“It is so important that we work as part of the team providing care”
Sam Scarisbrick, Rowlands Pharmacy, Southport
At our pharmacy, one of our key roles is supporting patients who have been in a care home for respite, and are now returning home. They are going from a setting where everything has been done for them – with nurses administering the right dose of their medicines at the right time – to having to manage it for themselves. So we liaise closely with the patients, the care home and their GP, then arrange to get their first prescription delivered to their home.
This is really important in delivering continuity of care. It is so important that we work as part of the team providing care. We really are the linchpin – we know what the care home has been administering and we can be the point of communication.
For example, I had one patient who was 93 years old, and due to leave her nursing home to return to her own home. It was after liaising with her daughter that we learnt the patient was unable to open the blister packs of her co-codamol tablets.
So we arranged to pop the blister packs for her and dispense the medicine – which was on a monthly prescription – in a bottle that she could open. This is something so simple, but can make a huge difference to a patient’s independence.
We have built a relationship with her daughter through this, too – now she rings up with other queries and we ask how her mum is getting on. It is all about putting the patient first.
“I found that my training in consultation skills was really useful.”
Abdulmubin Bux, Hub Pharmacy, Chorley
We currently work with one care home, which has 50 beds. We do everything from monthly medicines, training, ordering, drug disposal, controlled drugs and safety alerts, to all admissions and discharges. We have an excellent relationship with everyone from the care home manager to the nursing staff.
There are lots of examples of when we have worked together as a team, but one that stands out is when I was delivering a batch of flu vaccines to the care home. There was one patient with dementia, who was really scared to have his jab. Because of his dementia, he was not at ease with medicines, but the jab made him even more nervous.
Normally the nurses give the jab, but on this occasion they asked for my help. I found that my training in consultation skills was really useful.
I sat down and talked, we had a bit of banter, and then the patient watched me give one of the staff members their vaccine. I was able to really calm him down, and then gave him the vaccine. It was a big relief for the care home staff – and they know that if they have any queries, they can come to me for help.
You get great job satisfaction when you know you can help in situations like this.
"I wanted to be more proactive."
Jon Smith, Mayberry Pharmacy, Newport
Patients in care homes commonly have multiple conditions and significant levels of polypharmacy. The traditional approach has been for pharmacists to visit care homes, to review residents’ medication charts and suggest changes. This is time- and resource-intensive, and it’s also difficult to cover the entire resident population.
I wanted to be more proactive. So I set out to source a technology to track, in real time, the issues arising from both prescribing and administering medicines to each resident. For the past 14 months, I have been using a tablet device and barcode system in two care homes, to validate and record every drug that is administered. Using this system, we in the pharmacy can pick up on problems, and support deprescribing activities.
On one occasion, I noticed that one care home resident had poor adherence over several weeks, because he was asleep when it was time to receive his medicine. His medical history was complex, with significant issues around pain control. He was taking morphine, amitriptyline at night, high-dose gabapentin, and morphine solution for breakthrough pain.
I contacted his prescriber, and over the next four weeks we started to reduce the doses of his pain medication. After a month he was no longer drowsy during the day, which meant he stopped missing doses of his regular medicine, and his pain also improved. He regained his mobility, and became more socially involved in the care home, which had a knock-on effect on his mood and general wellbeing.
For me, being able to intervene at such an advanced level to improve the quality of our patients’ lives really is an absolute delight.