Care home nurses set to benefit from on-site pharmacists

Nursing and care home staff have welcomed plans to introduce on-site pharmacists to help reduce over-medication and cut unnecessary hospital stays

Nearly 180,000 people living in nursing or residential homes in England will have their prescriptions and medicines reviewed by one of 240 new pharmacists and pharmacy technicians.

The announcement by NHS England follows a year-long pilot scheme run at six enhanced health in care home vanguard sites.

The findings showed the scheme:

• Reduced reported emergency hospital admissions by 21%.
• Reduced oral nutritional support usage by 7%.
• Reduced ambulance call out by up to 30%.
• Made drug cost savings of £125-£305 per resident.

Medicine-related hospital admissions

The trial was launched after NHS England was made aware of studies revealing one in 12 of all hospital admissions were medicine-related.

Two thirds of these were entirely preventable.

Older care home residents often have one or more long-term health conditions, such as dementia, hypertension, diabetes or heart disease, and on average are being prescribed seven medicines daily according to NHS England data.

The newly-recruited pharmacists will review medicines in coordination with GPs and practice-based clinical pharmacists.

Professional respect

Independent consultant nurse Lynne Phair said the plans meant care home nurses were ‘at last being treated with the same professional respect as their hospital-based colleagues’.

She pointed out that while nurses in hospitals across England had regular access to pharmacists as part of their multidisciplinary team, access for care home staff was far more patchy and sporadic.

She added: ‘This proposal is not about saying “nurses in residential homes have been failing”.

‘Older people living in care and nursing homes are living much longer now with long-term conditions than in the past.

‘While we should rightly celebrate that, it brings with it many more complexities like multiple co-morbidities and patients being much frailer than they used to be.

‘Having a pharmacist as part of a multidisciplinary team is essential for nurses in these settings as they benefit from their expertise, risk analysis and together they can certainly help to reduce unnecessary hospital admissions.’

'A pill for every ill' causing problems

NHS England chief executive Simon Stevens said: ‘There’s increasing evidence that our parents and their friends – a whole generation of people in their seventies, eighties and nineties – are being over-medicated in care homes, with bad results.

‘Let’s face it, the policy of “a pill for every ill” is often causing frail older people more health problems than it’s solving.’

The Royal Pharmaceutical Society’s English Board chair Sandra Gidley said: ‘This significant investment highlights the growing recognition that pharmacists who support care home residents can reduce medicines waste, improve efficiency and provide better health outcomes.

‘To make the most out of this chance to improve health outcomes, commissioners can also better coordinate and integrate patient care by drawing on the expertise and knowledge of pharmacists wherever they are based.’

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