Through structured medication reviews, we supported the proactive management of individual care home patients needs, saving over £149,000 in drug costs and on average 62 GP appointments per month across the Black Country and West Birmingham Sustainability and Transformation Partnership. 

Background

NHS England and NHS Improvement commissioned NHS Midlands and Lancashire (NHS ML) to deliver its Medicines Optimisation in Care Homes (MOCH) pilot project across The Black Country and West Birmingham Sustainability and Transformation Partnership. This programme is focused on integrating pharmacists and pharmacy technicians into the wider primary care workforce and supporting patients in care homes.

Action

NHS ML’s pharmacists worked as part of a multidisciplinary team to provide leadership on person-centred medicines optimisation. Several services were provided including 30-minute, in-depth, structured medication reviews, pharmacy technician led medicines waste audits and system reviews to support medicines safety.

Impact

The programme is improving outcomes and access for patients, relieving the pressure on GPs and accident and emergency departments, ensuring best use of medicines, and driving better value. The structured medication reviews have supported the proactive management of individual patient need, improving their quality of life.

The pilot project generated actual drug cost efficiencies of over £149,000 (excluding cost improvement from potential hospital admissions avoidance), with a saving per patient reviewed of £100. The service freed up on average 62 GP appointments per month (this excludes setup time, and pause caused by the COVID-19 pandemic), plus time spent on processing 100 outpatient and 46 discharge letters.

The care home system review provided assurance across a range of areas and identified where improvements were required.

All of the care homes were found to require improvement in at least 35 per cent of the areas examined.

All were deficient in the areas of medicine policy and medical records

Where more than 70 per cent were deficient in the same area, this was classed as a priority theme and 55 per cent of priority theme areas required urgent improvement. These were self-administration, staff training, ordering and receipt of medicines, safe storage of medicines and medication alerts and adverse reactions.

Over £1,222 of avoidable waste was identified from waste medicine audits in 11 of the care homes.

The pharmacy technician provided training to improve repeat prescribing processes within care homes; supporting communication between care homes, GP practices and community pharmacy to embed the new way of working. Training also covered the 28-day medication cycle, expiry date guidance document and good practice on disposal of medicines.

100% of care home and GP practice staff, and patients responding to surveys said they’d recommend this service