Isle of Wight dressings scheme saves PCT money and pays pharmacies more
Allowing nurses to order bulk supplies of surgical dressings from community pharmacies on the Isle of Wight has saved the island's primary care trust money, at the same time as increasing the amount paid to pharmacies by more than 90 per cent.
Paul Jerram, medication review pharmacist at Isle of Wight PCT, told
The Journal that a reduction in wastage of dressings is behind the savings
made by the PCT. The scheme was praised by the Commission for Health
Improvement as “something the rest of the National Health Service
could learn from” during a clinical governance inspection in July
this year.
The PCT ran a trial of
the scheme last year (PJ, 2 February 2002, p124).
The trial initially involved two GP surgeries, one supplied from an independent
community pharmacy and the second from a hospital. After two weeks, the
second arm had to be switched from the hospital to a multiple pharmacy
and an independent contractor for logistical reasons. After six months,
cost savings of 10.3 per cent were seen, and both GPs and nurses reported
workload reductions. In November 2002, the scheme was extended across
the island with all pharmacy contractors being invited to participate.
The number of prescriptions issued for dressings has fallen by 72 per
cent.
Mr Jerram explained: “Prescriptions are a wasteful method of obtaining
dressings. Under our scheme, nurses now send a bulk order form signed
by them to a pharmacy for later collection or delivery. The order form
is also the formulary, drawn up by tissue viability nurses.” Prescriptions
are reserved for non-formulary dressings or bulk requests for use in
nursing homes.
Payments to pharmacies are higher because they receive Drug Tariff prices
plus VAT with no discount clawback. This more than compensates for lost
dispensing fees. The PCT is considering extending the scheme to sip feeds
and ostomy products.
Asked whether other primary care organisations could also make savings
by using such a scheme, Mr Jerram said: “The savings depend on
the level of waste.” However, he said that a number of PCTs have
expressed an interest in copying the scheme.
“You get the best service through community pharmacies,” Mr
Jerram added. “You may get cheaper prices elsewhere but pharmacists
will call up if there is a problem, and try and solve it for the patient.
If you are going to change the service you don’t want to see a
deterioration of the quality.” |
