Pharmacists funded to work in care homes in England

NHS England is planning to fund the
recruitment of 240 pharmacists and pharmacy technicians to work in care
homes to try to cut down on unnecessary medicines taken by the
residents.

Care home residents often have one or more long-term health conditions, with some prescribed 10 or more medicines.

Trials have shown that pharmacists reviewing medicines reduced their use and improved patients’ quality of life.

In one trial, an annual drug cost saving of £249 per patient was seen.

That pilot scheme took place in East and North Hertfordshire across 37 care homes

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Altering doses

Eleesha Pentiah,
a pharmacist in Letchworth, bases herself in a care home for the day
and goes through all the medicines taken by residents, addressing any
issues.

“I had an 85-year-old man who was on co-codamol after
surgery, but that made him feel fuzzy so we put him on regular
paracetamol instead, which was much better,” she says.

Sometimes
it’s as simple as altering doses of medication, taking into account
lowering blood pressure as people get older and more frail.

“Before, they might have been on a list to see the GP – but they don’t always have enough time to analyse it all.”

Eleesha says it has also stopped residents from ending up in hospital.

Studies
suggest that up to one in 12 of all hospital admissions of residents is
medicine-related and two-thirds of these are preventable.

Trials across six care home sites:

  • reduced reported emergency hospital admissions by 21%
  • reduced oral nutritional support usage by 7%
  • reduced ambulance callout by up to 30%
  • made drug cost savings of between £125 and £305 per resident

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.

‘Bang on target’

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 overmedicated 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.”

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Sandra Gidley, who chairs the Royal Pharmaceutical Society, told the
BBC: “Our overstretched NHS is crying out for solutions and this one is
bang on target.

"This is a great start towards improving the care of residents by making the most of the skills that pharmacists have to offer.

"We’d
like to encourage NHS England to go even further and give pharmacists
overall responsibility for medicines and their use in care homes.

"Around
£24m 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.”

The roles for 180 pharmacists and 60 pharmacy technicians are
being funded over two years at a cost of £20m by the NHS England
Pharmacy Integration Fund.

They will be recruited from April, with people starting to take up posts in the summer.

The
successful candidates will not be based in individual care homes but
will be deployed by the hospital trusts to work wherever needed.

There
are currently 45,923 registered pharmacists in England, 19,510
registered pharmacy technicians and 12,042 community pharmacies.

Ms
Gidley said: “Having a pharmacist available to provide regular medicine
reviews will help residents stop, reduce, or upgrade their medicines to
improve their health and quality of life.

"Better use of
medicines also improves residents’ safety by reducing the number of
falls they have, which are another cause of hospital admissions, and
incurring an estimated annual saving of approximately £135m.

"So the saving is great but the improved quality of life is even more desirable.”

Published by Residential Forum

The Residential Forum is to promote the achievement of high standards of care and support for children and adults living in residential care and nursing homes, supported housing, residential schools and colleges, hospices and hostels. It contributes to improving the quality of service to the public. Members of the Forum are people of standing and experience drawn from the public, private and voluntary sectors, as well as some who can speak for service users and carers.

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