Medicines management needs more pharmacy input
NHS hospitals should make better use of pharmacists' clinical knowledge, the Healthcare Commission indicated last week.
The results of the medicines management section of the annual health
check — the full report for which will be published later this
year — show that only 18 of the 173 acute hospital trusts in England
are doing an “excellent” job with medicines management. A
total of 12 trusts received a “weak” ranking in the review.
The figures look at many aspects of hospital pharmacy services and are
part of the wider Acute Hosptial Portfolio review.
A report on the scoring methadology for the 21 medicines management indicators
is linked to the results. “Pharmacy staff have a significant contribution
to make to patient care. If the trust has invested in pharmacy staff
who can be deployed to work on wards these staff should deliver benefits
as part of the ward-based team,” the report says.
“It is important that pharmacy staff are given sufficient training
time to ensure they maintain their competence. This will help them maintain
their current skills and also, if necessary, enable them to develop new
skills for taking on new roles,” it adds.
Medicines management success
South Manchester University Hospitals NHS Trust
was one of trusts rated as “excellent” by the commission. Steve Williams,
principle clinical pharmacist at the hospital, told The Journal that the hospital’s success with medicines management is
largely due to excellent strategic governance arrangements and
patient-focused clinical pharmacy services. The pharmacy also employs
a medicines management nurse. “We have a strong multi-disciplinary
medicines management committee, medication safety committee and
antimicrobial committee,” Mr Williams added.
“We encourage pharmacists to be proactively involved with the medical
teams, focusing on medication history and review on admission and
patient counselling on discharge,” he said.
Like most trusts, South Manchester hospital did not score well
on Controlled Drugs management. Mr Williams commented: “The
audit has identified that this needs more focus. The Duthie and
Shipman reports have made CD management a much higher priority.
We have all the proper arrangements in place — it is just
the need to ensure the regular auditing. We have to improve but,
as it is time consuming and needs to be done not at the expense
of patient-centred care, a balance needs to be struck.” |
Ray Fitzpatrick, chairman
of the Royal Pharmaceutical Society’s
Hospital Pharmacists Group, said: “Medicines are used in nearly
every health care intervention in hospital, and for many years hospital
pharmacists have been pressing for medicines management to be recognised
as an important part of a trust’s safe system of working. Making
medicines management part of trusts’ overall performance rating
supports this view.
“It is important to recognise that the Healthcare Commission’s
research identified only 12 trusts scoring the lowest score of ‘weak’,
with over 50 per cent scoring either ‘good’ or ‘excellent’ and
that all areas that were identified as requiring improvement are resource-dependent.
Educating patients about their medicines, and undertaking intravenous
medication risk assessments on wards, for example, requires pharmacy
staff time. The Healthcare Commission recognises this and in their report
urges trusts to invest in such things as automation to free valuable
staff time and therefore facilitate an improvement in services.”
Richard Cattell, vice-president of the Guild of Healthcare Pharmacists,
commented: “Investment in pharmacy staff and systems is essential
to implement the changes needed in many trusts to improve prescribing
and the systems of administering medicines. These in turn will produce
improvements in patient care through fewer errors and adverse reactions
and more appropriate medicines use, help meet performance targets through
speeding up discharge, and make savings on drugs well in excess of the
staff costs.”
Recruitment
issues Buckinghamshire Hospitals NHS Trust,
one of the trusts rated
as “weak” by the Healthcare Commission, has cited staff shortages
as having an impact on performance.
A spokesman for the hospital said: “Our pharmacy department shares national
recruitment issues, exacerbated by the Thames Valley region’s historical
recruitment difficulties.” Since the review was completed, the hospital’s
pharmacy has recruited several more pharmacists and the trust will continue to
review staffing levels, he added. |
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The
Pharmaceutical Journal
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