About Shahid Gani
Shahid is one of two lead pharmacists working in North Central London (NCL) STP to deliver on the Medicines Efficiency Program (MEP). His role is to identify QIPP projects that have the potential to benefit the NCL health economy and then engage with the appropriate commissioners and providers to implement these across the patch. While initially his projects have had a financial saving focus, he is now working on digital projects to improve quality, innovation and productivity as outlined in the NHS Long Term Plan.
Shahid is working with UCLP to support clinical engagement and implementation of TCAM (and PINCER).
Problem: It is recognised that adverse events tend to occur when patients move between care interfaces:
- Patients do not always fully understand how to take new medication
- Inadequate communication often results in re-admissions
- Community Pharmacists who prepare medicines are unaware of patients’ admission and subsequent changes, leading to waste.
- Community Pharmacists are generally not included in communication between clinicians
Solution: Many of the points raised above could be improved through better communication. NHS Digital e-referral and PharmOutcomes have the potential to resolve these through:
- Allowing a two-way communication channel between community and hospital pharmacists
- Alerting community pharmacies of admissions/discharge
- Communicating changes to medication
- Communicating any supportive needs of the patients
- Requesting NMS, MUR and Healthy Living Advice services
Scale: NCL comprises:
- Five CCGs – Barnet, Camden, Enfield, Haringey and Islington.
- Approximately 1.44m residents
- 5 acute hospitals, 3 specialist hospitals, 3 providers of community services and 3 providers of mental health services
- 237 GP practices.
Desired impact: The project aims to achieve:
- Reduced re-admissions
- Improved patient support following patient discharge
- Improved communication/relationship between hospital clinical teams, community pharmacists and GP practice pharmacists.
- Involvement of the community pharmacist in the medicines pathway
- Reduced waste of medicines.
Progress to date:
- Written a TCAM Landscape and Options Appraisal document for NCL.
- Chief pharmacists from Trusts in NCL are on board with the concept of TCAM.
- Presented TCAM at the North Central London STP Trust Chief Pharmacists meeting
- Defined what TCAM means. i.e. only involves transfer of patients from hospital to community pharmacists.
- National focus is garnering further interest:
- New National NHS Contracts likely to request a plan for TCAM from each Trust
- New Community Pharmacy contracts to get remunerated for conducting Medicines Reconciliation following transfer of care.
- Local Pharmaceutical Committee are on board. Transfer criteria to be negotiated.
- Whittington hospital are potentially the first site for embedding TCAM.