Background

MLCSU’s Liverpool medicines management and optimisation (MMO) team manages the Pan Mersey Area Prescribing Committee (PM APC), established in 2013. Wirral CCG, Wirral University Teaching Hospital NHS Foundation Trust (WUTH), Cheshire and Wirral Partnership NHS Foundation Trust and Wirral Community Trust became members of PM APC in 2018. Pharmacists from Wirral CCG and WUTH now attend all the APC subgroups and APC meetings.

"Joining Pan Mersey has improved the care of Wirral residents. The formulary is joined up with other areas which has improved consistency of prescribing. There is a greater knowledge pool and less duplication of effort."
Dr Simon Delaney, Medical Director, Wirral CCG

Action

Our MMO team chairs all the subgroups and drives all their work. With MMO support, Wirral colleagues have reviewed British National Formulary chapters and aligned them with the Pan Mersey formulary, which has been updated to reflect Wirral commissioning agreements where this is relevant.

We have also reviewed the shared care frameworks and prescribing support information documents and 35 out of 42 have been merged with Pan Mersey to date. This review is ongoing. Fifty three clinical guidelines have been reviewed and merged with Pan Mersey’s where possible (14 Wirral guidelines have been kept, three archived and the remainder adopted as Pan Mersey’s).

Following Pan Mersey alignment, each formulary chapter and guidance document was ratified through the CCG process.

"Pan Mersey has improved collaboration and standardisation of care between Wirral and the other Pan Mersey organisations, this has enhanced patient care across the interfaces."
Alison Evans, Lead Pharmacist, Medicines Management, Wirral University Teaching Hospital NHS Foundation Trust

Impact

Benefits include:

• Reduced duplication of effort. Wirral medicines management team is now collaborating with seven other CCGs to contribute to formulary updates and development of guidance.
• APC and subgroups have increased clinical input from Wirral.
• Greater governance for Wirral as the formulary is reviewed regularly as part of the APC review process and horizon scanning. Therefore updates will not be missed.
• The Pan Mersey formulary is reflecting Wirral commissioning arrangements so it is fully relevant to the CCG and trusts.
• Consistent decision making for Wirral patients who attend hospitals elsewhere in Merseyside.
• Wirral now has better insight into the tertiary trusts (Walton, Alder Hey) and specialist centres, for example gastroenterology and ophthalmology at Liverpool University Hospitals. Therefore Wirral has a greater understanding of working across Merseyside.
• Wirral formulary has expanded, where relevant, to include the specialist and tertiary trust input.
• Joint working between Wirral CCG and WUTH pharmacists is increased and commissioning issues can be addressed.

"Joining Pan Mersey has brought in improved governance. It has reduced inconsistencies in prescribing based on post code and helped improve care for Wirral residents."
Dr Saket Jalan, GP Lead – Urgent Care, Wirral CCG