Earlier this week, NHS England announced that the Pharmacy Integration Fund will be used to fund 180 pharmacists and 60 pharmacy technician posts to help improve medicines optimisation (pharmaceutical care) in care homes.[i] This is in addition to their commitment to 500 extra GP practice-based pharmacists this year.
The Royal Pharmaceutical Society (RPS) in Scotland welcomes this development, which will significantly improve care of some of our most vulnerable people in society. However, while the RPS in Scotland acknowledges progress delivered so far as part of the implementation of NHS Polypharmacy Guidance and the commitment expressed in the Scottish Government’s strategy “Achieving Excellence in Pharmaceutical Care” published last year, the Society is disappointed by the speed of progress in embedding dedicated funded roles for pharmacists in care homes and developing models of care that fully harness the skills and expertise of pharmacists.
In 2012, the RPS in Scotland launched its “Improving Pharmaceutical Care in Care Homes” report[ii] calling for a dedicated role pharmacist in every care home to ensure safe and appropriate use of medicines. The report highlighted research demonstrating that working as part of the multidisciplinary team, pharmacist-led medicine reviews led to better health outcomes and an improved quality of life. The report was broadly welcomed by the Scottish Government at the time, however outstanding recommendations from the 2012 report include:
- A dedicated role for pharmacists working in every care home providing pharmaceutical care such as medication reviews to improve pain management, skin health, falls and fracture prevention, palliative and end of life care.
- One community pharmacy and one GP practice aligned to each care home with service level agreements which ensure continuity of care and cultivate the quality therapeutic partnerships required to improve both care and effective team work.
- Improving safety through better sharing of information between all health and social care professionals involved in patient care including hospital discharge information and clinical information, such as, diagnosis, monitoring, test results, adverse drug reaction and allergies.
RPS in Scotland is currently working on a re-fresh of its 2012 report due for publication this summer.
Aileen Bryson, Head of Practice & Policy, said: “Some medicines can affect mental alertness, appetite, swallowing, and ability to self-care, so reviewing and reducing inappropriate medicines can improve residents’ quality of life. Staff also spend less time administering medicines and have more time to provide personal care. We welcome the progress so far within the Scottish Government Dementia Strategy and the prioritisation of care homes residents in the implementation of the national polypharmacy guidelines but more still needs to be done to achieve a high and consistent quality of care.
“People living in care homes are, in general, now frailer, nearer the end of their lives, and with more complex needs than in the past. The posts announced for England are indeed welcome news for care home residents south of the border. We would strongly urge the Scottish Government to follow suit to ensure care home residents in Scotland have access to the expertise of a pharmacist and the same level of pharmaceutical care as we provide to the wider community across primary and secondary care.”