A team of nine pharmacists and five nurses in Central Lancashire provides the Care Homes Effective Support Service (CHESS). The team is contacted when a home needs medicines expertise or support and it provides many of the services that GPs have traditionally provided.
The team makes an in-depth assessment of each home, discusses it with the care home manager and agrees a plan of action. Chess also provides health monitoring and assessment and has a current caseload of 1200 patients.
From August to December 2008 the team made 445 medicines interventions and 1143 healthcare interventions. During this time 22 medicines incidents were identified, of which three were serious.
During the pilot phase of the project (involving 160 people in four care homes) a one-year evaluation revealed that GP call outs, which cost the NHS around £50 each, had dropped by between 96.2 and 89.7 percent. A seven percent drop in hospital admissions was estimated to have saved £18,564.
The number of residents suffering falls had been reduced by 32 percent with the number of fractures dropping 60 percent, including an 80 percent reduction in hip fractures. Here the resulting saving to the NHS was estimated at £56,160.
Amongst other things the project has shown that, for a small investment, managing dementia appropriately, reducing medication, improving end-of-life care and ensuring appropriate, regularly reviewed medication is possible.
Email Louise Winstanley for further information.
(Taken from The Pharmaceutical Journal, 4 Jul 2009)