Mental health trusts need more pharmacy input
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Healthcare Commission wants pharmacists to have more input into
the use of medicines in mental health care |
Mental health trusts should increase the amount of clinical support provided by pharmacy staff to both wards and community teams, according to the Healthcare Commission in a report published last week. But there are concerns that such a development is beyond the current capacity of most trusts.
“Talking about medicines: the management of medicines in trusts
providing mental health services” is the first report that focuses
specifically on the management of medicines in mental health trusts and
details findings
from a review of 42 such trusts in England and Wales.
The report highlights relatively weak investment in clinical pharmacy
services in mental health trusts compared with acute trusts. However,
where clinical pharmacy services do exist, the contribution per patient
on each visit is similar to that reported by acute trusts. In addition,
there is limited evidence of pharmacy staff being involved with community
teams, which treat over 90 per cent of service users in mental health.
The report also emphasises the need to clarify the purpose and scope
of medication reviews.
David Branford, chief pharmacist at Kingsway Hospital, Derbyshire Mental
Health Services NHS Trust, commented: “Meeting the recommendations
of the report will be beyond the capacity of many mental health trusts.
The estimates in this report alone suggest a need for a pharmacy workforce
at least three times that currently employed by mental health trusts.”
He added that achieving the recommendations will depend on leadership
from the Department of Health and the Royal Pharmaceutical Society along
with funding to equip mental health pharmacy teams with the necessary
tools and staff. Leadership will also be required locally from mental
health trust chief pharmacists. “Sustained support over a number
of years is needed — this will not happen overnight,” he
warned.
David Pruce, director of practice and quality improvement at the Society,
agreed that a strong pharmacy infrastructure needs to be put in place. “The
future should see specialist mental health pharmacists having an increased
role in the care of patients,” he said.
Acute trusts A report that
draws out national issues from a review of medicines management in all
173 acute and specialist NHS trusts in England was also released
by the Healthcare Commission last week — data from this review were first
published last year (PJ, 19 August 2006, p209).
The report emphasises that there has been investment in clinical pharmacy services
since a previous review in 2002 but identifies many issues that still need to
be addressed, some of which also apply to mental health trusts (see Panel below).
Weaknesses in information sharing between hospitals and GPs and slow progress
in automation
and self-administration of patients’ own medicines are highlighted in the
report.
Both reports describe 10 areas for trusts to focus on to help them review their
strategy for medicines management.
The reports are available
online |
Recommendations common to both reports
The two Healthcare Commission reports make a number of shared
recommendations. They are:
• Pharmacy staff should look to improve their profile, ensuring
other hospital staff and patients are aware of how they can contribute
to the care of patients
• Pharmacy staff should be made key stakeholders in trust initiatives
with a medicines content and chief pharmacists should have the
status of a clinical director and be actively involved in clinical
policy development
• Trusts should identify and communicate their requirements for
electronic prescribing systems to ensure the benefits can be
realised at the earliest opportunity
• Trusts should maximise benefits from independent and supplementary
prescribing by determining where it can best be used to meet
clinical need |
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