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A faulty production line

Pharmacists to review medication of 180,000 care home residents

GPs will be part of a pharmacist-led medicine review including 180,000 care home residents, under a new NHS England scheme announced today.

The programme, which is aimed at reducing overmedication in care homes and cutting unnecessary hospital stays, will see an additional 240 pharmacists and pharmacy technicians recruited at a cost of £20m.

NHS England has said that around 180,000 people living in nursing or residential homes will be reviewed, as they often have multiple long-term conditions and take an average of seven medications daily.

It explained that the reviews will be done ‘in coordination with GPs and practice-based clinical pharmacists to ensure people are prescribed the right medicines, at the right time, in the right way to improve their health and overall quality of life’.

This comes as the Department of Health and Social Care told Pulse that every practice will have its GP prescribing data linked to hospital admissions and published within months.

The first pharmacists, set to be recruited from April 2018, will not be based within single care homes, but deployed by providers where needed. A clinical training and development programme will be also be run to allow pharmacists to become independent prescribers.

Previous trials have already been run in areas such as East and North Hertfordshire, which saw an annual drug cost saving of £249 per patient, across 37 care homes.

NHS England said that they also saw a 21% decrease in reported emergency hospital admissions and up to a 30% drop in ambulance callouts.

NHS England chief executive Simon Stevens 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.

'Let’s face it – the policy of "a pill for every ill" is often causing frail older people more health problems than it’s solving. So expert pharmacists are now going to offer practical NHS support and medicines reviews in care homes across England.'

BMA GPC chair Dr Richard Vautrey said that while he welcomed the scheme, the 'Government must now follow through with this commitment to patients and provide every GP practice with its own pharmacist, which will not only ease workload pressures on doctors, but also ensure that these errors are prevented in the wider community.

'Every hospital ward has a linked pharmacist. It’s about time every practice had one too.'

The scheme was created by CCGs, the CQC, the Royal Pharmaceutical Society, pharmacy groups, care home stakeholders, and the NHS England Better Use of Care Homes group with representation from Public Accounts Committee on Social Care Workforce and the Local Government Association.

It follows a recent study which found that when GPs and geriatricians teamed up to review the prescriptions of local elderly patients, 91% saw changes to their medication regimens, which equalled an average of four changes per patient, with more than half of those being a reduction to the dose or stopping a medication.

Readers' comments (7)

  • There’s a lot we can do if we put extra staff and resource in

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  • Not saying it is a bad thing, but ‘91% of patient’s had 4 or more changes’. So how many extra GP consultations will follow...’she is more agitated since...’ ‘he needs bloods’ ..’she does not like the larger pills and refuses to take them’...’please come and document the changes in our notes’.. ‘her daughter says that she felt awful when she had these in the past’..’she never sleeps without...’ etc.

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  • AlanAlmond

    I’m not convinced. We regularly had pharmacists carrying out ‘medication reviews’ and, whilst the occasional genuine issue was picked up, more often the end result was a heap of pointless appointments with people coming in worried about their medications, for no good reason. This is because the pharmacist didn’t have access to the medical record, and didn’t know the full history, and to be honest, often didn’t really have much of a clue about the reality of balancing risk vs benefits - because that’s not their job. The person doing the review needs to be the person doing the prescribing, otherwise you may simply be creating additional work at additional expense.

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  • And will this really reduce admissions?

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  • doctordog.

    But at least they can’t blame us.

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  • Macaque

    Let's be honest. Polypharmacy among the elderly is a huge problem that we are not bothered to sort out. Jeremy to the rescue!

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  • Easy Peasy when their frailty score breeches a certain level stop all the drugs' bit Like logans run really salty Tsar Jeremy says so he can set it we can follow.May be he can get his puppets at Nice and the CQC to police it and rally the troops the only way they can with the big stick.

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