Every year over 1.5 billion medications are administered in care homes across the UK, which indicates there are over 1.5 billion chances something could go wrong.

A report from the Royal Pharmaceutical Society (RPS), ‘The Right Medicine: Improving Care in Care Homes’ highlights the challenges of looking after our ageing population that are in a care home setting. The recommendations from the RPS are not new. Numerous reports have highlighted the value a medicines expert, a pharmacist, can bring to the management of medicines.

Every hospital in the country has access to a whole team of pharmacy professionals, from the Chief Pharmacist, Specialist Pharmacists, Technicians, Dispensers, Procurement, Automation Technician, and logistics technicians/porters. These teams are efficient in what they do and they deliver a high quality of service that saves the NHS millions each year.

What Government support do care homes receive for medication management? Well, not a huge amount at all and the situation is far from ideal. Part of the problem is that the ‘national pharmacy contract’ remunerates dispensing and very little else. New models of care delivery could make a huge difference.

So what’s different now? The recent Tariff cuts of £170m mean that many pharmacies will be left wandering if the cost and effort of assembling medication for care homes is commercially viable. One statement that resonated was that the cost of providing a ‘blister pack’ service will become unviable in 3-5 years if Government cuts continue at the rate they have in the past. Having listened too many of my Pharmacy colleagues, from senior staff at the multiples, Independent Pharmacy Contractors, LPC (Local Pharmaceutical Committees) members and care home owners, one thing is clear; they all agree that things can and should be improved. What isn’t always clear is how this change can come about in the current austere times.

“The recent Tariff cuts of £170m mean that many pharmacies will be left wandering if the cost and effort of assembling medication for care homes are commercially viable.”

There is light at the end of the tunnel…Many care homes and pharmacies are investing in medication management technology and as a result are able to do away with the old fashioned supply of medicines in blister packs. This change significantly reduces errors and reduces the operational cost of ‘popping pills’ from professional calendar packs. The cost of the technology is offset by the reduction in consumable and labour costs. I hear the joy of many Pharmacy Technicians and Carers who are delighted to wave goodbye to the previously laborious system, for good. With Electronic Medication Management technology, the move to ‘original packs’ from blisters is made possible. The wins at the care home are also huge. Carers can do away with those cumbersome blisters and let us not forget the illegible paper MAR (Medication Administration Record) charts. Pharmacists play a key part in modernising the way medicines are handled in care homes.

“Pharmacists play a key part in modernising the way medicines are handled in care homes.”

Having a pharmacist for every care home, according to the RPS report, has the potential to save the NHS £135m. Isn’t it basic business sense to ring-fence some of the £170m saving the Government is enjoying, courtesy of the pharmacy profession, and re-invest it to create and commission ‘modern’ models of care? The cost of achieving the RPS report recommendations is not huge. A model where care homes are supported by their local pharmacist is made easier where technology is available. This would allow desk top reviews of medication (akin to MURs) before going to a care home, making the visit itself more patient centred. Pharmacy and care home operators will need to look to the future to ensure the ongoing viability of their businesses. Both the care home and pharmacy sectors have faced, and will continue to face, Government cuts. Those that have a plan to evolve will continue to ride the storms, those that don’t will sell or close.

 “Both the care home and pharmacy sectors have faced and will continue to face, Government cuts. Those that have a plan to evolve will continue to ride the storms, those that don’t will sell or close.”

My view on this is that pharmacists and care homes should collaborate to effect change such that every care home has access to a pharmacist that is able to deliver a more modern medication service (beyond dispensing). The outcome measures of harm and waste reduction can be easily measured. Equally, the CQC and commissioners such as CCGs or indeed NHS England itself also need to seize the opportunity to enable modern models of safer medication management to be provided to care homes. The benefit to our ageing population and the taxpayer are obvious. How can it be that in our modern technology-driven times, that we are still [in the main] managing medicines in care homes as though it were still 1980? Other developed countries (mostly those with private healthcare plans) have more easily embraced technology in a care home. Surely, now is the time to change in the UK?

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