Medicines Optimisation in Care Homes (2019)
Mid Essex CCG
We describe how a Medicines Optimisation in Care Homes (MOCH) service was developed, commissioned and implemented across Mid and South Essex STP.
The MOCH service was designed to tackle the lack of mental health support to care homes and ensure that the service integrated into existing pharmacy provision across the STP and avoided duplication of effort.
The service was specifically commissioned to address the lack on mental health expert pharmacist provision into care homes, and with a focus on shared decision making with families as well as patients. The service is service involving face to face work in care homes is available between the hours of 10am and 8pm Monday to Friday (excluding Bank Holidays). These hours allow access to all care staff (day and evening/night staff) and family members who may not be able to visit during normal working hours, although recognising that a large proportion of the Service will be delivered between 10am and 5pm. Professional pharmaceutical advice is available to support residents and care home staff 7 days a week between the hours of 10am and 8pm) using a dedicated Care Homes Pharmacy helpline, and links have been established with the Integrated Urgent Care Provider for the STP (IC24) covering the OOH period.
Care homes have access to pharmaceutical advice through the helpline and support for their residents, reducing hospital admissions, reducing harm from medication and improving patient experience.
Patients have medication reviews undertaken, on a stratified risk basis using anticholinergic burden and other risk assessment tools. As the project is mental health and dementia focused, patients prescribed antipsychotics and other behaviour controlling medications are targeted for review.