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RPS: Pharmacist for every care home could save NHS £135m

RPS: Commissioners should pay pharmacists to go into care homes (credit: Care Quality Commission, licence: bit.ly/carehomepic)

Pharmacists should conduct regular medicines reviews in care homes and train staff, the RPS says

Aligning a pharmacist with every care home could save the NHS £135 million a year, according to a new report from the Royal Pharmaceutical Society (RPS).

A review of three local pilots has suggested that pharmacist medication reviews could save £60m a year by optimising patients’ medicines use, the RPS said. A further £75m could be saved by keeping care home patients out of hospital, it said.

One pharmacist, working with a single GP, should “take charge” of medicines use in each care home, the society suggested.

Local commissioners should pay pharmacists to provide regular medicine reviews and train staff to improve medicines safety in care homes, it said in The Right Medicine: Improving Care in Care Homes report, published today (February 23).

“This will help to solve the issue of medicines waste, improve efficiency and provide better health outcomes for care home residents,” the RPS said.

Embedding a pharmacist within a care home's multidisciplinary team would ensure "consistently high care", the RPS said. Community pharmacists are “ideally placed” to take on this new role, it told C+D this week.

England's chief pharmaceutical officer Keith Ridge said he looked forward to "exploring the proposals further". "It is important that pharmacists are given the opportunity to use their skills to support care home residents," he said.

The proposals in detail

The RPS said pharmacists could particularly help with reviewing the use of psychotropic drugs in care – including antipsychotics – to ensure their use is kept to a minimum.

Pharmacists, prescribers, and care home providers should work together to formalise plans for patients’ end-of-life care, it said. Where a care home specialises in a certain type of care – such as dementia – the pharmacist involved should ensure they are competent in this area, the RPS said.

To establish this new role, clinical commissioning groups (CCGs) should create a blueprint for “what good pharmaceutical care in residential homes looks like”, it said. CCGs or care homes themselves should agree contracts for pharmacists to provide additional professional services, the RPS added.

The GP view

The Royal College of General Practitioners (RCGP) said the concept of allocating one pharmacist per care home is “worth exploring”, and could help reduce pressure on GPs. “We welcome the opportunity to further develop the valuable relationship that GPs have with our pharmacy colleagues.

“Managing polypharmacy effectively is key to ensuring our patients in care homes are kept safe and only take the medicines they need,” RCGP chair Maureen Baker said.

 

How closely do you work with local care homes?

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22 Comments

Gerry Diamond, Primary care pharmacist

The local mental health teams just go in and pill them up on lorazepam to stop old folk roaming around and causing too much work for the support workers.

Brian Austen, Senior Management

Included in the RPS report is reference to good evidence from Brighton & Hove CCG of how a medicine optimisation and de-prescribing scheme can work for patients, pharmacists, GPs and commissioning CCG. The cost of the scheme was a third of the savings. Very successful. On the other hand there was non-recurring funding for a similar scheme in Leeds West CCG but this looks like it will be replaced by a GP-led scheme.

Leon The Apothecary, Student

It was a good start to the area. Now to sort out the lack of actual surgeries in Brighton and Hove! Optimisation is a really good idea. And one I've touched upon on here before.

Chris Pharmacist, Community pharmacist

Blind optimism...how long will it take for the RPS and PSNC to wake up and realise there is no desire or willingness for anyone to fund community pharmacies 'so-called' extended role. Call my cynical, backward thinking, a nay-sayer, whatever. We have given the pharmacy leaders and the NHS over 10 years to think of something and deliver - we have been given nothing. Enough is enough, we need to fiercely protect the income we recieve from dispensing...the RPS are leading us nowhere as per usual

Clive Hodgson, Community pharmacist

Chris, I completely agree with your comment. Unfortunately our "leaders" still see our future in a "clinical" utopia. There are indeed niche roles for a few Pharmacists in new clinical roles but if (or when) we loose the dispensing role then it is game over for the majority.

Chris Pharmacist, Community pharmacist

RPS/PSNC seem quite happy to surrender payments for our core role and hope/assume that the NHS will fund another more clinical role when all the evidence over the last 10 years points to the fact they won't. And I still can't understand the silence from multiples - perhaps just content in passing the cuts to branch staff pay and staffing levels? Very strange.

London Locum, Locum pharmacist

Not strange at all. The silence speaks volumes. Any cuts will be absorbed by the staff. Profits for the chaps are ring fenced. Unity? Indeed. Strike? Multiples are praying for one.....

Shaun Steren, Pharmaceutical Adviser

Silence = The  Control of Entry guarantee 

Clive Hodgson, Community pharmacist

"Community pharmacists are “ideally placed”"

How many times have we heard this expression? And how many times has anything of substance resulted?

Chris Pharmacist, Community pharmacist

Who is going to fund it? NHS England? Nope. The patients GP? Forget it...the care home itself? very doubtful...a decent idea and one that could and probably would help and improve the care of elderly people in homes but as per usual an idea that will not come into fruition as the funding will not happen...this has been the problem for over 10 years in pharmacy now, when will the RPS and others wake up? 

Harry Tolly, Pharmacist

This is a win win for patients and Pharmacists. Better than working in slave like conditions imposed by the multiples.

P M, Community pharmacist

show people the money -- if you were an accountant and you said you could save the client a million pounds in tax a year  but for a 10% fee - people would jump at he chance and hire you  - as a pharmacist you could help and do the the same for a nursing home all for around £ 18 grand a year oh but you'll get job satisfaction - but the accountant will get he porsche

peace out 

 

 

 

London Locum, Locum pharmacist

Job Satisfaction? That old chestnut used by government/multiples/contractors. Paying adequately usually goes some way to satisfaction

Paul Miyagi, Information Technology

Yeah, this is good news and was proposed years ago , but then the nurses , et al , got on the band wagon and then it all went wrong. Like Harry says , much much better than being a " multiple drone ".

P M, Community pharmacist

please apply below : pay starts at £18 000 per annum

Barry Pharmacist, Community pharmacist

I've learned from the past two months from the announcement of the 6% cut just how deep the ill feeling and mistrust goes between pharmacists who have seen their working conditions deteriorate, job satisfaction evaporate and stress levels rise to unbearable proportions. According to some pharmacist wages are going to continue to go down, particularly for new registrants. So PM you might slight those that would take this work for £18K a year BUT there will be more job satisfaction and a chance to learn and develop your skills. £18K will soon rise once you have more experience. And CCGs will want to employ you. Go for it. Oh and by the way smarmy comments like yours are not needed. A new vision is needed and you're view is too narrow to participate - in MHO.

P M, Community pharmacist

youre right barry develop those skills do your cpd adhere to all standards  / ig requirements / sops have ethics-  learn - try and help as much as you can with unpaid overtime etc - drive miss daisy around so she can buy some toothpaste be a good pharmacist  

then work your way up to 22 k after 5 years - good luck - oh and we all know the new vision 

its bend over so i can shove this bnf up your - i think you know where!

peace out

 

Hospital Pharmacist, Hospital pharmacist

I really think you guys are disillusioned. After 6 years of studying post-grad courses wages are approximately 45,000.

I honestly think a lot of people complain about their jobs 'not being clinical enough' then moan when great opportunities are provided.

Unpaid overtime? its not unknown- nurses/doctors do this all the time!

Hospital Pharmacist, Hospital pharmacist

I really think you guys are disillusioned. After 6 years of studying post-grad courses wages are approximately 45,000.

I honestly think a lot of people complain about their jobs 'not being clinical enough' then moan when great opportunities are provided.

Unpaid overtime? its not unknown- nurses/doctors do this all the time!

P M, Community pharmacist

6 years post grad - omg - lucky boy - is that £45 000 after tax?

 

 

 

Hospital Pharmacist, Hospital pharmacist

another complaint... what a surprise!

 

P M, Community pharmacist

eh yeah complaint .. i live in my car . i cant afford to buy a house , my wife left, the kids arnt happy with porridge three times a day and i want new shoes ... of course complaints

 

 

 

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