Greater Manchester Palliative Care Service

In April 2020, at the height of the COVID-19 pandemic when the country was in its first lockdown, ensuring access to palliative care medicines for end-of-life patients across Greater Manchester was a significant priority for the 10 GM CCGs. 

In collaboration with the GMHSCP Primary Care team, an audit of existing commissioned palliative care stock holding services in community pharmacy was conducted by CHL, including the number of commissioned pharmacies per locality and the stock lists. A number of issues and concerns around current provision, stock lists, access, availability, and reporting were identified following the audit and feedback from commissioners. It was also identified that the NW region required reporting on stock at pharmacy level; CCGs needed up to date pharmacy information in order to complete the required report. 

CHL prepared a standard offer to all 10 GM CCGs with a summary of the work to be completed, the timescales in which it would be delivered and a cost-effective standard fee for all. 6 of 10 GM CCGs took up the offer, with 2 CCGs opting for the enhanced service commissioned at tiers 2 and 3. 

In collaboration with the LPCs and GMHSCP, CHL: 

  • Prepared an updated service specification for all GM commissioners with the flexibility to commission 1 or all of a 3-tiered service.  
    • Tier 1 - stockholding only 
    • Tier 2 fast track delivery in hours  
    • Tier 3 out of hours on-call service 
  • Purchased mobile phones for all palliative care community pharmacies in GM, and shared the numbers with commissioners, general practice, out of hours services and other relevant organisations 
  • Conducted an EOI in localities identified as requiring wider coverage, setting the scoring criteria and decision rationale 
  • Contracted with a taxi organisation to support the tier 2 and tier 3 services 
  • Supported the LPCs to negotiate a standard set-up fee and annual retainer across GM 
  • Prepared a set of PharmOutcomes modules in line with the service specification and tailored to each localities’ stock list  
  • Held a series of webinars to support pharmacies with the specification & requirement of the new service 
  • Implemented weekly reporting to assure commissioners of up-to-date stock levels in pharmacies and to inform the mandatory NW region reports 

The work on the palliative care service for community pharmacy in GM was considered a significant contribution to the GM NHS at the height of the pandemic, and allowed CHL to clearly demonstrate to NHS commissioners our flexible and agile approach through: 

  1. Securing a standard service specification for palliative care across 6 of 10 GM localities 
  2. Delivering the work in less than 4 weeks  
  3. Implementing in over 90 pharmacies across GM ​​​