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25.02.16

Pharmacists in care homes could save NHS £135m each year

Introducing a pharmacist for every care home could save the NHS £135m every year and reduce problems such as falls and inappropriate use of psychotropic medicines, a new Royal Pharmaceutical Society (RPS) report suggests.

The report says that 405,000 elderly people live in UK care homes, of whom 97% are being prescribed medicine daily.

Problems caused by medicines included 25% of residents being prescribed antipsychotics despite an audit finding that in 58% of cases the danger of the medicines outweighs the benefits and in 26% of cases they were unnecessary, medicine side effects increasing the risk of patients falling, and £24m of medicines being unused every year.

Sandra Gidley, chair of the RPS English Board, said: "At a time when GP workloads are overwhelming and the NHS needs every penny, pharmacists can provide the solution by stopping the use of unnecessary medicines, upgrading residents to newer types of medicines with fewer side-effects and reducing the amount of wasted medicines.

“Having a pharmacist responsible for the use of medicines in a care home as part of the team of health professionals would also bring significant savings through regular reviews. The evidence is clear: now is the time for the NHS to act and improve the care of residents by ensuring a pharmacist has responsibility for the whole system of medicines and their use within a care home.”

Based on three local pilots, the report estimates that having one pharmacist and one GP responsible for all medicine in each care home would save £135m through reducing unnecessary hospital admissions and optimising medicine usage, as well as supplying better end-of-life care.

Currently, pharmacy services for care homes are mainly limited to the supply of medicines and care homes are often served by multiple GP surgeries and pharmacies. One four-month pilot in London found that when a pharmacist was given full responsibility for medicine management, it led to a 91% reduction in errors.

Dr Maureen Baker, chair of the Royal College of GPs, said: “We welcome the opportunity to further develop the constructive and valuable relationship that GPs have with our pharmacist colleagues, in a way that can increase our patients’ safety and save the NHS money.

“Our patients who live in care homes are invariably living with multiple, long-term conditions, and as a result are often taking multiple medications, which can lead to health problems in itself. Managing polypharmacy effectively is key to ensuring our patients in care homes are kept safe and only taking medicines that they need to – this also reduces medicine waste, and at a time when the health service is running with scant resources, this is particularly important.

“With GPs and our teams under incredible resource and workforce pressures, the suggestion that pharmacists to take on some of the medicine management responsibilities in care homes is definitely worth exploring – and we thank the Royal Pharmaceutical Society for putting these propositions forward.”

Howard Duff, RPS director, told NHE last year that the NHS should also increase pharmacists’ role in emergency medicine.

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