About Taher Esfandiari
Taher is a Clinical Commissioning Pharmacist, part of the Medicines Optimisation and Long Term Conditions team at Lambeth CCG. Since the start of his career as a Pharmacist in 2012, Taher has held several roles spanning community pharmacy and CCG’s across South West, North West and South East London. Taher has played a significant role in using digital innovation to create tools for clinicians to help promote best practice and reduce unwarranted variation for specific patient cohorts.
Problem: For the upcoming financial year an element of Taher’s focus will be on the reduction of medication safety incidents. Medicines safety is a significant cause of hospital admissions, with 66 million clinically significant errors per year, 71% of which are in primary care, and contribute to 4% of hospital admissions.
Solution: Practices to run searches on EMIS to identify patients at risk of a range of common prescribing and drug monitoring errors (initially 13 of 133 PINCER indicators). Pharmacists will be specifically trained to deliver the intervention to:
• Discuss results of searches and use educational outreach techniques
• Agree action plan for correcting the errors and improving safety systems
These pharmacists will then implement the agreed action plan. Taher plans to look at more indicators over time.
Scale: 43 practices – 410,824 patients.
Desired impact: To reduce the potential for medication errors in primary care and to embed a culture of safety first across the borough. Taher intends to add further PINCER indicators in subsequent years.
Progress to date: As at December 2019 Taher and his team had successfully gone live and trained 28 out of 32 Pharmacists. Nearly 95% of practices had uploaded data, and they are now asking Pharmacists to upload post intervention data. The project has gone better than expected with high levels of GP engagement. The project is starting to see some reductions (approx. 6%). The parameters that they are using to measure practices on do yield false positives, and not all practices have implemented the intervention yet.
“I joined the Fellowship programme because at the time I had recently joined Lambeth CCG and coincidentally, there was a call out for pharmacists to lead PINCER.
The elements of the programme that created the most value for me were the other Fellows and I found my Action Learning Set group very helpful and supportive. I liked the mix of people and experience levels. I have been sharing some of my knowledge back, internally at the CCG.
As a result of being on the Fellowship programme, my profile has been raised. I was invited to speak to the DigitalHealth.London Accelerator cohort about NHS funding flows. I feel much better equipped to drive change, mainly because of the difficult conversations session. I am the most junior person in the team, however, the programme has helped me to gain trust and respect from others. We are managing queries from GPs at the CCG about prescribing better and sell the benefits of the intervention with more conviction. My line manager is happy with the project progress and has asked me to produce a PINCER process for sharing on the CCG intranet.
As I move forward, I would like to share my knowledge with others, particularly in the Pharmacy network, I have been invited to do some motivational speaking.”