The Pharmaceutical Journal Vol 267 No 7157 p83
July 21, 2001

What will the successful medicines management pilot sites be offering?

This week saw the announcement of the 26 sites that will take part in the first wave of the medicines management pilots hosted by the National Prescribing Centre. Frances Thompson looks at some of the services they will be offering

The medicines management services team: (left to right) Richard Seal, Gillian Harvey, Breeda Worthington and Mark Pilling. Not pictured, Debra Hunter and Simon Ali

The Medicines Management Collaboration, which is hosted by the National Prescribing Centre in Liverpool, was first announced in “Pharmacy in the future”. The idea behind the scheme is to use the skills of pharmacists to help patients make better use of medicines.

There were 116 applications from primary care organisations to take part in the first year of the programme, of which 26 have been successful. Richard Seal, the medicines management services team leader, told The Journal: “A lot of work went into preparing the bids but the ones that really stood out were those where people from different professional backgrounds worked together on their application.” So, what are some of the successful sites planning to do?

In the North West, Bootle and Litherland Primary Care Trust (PCT) will be assessing the ability of certain patient groups to self-medicate, with a view to improving concordance. Alison Astles, the prescribing adviser at the PCT told The Journal that elderly patients would mainly be targeted. This was because older people were most likely to need assistance with taking medicines. By targeting this group, the project would also help the PCT to meet requirements set out in the National Service Framework for Older People.

Describing the scheme, Miss Astles said that patients who required help with taking medicines would be identified and referred to a local community pharmacist by general practitioners, social services, carers, nurses or by pharmacists themselves. The pharmacist would then meet the patient to discuss their medicines.

Miss Astles explained: “The pharmacist who will be undertaking the reviews has a second pharmacist working with him. This will give him the flexibility to see patients wherever it is most convenient — for example, in the pharmacy, in their own home or at the GP’s surgery.” Having assessed the patient, the pharmacist will make recommendations for helping them with their medicines. He will then review and reassess the patient on a regular basis, if appropriate.

Successful bids from Trent included those from South East Sheffield and from North Eastern Derbyshire PCTs. Steve Morris, the prescribing adviser at South East Sheffield explained that one of the major aims of the PCT’s project would be to investigate the complementary roles of community pharmacists and practice pharmacists. By building on the strengths of pharmacists working in a variety of settings, the PCT hopes to provide convenient access to a range of medicines management services in different environments.

Medication review will be a priority in the scheme and will be targeted at elderly people known to be at high risk of medicines-related problems. A number of projects will also be piloted that will explore the extended role of community pharmacists, including concordance schemes, management of minor ailments, repeat dispensing and the provision of anticoagulation monitoring.

Ann Gates, prescribing adviser for North Eastern Derbyshire PCT told The Journal that the bid made by her PCT had two components. First, it aimed to develop the understanding of patients, carers, intermediate care workers, social services, and all partners with regard to medicines management, through a collaborative approach to learning. Secondly, it aimed to provide person-centred pharmaceutical care to older patients who need multidisciplinary medicines management support.

“This should improve the quality of care of patients, reduce unnecessary admissions to acute or residential care, limit loss of patients’ independence and give patients and carers access to more information about medicines,” she said.

Elderly patients who would be most likely to need help would be those who had suffered or were at risk of suffering a stroke, those at risk of falling, those requiring regular pain management and those receiving over four medicines, she explained.

Cheltenham and Tewkesbury Primary Care Group sent in one of the successful bids from the South West. Teresa Middleton, the prescribing adviser for the PCG said that she saw the bid as a way to help local practices to work together. With the support of the PCG’s prescribing lead, she had set up a brainstorming meeting. Out of 19 practices in Tewkesbury town and Cheltenham, representatives from 11 agreed to attend. The local pharmaceutical committee chairman, a representative from the pharmacy within the local acute trust and a community pharmacist also came. “The group came up with a number of ideas but decided on a common vision — repeat prescribing and dispensing should be safe, appropriate, cost-effective and convenient. We will now look at ways in which to achieve this vision using a collaborative approach,” Mrs Middleton said.

The Cheltenham and Tewkesbury PCG pilot will involve local pharmacists and nine practices. In addition to achieving the group’s vision of repeat dispensing and prescribing, it will aim to reduce wastage of medicines, so that more money can be used for priorities such as reducing coronary heart disease and cancer.

Dr Nick Young, the prescribing lead for the PCG said: “This is a great opportunity for us to make sure that the medicines patients have been prescribed are doing the job. If not, we will help patients to find the right medication for their complaint. Most importantly, this will help the patient but it will also help us to channel more money into providing care and services where they are really needed.”

The NPC is developing a section for its website (www.npc.co.uk) specifically about the medicines management scheme, although it has not yet been completed.

Back to Top

Frances Thompson is on the staff of The Pharmaceutical Journal