Section 4: Pharmaceutical needs in social care settings
The objective of pharmacy services in social care settings is to support the people in social care to ensure that they are able to make the most effective use of their medicines. This contributes to improving health outcomes for individuals.
This section describes the elements of a pharmaceutical support plan. A person will need different elements according to his needs and circumstances. The starting point will always be the person’s needs.
Some of the medicines-related needs of people in social care settings can be met by direct person-centred services, for example, medication reviews or signposting to patient support groups. Other needs can best be met indirectly by services designed to support care settings or GP practices, for example, care worker training, helping care managers to comply with medicines legislation or repeat dispensing schemes. Figure 2 below shows how pharmaceutical support services, both those that are available now (as ‘essential services’ in England and Wales or ‘core services’ in Scotland) and those that might be commissioned in future, contribute to the overall support for medicines-related needs for people in social care settings.
The next section gives a short description of each of the services shown on the figure and explains how the service can help to meet specific medicines-related needs and improve outcomes for people. We have also included some examples of established services to illustrate how services can work in practice.
Some of the services listed on the figure form part of the current community pharmacy contract. However, a care home service, which includes the provision of advice and support to the residents and staff within the care home, over and above the Dispensing service, falls into the category of enhanced services which are planned and funded locally to meet local needs. It is unlikely that all community pharmacies would be able to provide all the services listed and commissioners should also consider the possibility of provision of some services from other sources such as pharmacists working in secondary care or other healthcare professionals.
One important aspect of medicines management in connection with people in social care settings is equitable provision of routine services. Someone who visits a pharmacy is able to access pharmaceutical advice, for example about the use of dispensed medicines or healthy living, but this may not be available to people in some social care settings. In these situations some form of locally funded outreach service may be considered (see case study 7).