Improving the administration of medicines in care homes

The Department of Health issued a safety alert (DH ALERT(2010)001) on 6th January 2010 requiring Primary Care Trusts with primary medical care contractors, providers of pharmaceutical services and social care partners to review the safety of local prescribing, dispensing, administration, and monitoring arrangements in the provision of medication to older people in care homes and establish a plan for effective joint working in the future, including auditing on-going progress. All of the Primary Care Trusts across the South West are making significant progress with this and some examples are shown below.

Plymouth City Council working in partnership with NHS Plymouth has won a Great British Care Award for its Dignity in Care Home Forum. One of the strands of its work was to provide additional support to care homes for safe medicines practice including a critical incident report process to encourage learning from errors and share the learning from these through the forum.

NHS Bristol are leading a project on this as part of their quality, safety and productivity work and are working closely with general practitioners to improve medication safety in care homes through a local enhanced service and multidisciplinary review of care home patients. They are developing a training package with the University of the West of England and are also trialling a partnership with a commercial provider to improve the safe use of medicines in care homes.

NHS Cornwall is working across agencies and involving community pharmacy in reviewing care home patients through clinical medication reviews. They have produced an interim report showing the results of reviewing 758 residents of care homes jointly by their general practitioner, a pharmacist and a senior carer responsible for administration in the home. 518 interventions were made for 68% of patients. Safety was significantly improved for 43 of the patients, moderately improved for 81 patients and slightly improved for 237. A significant amount of prescribing and wastage was addressed with savings from this amounted to £4 per patient per month.

An order of prescribing for dementia caee will be implemented by the South West Strategic Health Authority in September 2010.