Many older and frail people living in care homes could be routinely taking medicines which they do not need and which, in some cases, might even put their health at risk.
Now, in a bid to tackle the problem, NHS England has announced a plan to recruit and deploy hundreds of pharmacists into care homes to review residents’ prescriptions and medications.
Around 180,000 people living in nursing or residential homes will have their prescriptions and medicines reviewed by the new pharmacists and pharmacy technicians. Benefits will include reducing ‘overmedication’, cutting the cost to the NHS of supplying unnecessary drugs and, most importantly, reducing the number of medication-related hospital admissions and stays.
Elderly care home residents often have one or more long-term health conditions, such as dementia, high blood pressure, diabetes or heart disease. On average they are each being prescribed seven medicines daily, but it can be more, with around 10% of people aged 75 and over currently being prescribed 10 or more medicines. This is significant as studies suggest up to one in 12 of all hospital admissions are medication-related and two-thirds of these are preventable.
NHS trials show that pharmacists reviewing medicines improved care home residents’ quality of life by reducing unnecessary use and bringing down emergency admissions, with less time spent in hospitals. This approach also led to meaningful savings in unnecessary prescribing costs of £249 per patient in one pilot over a year.
NHS England will roll out the approach by funding recruitment of 240 pharmacists and pharmacy technicians across the country. The reviews will be done in co-ordination with GPs and practice-based clinical pharmacists to ensure people are prescribed the right medicines, at the right time, in the right way to improve their health and overall quality of life.
Simon Stevens, chief executive of NHS England, said: “There’s increasing evidence that our parents and their friends – a whole generation of people in their 70s, 80s and 90s – are being overmedicated in care homes, with bad results. Let’s face it – the policy of ‘a pill for every ill’ is often causing frail older people more health problems than it’s solving. So expert pharmacists are now going to offer practical NHS support and medicines reviews in care homes across England.”
Results from six NHS England care homes sites which piloted the new approach showed:
- Emergency hospital admissions reduced by 21%
- Ambulance call out reduced by up to 30%
- A 7% reduction in residents’ need for oral nutritional support
- Annual drug cost savings of £125 to £305 per resident.
Sandra Gidley, chairman of the Royal Pharmaceutical Society’s English Board, said: “This significant investment highlights the growing recognition that pharmacists who support care home residents can reduce medicines waste, improve efficiency and provide better health outcomes.
“Many pharmacists already play a vital role in care homes, including through supporting other staff as part of a multi-disciplinary team, and we know that our members will welcome the opportunity to get more involved in providing direct patient care.”