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Pharmacists in Care Homes
Since my time in care settings where I would visit and provide pharmaceutical advice to both service users and their carers, I have always advocated for there to be a circumstance where pharmacists were assigned to them. It made sense to me and the even the care setting managers were asking for this too!
So, I’m pleased to now learn that as of last month (March 2018) NHS England announced plans to recruit and deploy hundreds of pharmacists into care homes to help reduce over medication and cut unnecessary hospital stays. This is welcoming news and a long time coming too!
Studies have shown that up to 1 in 12 of all hospital admissions are medicine-related and two thirds of these are preventable, said NHS England, which hopes the move will reduce emergency admissions and make savings in unnecessary prescribing costs. On average, care home residents are prescribed seven medicines daily for conditions such as dementia, hypertension, diabetes, and heart disease. Around 10% of people aged over 75 are prescribed 10 or more a day.
The scheme announced by NHS England will recruit 240 pharmacists and pharmacy technicians. Recruitment begins during April 2018 with plans to have them in place by the Summer of 2018. They will not necessarily be deployed in individual care settings but deployed by service providers (e.g. NHS trusts) where they are needed.
They will review the medicines of around 180,000 people living in nursing or residential homes. The reviews will be done with GPs and practice-based clinical pharmacists to make sure patients are prescribed the right medicines at the right time to improve thz\ZX`1eir health and quality of life, said NHS England.
A pilot of the scheme in Northumberland showed that one hospital readmission could be avoided for every 12 residents reviewed. In East and North Hertfordshire, an annual drug cost saving of £249 per patient was made across the 37 care homes where the scheme was trialled
Results from the six NHS England care homes vanguard sites piloting this approach showed that they:
- Reduced reported emergency hospital admissions by 21%
- Reduced oral nutritional support usage by 7%
- Reduced ambulance call outs by up to 30%
- Made drug cost savings of £125 to £305 per resident
These statistics make a case for these healthcare specialists to be providing ongoing advice and more to the point and importantly in the care setting itself.
In my own case, I often experienced situations where service users were being over medicated and in some cases service users were taking medication they did not even need and were doing so for many years! During my visits, I would carry out a full medication review with the service user and thereafter contacted their GP and provided sound advice on where we could reduce the service users’ dependence/need for unnecessary medication.
As a result, the GP, the care setting, and I worked together to reduce the burden on the NHS and help reduce unnecessary waste and money being spent. It just made common sense!
The introduction of these specialists is part of NHS England's refreshing NHS Plans for 2018-19 scheme, which sets out measures to provide joined-up services for patients to ensure they receive the most appropriate care. Simon Stevens, chief executive of NHS England, said: "There's increasing evidence that our parents and their friends - a whole generation of people in their 70s, 80s and 90s - are being over medicated in care homes with bad results. "The policy of 'a pill for every ill' is often causing frail older people more health problems than it's solving.
The current chair for the Royal Pharmaceutical Society stated “Around £24 million of medicines is wasted every year in care homes and pharmacists can set up systems that improve efficiency whilst at the same time providing better health outcomes."
These are certainly exciting times for the pharmacy profession and a real recognition by the NHS on the value of the professional advice provided by pharmacists every day. And I’m sure all care home managers will welcome this news too.
*All information is correct at the time of publishing