as these
services are prescribed, your local PCT will still be funding the service.
There should be a flexible approach to adapt national services to fit local
needs.
With the proliferation of new professional services within community pharmacy,
it may be tempting to borrow existing services as an off-the-shelf solution.
This is a great way to minimise workload and rapidly execute the service.
However, do not forget to first analyse the service through a needs assessment
to make sure it meets your local needs.
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