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G3Topic 1: What aspects of PINCER/OptimiseRx would be key to facilitate its use and engagement across groups of users (e.g. clinicians, managers, patients and carers, etc.) while maintaining a positive impact on safety? 

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G3Topic 1: What aspects of PINCER/OptimiseRx would be key to facilitate its use and engagement across groups of users (e.g. clinicians, managers, patients and carers, etc.) while maintaining a positive impact on safety? 

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Making sure there is buy in from the correct people and it doesn't mean more work, it's for the patients' benefit
Engaging pharmacists more, especially newer pharmacist, e.g. have it as part of their induction/embed it into their role at an early stage, and include in CPPE
Honest and open communication with patients, explain why medicines are bad or good for you and how drugs work including side effects - help facilitate self-management, give adequate time to patients to make their own decisions and check with patients later that they have understood what has been discussed
Allow longer appointment times for patients on more complex medication regimes

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G2Topic 1: What aspects of PINCER/OptimiseRx would be key to facilitate its use and engagement across groups of users (e.g. clinicians, managers, patients and carers, etc.) while maintaining a positive impact on safety?

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G2Topic 1: What aspects of PINCER/OptimiseRx would be key to facilitate its use and engagement across groups of users (e.g. clinicians, managers, patients and carers, etc.) while maintaining a positive impact on safety?

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Optimise RX slows the system
Pop up fatigue - particularly on cost savings - too many alerts about interactions
2. Engagement with GPs and practice team - but work needs to be resourced - incentivised etc - stratification
PINCER using searches that are in clinical systems - not reliant on additional software
Get those searches centrally located
1.Ease of access and ease of implementation
3. Consistent approach - a simple a process as possible -standardisation - becomes easier to measure outcomes

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Go to menti.com and use the code 7552 6507
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Go to menti.com and use the code 9693 1375
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Go to menti.com and use the code 4073 2425
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G1Topic 1: What aspects of PINCER/OptimiseRx would be key to facilitate its use and engagement across groups of users (e.g. clinicians, managers, patients and carers, etc.) while maintaining a positive impact on safety?

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G1Topic 1: What aspects of PINCER/OptimiseRx would be key to facilitate its use and engagement across groups of users (e.g. clinicians, managers, patients and carers, etc.) while maintaining a positive impact on safety?

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PINCER - help with planning and prioritisation (generating caseloads), matching to clinical capacity (1).

Promoting collaboration, sharing learning across practices, involvement of all staff in training and implementation. Being able to share good practice. Show data to make difference at the end. Ability to predict reduction of patients at risk. Being able to make a difference. Picking up patients that may have otherwise been missed. Sustainable training that shares learning across practices (2).

The availability of a dataset to see reduction and changes made (3). Being able to see variances and why.

Structure of PCNs more manageable than CCGs, enabling sharing across practices.

Continued availability of the indicators, infrastructure.

Patients - informing and involving patients in prescribing safety, emphasising monitoring and improving practice.

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G1Topic 2: What are the important considerations in taking a team approach across the healthcare system in implementing and sustaining PINCER/OptimiseRx for the longer-term?

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G1Topic 2: What are the important considerations in taking a team approach across the healthcare system in implementing and sustaining PINCER/OptimiseRx for the longer-term?

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Incentivising SMRs - to help identify patients at highest risk first. Consistent evidence-based approach to identify and manage patients. Making it more visible to policy makers and alignment to existing agendas (talking their language) (1).

Encourage CCGs to use PINCER as a tool to learn from each other and with PCNs (3). Learning at a local level, building relationships and friendly competitiveness.

Emphasising safety and quality as well as cost effectivesness.

Incentivising according to local priorities instead of blanket approach.

Training practices to work together to bring high risk patients to the forefront. High dose opiates as well as long term opiates. Long term risk reduction.

Emphasising PINCER and OptimiseRx complementing each other in enhancing safety (2), i.e. PINCER acting as safety net, OptimiseRx stopping patients being "PINCER patients".

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G1Topic 3: How could engagement with secondary care be achieved for PINCER/OptimiseRx to ensure alignment of prescribing safety guidelines?

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G1Topic 3: How could engagement with secondary care be achieved for PINCER/OptimiseRx to ensure alignment of prescribing safety guidelines?

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Communication between secondary and primary care needs improvement (2). Potential for missed communication due to business.

Gaps between primary and secondary care.

Alignment in local policies for both secondary and primary care (1).

Shared targets between primary and secondary care (3). NICE-level guidelines. Up-to-date national guidelines for all.

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G2Topic 3: How could engagement with secondary care be achieved for PINCER/OptimiseRx to ensure alignment of prescribing safety guidelines?

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G2Topic 3: How could engagement with secondary care be achieved for PINCER/OptimiseRx to ensure alignment of prescribing safety guidelines?

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3. IT in secondary care not up to date to support Optimise RX or PINCER
Discharge summary - Transfer of care discharge summaries - involving CP - Engagement with patient at the transfer of care
1.Communication and a system wide approach - not working in silos  talking to eachother.
Communication - involve patients
PINCER  - most successful where their is discussion across the NHS
PINCER is about the training aswell as the indicators and bringing all sectors into that important
2.Design indicators so can enable conversations to be opened up
Involve community pharmacy - eg feed back supply or local medication strategies/prescribing
Shared decision making and shared data

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G3Topic 2: What are the important considerations in taking a team approach across the healthcare system in implementing and sustaining PINCER/OptimiseRx for the longer-term?

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G3Topic 2: What are the important considerations in taking a team approach across the healthcare system in implementing and sustaining PINCER/OptimiseRx for the longer-term?

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Reassurance and education of patients and carers that this is a positive change and not to be concerned about, it's part of normal care
Ensure that other team members understand the role of the practice pharmacist and overlaps with the role of others. Have a co-ordinated approach as to where the practice pharmacist fits in and their workload and what PINCER entails
In terms of sustainability,  presenting case studies, evidence of the benefits and direct improvements would be helpful to share within practices/PCNs/CCGs - have a two pronged approach of as well as presenting the medical side of things also present lived experiences of improvements to quality of life and how the time taken to run the PINCER activities has much larger benefits to the patients

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G3Topic 3: How could engagement with secondary care be achieved for PINCER/OptimiseRx to ensure alignment of prescribing safety guidelines?

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G3Topic 3: How could engagement with secondary care be achieved for PINCER/OptimiseRx to ensure alignment of prescribing safety guidelines?

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Secondary care do not have access to full care records, OptimieRX would be helpful in hospitals when dugs are being prescribed  (whereas PINCER tends to pick up medications prescribed in secondary care in potentially in error)
Secondary care should take the opportunity to improve prescribing just as primary care does
Communication and filling the gap, it would help to have a system that allows secondary care and primary care pharmacists to communicate with one another. It might be useful to have a regular platform where both practice pharmacists and hospital pharmacists are able  see/have an overview of all medication reviews and communicate with one another
Discharge summaries are normally written by the discharging doctor despite the patient receiving care from different health care professionals - would be helpful if everyone involved in the care could have input into this summary?

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G2Topic 2: What are the important considerations in taking a team approach across the healthcare system in implementing and sustaining PINCER/OptimiseRx for the longer-term?

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G2Topic 2: What are the important considerations in taking a team approach across the healthcare system in implementing and sustaining PINCER/OptimiseRx for the longer-term?

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PINCER - reduced to a set of indicators - it is actually a quality improvement intervention - training of pharmacists - engagement with pharmacists - solution based discussions
Skill set of pharmicist delivering PINCER - not easy and should be valued
Identify where weaknesses are in system
2.Effective communication - mechanisms at regional and national level
Advent of PCN pharmacists - becomes more about day to day practice
3. Embedding PINCER in the system, involving the practice team
1.National leadership - help with funding stream - resources -data infrastructure
Reference in policy documents
Data - infrastrucure - allows the interventions to happen at local and national level
Ability to collect data nationally