by Liz Butterfield, FRPharmS Telemedicine Specialist Pharmacist, Airedale Digital Care Hub
Since May, I have had the privilege of working as a pharmacist in a wonderful clinical team at Airedale Digital Care Hub. This role was pushed forward by COVID-19 when the Digital Care Hub received funding to provide additional support to care homes in Bradford District and Craven CCG. It was a visionary decision made by local commissioners, who wanted all local care homes to have 24/7 access to clinical support through a single point of access with an aim of keeping residents safe in their home, as well as reducing GP and A&E pressures during COVID-19. I was included 2 days per week as part of a ‘Super Rota’ of health professionals who were added to provide additional expertise relevant to their different skillsets. The hub is staffed by experienced senior nurses with a variety of backgrounds – A&E, community, oncology, cardiology, care of elderly, respiratory and more – supporting each other as a team. The Digital Care Hub has a two-way video link with the care home who have a camera linked to a laptop, with access to the patient’s GP records where all consultations are recorded.
Digital care is not replacing normal care, but is helping to get patient access to clinical support in order to keep them safe in their care home during the pandemic. From a medicines optimisation point of view, a call to the hub is often a trigger for a medicines review caused by increasing frailty, falls, dehydration, increasing confusion, drowsiness, and other possible adverse effects. As a pharmacist, I can help to identify where medication review can reduce risks and improve quality of life.
Here’s an example of one of my days in September. Start with a referral for a Discharge to Assess patient who is leaving hospital and transferring to a care home as a new resident with a new GP surgery and new pharmacy. The discharge medications are very different from those on the repeat list from previous GP records and there is a real benefit in ensuring this complex transfer of care goes well and that only medicines which are beneficial for the patient long term are added at the new surgery. This includes a discussion with the care home to see how the resident is, how they get on with their medicines and what is important to them – a conversation with the patient by video is an important part of this.
I go to Employee Health and Wellbeing for training to administer IM flu vaccinations as a Peer Vaccinator for the Digital Hub. I am pleased to have added another useful skill that will be transferable to other setting including care homes. Hospitals feel a very supportive environment where the team pull together and welcome each other’s involvement.
At a staff meeting, we discuss access to medicines resources and refreshing awareness around potential of medicines to increase falls risk, particularly as a result of dehydration. I am finding the RPS COVID-19 resources so useful in supporting my role during the pandemic. We agree to discuss a polypharmacy case study at next team meeting where we will all learn things from each other.
During the day, two care homes have approached the digital care hub for support and reassurance around medication administration errors that have been noticed. I have coordinated a survey for care homes about how we can collaboratively reduce the frequency of medicine administration errors and learn from them.
I am delighted that the pharmacy skillset has been valued so much during COVID-19, that funding has been identified to continue for a further six months and during that time recruit a permanent pharmacist for Digital Care Hub.
My thanks to Gavin Miller, Chief Pharmacist at Airedale Hospital Foundation Trust, for this opportunity and for giving me a free reign to explore what a pharmacist can contribute to improving care and safety.