We worked with a team of clinical care home pharmacists to improve the medicines management support offered to older people living in care homes. You can read the background to this case study below or watch our animation to find out how care home residents like Doris have benefited from the medicines management service.
Older people in care homes are among the most vulnerable members of our society, reliant on care home staff for many of their everyday needs. A combination of complex medical conditions often means that people need to take multiple medications, with care home residents taking 7–8 medications on average. This ‘poly pharmacy’ in turn increases the risk of medication errors. Medication errors may occur as a result of a failure in prescribing, dispensing, administering or monitoring medication.
A recent study recommended that an independent clinician should review medication processes in care homes. In response, the CCG commissioned specialist pharmacists to work with GPs to monitor and adjust medications so that long term conditions can be managed safely and effectively and medicine-related admissions to hospital are reduced.
Involvement and engagement
Our communications and engagement team met with the care home pharmacy project lead to discuss the project. An engagement plan was produced to outline how we could start to understand the experience of residents and their carers and staff.
The engagement plan was then taken to our patient assurance group (PAG) for approval. The patients who attend the group were satisfied that the plan was appropriate.
Following approval from the PAG we produced a survey to capture the views of residents, their carers and staff. We shared the survey with care homes and attended a number of these to support people to fill in the survey. We also promoted the engagement with our CCG patient network and asked local community organisations who work with older people to share the survey with their service users.
Once the engagement was completed a feedback report was written for the CCG. The report summarised the feedback from staff, residents and their carers and made a series of recommendations based on the findings. The report was shared with all the people involved in the engagement as well as being added to the CCG website and included in the monthly CCG newsletter.
In eight months a total of 460 care home residents had their medication reviewed with 25% requiring a referral for further support, including 15% requiring a review of their existing dementia medication. In addition 28% of patients required a follow-up review. The local NHS was able to make approximate savings of around £90,000 as a result of this project, money that can be re-invested in local services. Thanks to the success of the initial pilot we have extended the project for an additional year.