Hospital Pharmacist
2007;14:37
February 2007

News summary

Medicines management must be “top priority” in mental health

Mental health trusts need to make improving medicines management a top priority, according to last month's report from the Healthcare Commission.

“Talking about medicines: the management of medicines in trusts providing mental health services” (PDF 1.2MB) was based on data supplied voluntarily by 42 (out of 83) mental health trusts in England and Wales. It was released at the same time as “The best medicine: the management of medicines in acute and specialist trusts,” which details the full findings of the Healthcare Commission’s medicines management review.

Data from the latter report, forming part of the NHS annual health check, were first published last year (Hospital Pharmacist 2006;13:269). The same methodology was used for both the mental health and acute trust reports and results were compared.

The Commission found that levels of medicines management support available within mental health trusts tend to be less than those found in acute trusts. For inpatients, 24 per cent of wards received no visits from pharmacy staff, compared to only 14 per cent in acute trusts, and only 14 per cent of wards received more than five hours of pharmacy staff time each week, compared to 64 per cent in acute trusts. There are noticeably fewer pharmacy staff in mental health trusts, and the staff mix is also different, with fewer pharmacy assistants and technicians.

It is unjustifiable for mental health trusts to invest less than acute trusts in clinical pharmacy services, the report points out, because similar outcomes from pharmacy services can be achieved at both settings. Around 67 per cent of suggestions made by pharmacy staff were acted on in mental health trusts, with the corresponding figure for acute trusts being about 80 per cent. Pharmacy staff interventions were considered necessary to reduce harm for one in every 29 patients in mental health trusts and one in every 26 patients in acute trusts.

Poor medicines management support to mental health trusts is of particular concern, the report notes, given the importance of medicines in mental health treatment plans — over 90 per cent of service users have taken medicines for their condition in the past year. Medication reviews highlighted that 46 per cent of patients were not taking their medicines appropriately, compared to 12 per cent in acute trusts.

Recommendations are made throughout the two reports. However, David Branford, chief pharmacist at Kingsway Hospital, Derbyshire Mental Health Services NHS Trust commented that: “Meeting the recommendations of the [mental health trust] 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.” Funding, leadership from chief pharmacists and direction from the Department of Health and the Royal Pharmaceutical Society will be needed, he added.

Mr Branford was among the speakers at the Hospital Pharmacist conference held last week, focusing on the Commission’s medicines management reports. Coverage will appear in next month’s issue.