This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

GPs asked to review medicines of care home residents as part of Covid service

Primary care networks (PCNs) are to start delivering structured medication reviews (SMRs) as part of the support they are providing to care homes during the coronavirus pandemic.

The service, which was due to be introduced from April this year under the network DES, was postponed until October just before the UK entered lockdown in March.

But now NHS England has told practices that the service is to be introduced in care homes as part of the support package provided to them.

Speaking in a GP webinar on care home support, NHS England’s deputy chief medical officer Dr Bruce Warner said there are residents with ‘complex’ needs for whom SMRs would be ‘appropriate’.

Dr Warner said: ‘While these were being worked up before the pandemic and although they are part of the PCN DES to be introduced in October, we still recognise there are patients out there right now with complex polypharmacy needs where a structured medication review is appropriate.’

Pharmacy staff, who are part of PCN multidisciplinary teams recruited under the additional roles reimbursement scheme (ARRS), are ‘very keen to get involved’, he added.

He said: ‘Many of them are in place now to start undertaking those reviews and making sure we keep our patients as safe as we can.’

A new NHS England operational model published last week added that pharmacy teams across the health and care system, including general practice, must ‘rapidly mobilise’ to support care homes.

The reviews ‘could’ be delivered remotely via video or telephone consultations and should prioritise those with ‘high risk’, it added.

It said: ‘For some residents, it is still important to deliver SMRs to ensure medicines safety. SMRs could be delivered via video or telephone consultation and where appropriate, involve residents and/or their family/carer. 

‘Local teams will want to consider priority groups, ensuring that those residents that are on high risk medicines or combinations of medicines are prioritised.’

First introduced in last year’s network DES, NHS England said it expected an SMR to take 'considerably longer than an average GP appointment' in its original draft service proposals. 

The proposals were diluted in February following concerns from GPs over the additional workload they would create - along with the controversial plans around care homes.

And in March the introduction of SMRs was postponed until October when the enhanced health in care homes service requirements were originally due to begin.

However, practices are now expected to monitor care home patients with Covid-19 face to face as well as remotely under a new support service which includes weekly virtual ward rounds.

Readers' comments (10)

  • National Hopeless Service

    So it was the DES but wasnt the DES but is the DES.

    Unsuitable or offensive? Report this comment

  • Yes, despite being told that the DES is not being brought forwards in terms of "weekly rounds" and that this was only Covid related, the SMRs are also being brought forward - but this is NOTHING to do with the DES and everything to do with Covid.

    This is so confusing that I might have to drive to Barnard Castle to clear my mind and sort out my eyesight.

    Unsuitable or offensive? Report this comment

  • Most care home elderly patient have complex medical histories and polypharmacy. There is a clear need for good medicines reviews as in many cases this does not occur on a routine basis and leads to problems[ no renal function checked on patients on ace inhibitors etc]. However, my experience is they take at least 20 minutes a patients if done properly, and the practice pharmacist I worked with requested an hour per patient. Good idea, but not sure how this gets fitted in with everything else!

    Unsuitable or offensive? Report this comment

  • Sorry obviously didn’t go to NHS E school of obfuscation and attend Mr Cumming lecture on double dealing regarding when is a DES not a DES!

    Keep them coming please I love to hear reasons why I’m leaving at earliest personal convenience and not the NHS convenience.

    Unsuitable or offensive? Report this comment

  • Do more, think less, die quicker.

    Unsuitable or offensive? Report this comment

  • End of the line?

    Stay Elite

    Unsuitable or offensive? Report this comment

  • End of the line?

    Perhaps the Care home named GP.. (record uptake of compulsory role)
    could co ordinate this ..
    and the likely need for further monitoring blood tests..
    All whilst avoiding exposure to COVID
    for both the home its patients and healthcare staff

    NHS England desperately wants to be seen to be doing something..
    or do they think GPs are twiddling their thumbs
    and could be doing this instead? While things are quite...

    Unsuitable or offensive? Report this comment

  • been doing this for years in my patch. best allow us to think and innovate locally.

    Unsuitable or offensive? Report this comment

  • so long that someone does something that can be described as significant supportive actions during daily covid update

    Unsuitable or offensive? Report this comment

  • If you aren't happy doing it, well then, just sing this little song

    "JDFDI, JDFDI, I know I can I'm sure I can, JDFDI"

    Tune: I'm h.a.p.p.y
    words: contain just, don't, fucking, do, it

    Unsuitable or offensive? Report this comment

Have your say