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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.