Medicines management reflects trusts' strengths and weaknesses
Controlled Drugs management is an area in which trusts need to improve |
Pharmacy input is essential for good medicines management in hospitals, a new review indicates.
Results from the Healthcare Commission’s medicines management review,
part of the NHS
annual health check, were published recently, assessing
all 173 acute hospital trusts in England on different aspects of medicines
management.
Trusts were assessed on 21 indicators, grouped under the three themes
of patient focus, clinical focus and efficiency and capability. For example,
trusts were assessed on the percentage of patients who had a medicines
review within 24 hours of admission and who had a complete medicines
record for their stay in hospital. Some of the other indicators are shown
in the box below.
Overall, 18 trusts were rated “excellent”, 70 were rated “good”,
73 were “fair” and 12 were “weak”. Since the
review is based on relative assessments, an overall assessment of “weak” implies
that the trust is lagging behind other trusts those areas, but does not
in itself suggest unacceptable practice. Similarly, trusts scoring “excellent” are
ahead of other trusts but may still have scope for improvement.
“Involving pharmacists in patient care” was one of the indicators
of good performance. Of the 12 trusts rated as being weak overall, 11
performed badly in this area.
The Healthcare Commission says that pharmacists should help develop best
practice on wards in order to ensure medicines are being used for most
benefit and to minimise medication errors. It says: “Hospitals
need to invest in automation of dispensing and find new ways of working
so pharmacists can spend sufficient time on wards and in the management
of medicines.”
Trusts were awarded one to five points for each indicator, one being
the lowest. Overall, trusts scored poorly on Controlled Drugs management,
with 85 per cent getting just two points. They were assessed on the percentage
of pharmacy stock CD destructions which are witnessed, the percentage
of target CD audits undertaken, and transport policies in place for the
internal and external transfer of CDs. However, trusts scored well on “effective
barriers to prevent prescribing/ administration errors relating to allergy”,
with 73 per cent scoring four or five points in this area.
Ray Fitzpatrick, chair of the Royal Pharmaceutical Society’s Hospital
Pharmacists Group, commented that making medicines management part of
trusts’ performance rating supports the view that it is an important
part of patient safety. He added: “In the interest of patient safety,
quality of care and effective use of resources, the NHS must invest in
hospital pharmacy services if all trusts’ are to achieve the best
standards.”
A national report, outlining the full findings from the medicines management
review will be published later in the year.
The report
and individual trust ratings, plus details on the scoring
methodology (PDF 280K).
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Hospital Pharmacist