Health Board HEAT targets and the supporting role played by Community Pharmacy Contractors
All Health Boards are accountable to the Cabinet Secretary for Health and Wellbeing. To ensure NHS Scotland delivers the Cabinet Secretary's key objectives and outcomes all Health Boards are monitored against a key set of operational targets and measures.
These key targets are known as the HEAT targets. The HEAT targets are broken down into four categories Health Improvement, Efficiency and Governance, Access to Services and Treatment.
|
|
Number of Targets |
Example of a Target from each Section |
H |
Health Improvement |
7 |
Through smoking cessation services, support 8% of your Board's smoking population in successfully quitting (at one month post quit) over the period 2008/9-2010/11 |
E |
Efficiency and Governance |
7 |
Universal Utilisation of CHI |
A |
Access to Services |
7 |
Ensure that anyone contacting their GP surgery has guaranteed access to a GP, nurse or other healthcare professional within 48 hours |
T |
Treatment |
9 |
Reduce the annual rate of increase of defined daily dose per capita of anti-depressants to zero by 2009/10, and put in place the required support framework to achieve a 10% reduction in future years. |
The full list of HEAT targets for 2008-9 is available here
HEAT targets 2008-9 where Community Pharmacy Contractors have a role
Health Improvement
H1: Coronary Heart Disease Mortality in deprived areas
Some community pharmacy contractors provide screening for hypertension and cardiovascular risk. Ensuring early detection and management of both hypertension and cardiovascular risk will support NHS Scotland in reducing mortality from CHD.
H6 : Smoking Cessation
The national rollout of the smoking cessation service through the Public Health Service component of the new Pharmacy Contract will support NHS Scotland in ensuring as many smokers are offered support to quit smoking.
Efficiency and Governance
E1: Universal Utilisation of CHI
The implementation of ePharmacy and recording of CHI numbers by contractors will support the utilisation of CHI throughout all prescribing and dispensing processes.
Access to Services
A1: 48 Hour Access to Primary Health Care Team
The Minor Ailment Service has helped improve delivery towards the 48 hour access target for primary care. Patients who may have traditionally presented to their GP or primary health care team member for a self limiting condition are now able to consult a Community Pharmacy contractor using the Minor Ailment Service.
The Community Pharmacy contractor is able to provide advice and treatment promptly without appointment. The utilisation of the Minor Ailment service may prevent unnecessary GP or primary health care team appointments thereby improving access.
Treatment
T1 : Reduce the proportion of older people (65+) who are admitted as an emergency inpatient by 2 or more times in a single year
Community Pharmacy contractors can support the achievement of this target by recognising and referring patients who are exhibiting symptoms of deterioration of their long term conditions such as heart failure and COPD. Early referral to GPs and subsequent management can prevent admission to hospital. For example deterioration in COPD may be managed as appropriate by the use of antibiotics and/or steroids.
T3 : Reduce the annual rate of anti-depressants prescribed
Community Pharmacy contractors can support the achievement of this target by ensuring patients only request medicines they are currently taking. Any medicine which is requested by the patient and not taken will lead to an increase in prescriptions and wastage.
Community Pharmacy contractors may also support this target by recognising patients who are suffering from adverse effects of the anti-depressants and ensuring the medication is reviewed at an early stage. This review will possibly facilitate a change to an alternative product and reduce the likelihood of non-compliance and waste by the patient.
T5 : To reduce all staphylococcus aureus bacteraemia (including MRSA)
Community Pharmacy contractors can support the achievement of this target by helping support the reduction of MRSA.
Community Pharmacists can ensure they are aware of NHS Board joint prescribing formularies recommendations for the prudent prescribing of antimicrobials within their local area. This will help support effective use of antibiotics in primary care. Contractors could ensure prescribing of maintenance antibiotics are reviewed annually and continuation of prescribing is confirmed with the GP.
Independent pharmacist prescribers should be recognisant of health board antibiotic prescribing formularies and supplies of antibiotics should only made if the prescriber is satisfied they are appropriate.
T6: To achieve agreed reductions in the rates of hospital admissions and bed days of patients with a primary diagnosis of COPD, Asthma, Diabetes or CHD
Community Pharmacy contractors can support this target by ensuring patients are maximising the benefits from their medicines. This can include concordance with the medication and supporting patients to achieve blood pressure, HB1ac and cholesterol targets to reduce the risk of further acute events leading to hospitalisation.
T7 : Increase the level of older people with complex care needs receiving care at home
Community Pharmacists can support the achievement of this target in a myriad of ways. This can include advice on self care, supply of oxygen and support for carers around knowledge of the older person's medication.