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Getting medicines right in hospital and at home

Getting medicines right in hospital and at home
24 September 2015

An innovative new local service to help prevent re-admissions to hospital and support people in their own home has been shortlisted for a national award. 

The Pharmacy Reablement Service led by the Isle of Wight NHS Trust with Pinnacle Health Partnership LLP has been shortlisted in the Primary Care Innovation category of the Health Service Journal (HSJ) Awards 2015. 

Developed in partnership with the Local Authority and Social Services,  the service supports people with poor physical and mental health to better manage their medicines by providing one to one support from the time they come into hospital to when they return home.  It is estimated that around 6% of hospital admissions are caused by problems with medication.  

Before being discharged from hospital, patients that are identified as being at a higher risk of re-admission due to an inability to manage their medicines are assessed by a hospital pharmacist. The assessment looks at how well they know their medicines, their cognitive ability, home circumstances, memory, and ability to manage their medicines. This information enables health professionals to put in place the necessary help and support needed for when the patient goes home. 

A referral to a community pharmacist can be made and a home visit arranged whereby a full Medicines Review is carried out to make sure the right medicines are being taken, any discontinued medicines are safely disposed of and if any support services such as home delivery and repeat prescriptions are needed, these can be arranged. 

The service has run for 3 years and already it has reduced readmissions, made hospital stays shorter, and released over £800,000 worth of health care for local patients. Commenting on the difference it has made, Gill Honeywell, Chief Pharmacist at St. Mary’s Hospital, said: “Medicines are the one form of treatment that patients are expected to manage themselves at home, yet they can be the most complex care, requiring special instructions, multiple times a day, and self monitoring for side effects. 

“A hospital stay usually involves changes in medicines which can complicate self care even further. We provide an opportunity for patients to open up about their medicines when they come into hospital, help with any problems and changes, and the reablement service enables us to continue that support after they go home, handing over to our community pharmacist colleagues safely to continue to help patients get the most from their medicines. This close working between hospital and community pharmacy is being used as a service model for other areas and we are really pleased to see it recognised nationally in this way.” 

Feedback from patients and carers who have received a community pharmacy home visit have said they felt less anxious and more confident about managing their own medicines. Community pharmacists participating in the service feel personal and professional satisfaction at making a significant impact on the patients’ ability to remain at home. Participating in the service has also altered pharmacists approach to managing other patients who have been recently discharged from hospital. 

Gary Warner, local community pharmacist and managing partner of Pinnacle Health Partnership LLP said: “The recognition by a national organisation of the innovation in care for our patients highlights the work and dedication of pharmacists in the community. At a time when the NHS is struggling to make ends meet, the Island is starting to make better use of our clinical skills to support patients out in the community rather than always at the hospital or surgery. I’m particularly proud of my colleagues who gave up lunchtimes and evening meals to attend patient’s homes to help and support them in the initial pilot phase and now we have clear evidence that this brings tangible benefits we look forward to working with the Trust to make this a sustainable and resilient service.” 

The winners of the HSJ Awards will be announced at an event on 18th November at the Grosvenor Hotel, Park Lane, London.

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