South Tyneside CCG Care Home Team CBC PHARMICUS
South Tyneside CCG Care Home Team 2 pharmacists, 3 pharmacy technicians Work in South Tyneside area covering 24 nursing/residential homes We work closely with the homes, GP surgeries and community pharmacy
What do we do? Advisory service Help with CQC inspections and improve resident safety from referral Pharmacy Technicians – SYSTEMS REVIEW Review all processes in the home Includes ensuring that all medications are prescribed correctly, have directions, are stored appropriately, are lined up to the care homes cycle, reduce waste where possible, update allergies Observe a medication round Flag any issues to the pharmacist/GP Give a detailed report to the care home manager Pharmacists – MEDICATION REVIEW Support pharmacy technician Undertake medication review with each resident Liaise with GP/other healthcare professionals
How do we help the care home? Ensure all processes are robust One resident had numerous medications prescribed at night. With agreement of GP All paperwork is legal and up to date we changed timing so that medication was not missed. Another resident was given Aid the home in streamlining the paracetamol via homely medication process (ordering, remedies – the home needed administration, waste) to update their policy Improve resident safety by liaising with care staff to improve outcomes – referral to MH, Dietician
How do we help the resident? Undertake medication reviews Speak with residents (where possible), carers, relatives, GP’s – FORUMS Stop any unnecessary medication Start any medication needed Help with any issues – swallowing etc
Patient MD: 82 year old female in a residential home. Adcal D3 - one twice daily - STOPPED Alendronic acid 70mg weekly - STOPPED Codeine 30mg four times daily – STOPPED Laxatives - ADDED Salbutamol inhaler – when needed – STOPPED Rivaroxaban – DOSE CHANGE Furosemide 20mg daily - INCREASED Mirtazepine 45mg daily – REDUCED THEN STOPPED Paracetamol - when needed Hydromol cream – use for dry skin – OPENED FOR 6 MONTHS
Who do we work with? DIETICIANS: We have recently forged a link with the dietetic service at South Tyneside District Hospital We worked with the dietitians to ensure that all residents prescribed supplemental drinks were under review, that they were prescribed the correct quantity and type of drink and reviewed weight to see if the drinks could be stopped We identified residents who had been lost to follow up Stopped inappropriate items Amended supplements to reflect dietitian letters Improved resident safety and outcomes as well as making significant cost savings (due to stopping products being wasted)
MENTAL HEALTH TEAM: For example: risperidone, bloods for high risk medication DISTRICT NURSE: For example: dressings, vitamin B12 injections PRACTICE NURSE: For example: med reviews at same time, BP , etc SALT Team/Falls Team/Behavioural Team GPs: Patient centred approach
What have we achieved? From July – September 2019 We reviewed a total of 204 residents and made 282 prescribing interventions (including stopping/starting medication, updating allergy status, ensuring monitoring is being undertaken) We saved approx. £26,000 (annualised) Patient safety netted Developed as team across South Tyneside
Our future plans Work further with dietitians to repeat our review Promote food first Inhaler reviews Reviewing medication post-discharge Apply learning from the CPPE course Participate in symposiums, conferences and showcase our work
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