Our Innovation:
We have implemented direct referral of residents on discharge to those pharmacy teams providing clinical pharmacy services to care homes. In our pilot site, this was to a team of pharmacists in the CCG but in other systems the referral may be to GP practice pharmacists, PCN, or MOCH pharmacists. The team worked with Pinnacle Health (the provider of PharmOutcomes, the e-platform used to refer patients through the TCAM pathway) and developed a new platform which would make referrals to the appropriate team/ individual providing clinical pharmacy services to respective care homes. It was hoped that this service would provide the same evidence-based outcomes as the main TCAM pathway such as a reduction in readmission rates and decrease length of stay as a result of improved medicines optimisation at the interface.
Impact of COVID-19:
The NHSE letter of 1st May in response to COVID-19 has increased the interest locally and nationally in this pathway. The letter stated that pharmacy professionals working with the care sector need to consider a range of support options for care homes to improve the quality of service.
This included “supporting reviews of new residents or those recently discharged from hospital”. However, at the same time, social distancing and shielding has restricted access for the pharmacy teams who normally provide MO services. Care home residents are not only at risk from the virus but also from the lack of support provided by these teams who were often home based.
Outcomes & Evaluation:
Although we have as yet little evidence for the impact of this intervention for care homes, we see no reason why the benefits should be any different from those already proven in the main TCAM pathway. Certainly, the over 65s have been identified as a specific cohort benefitting from support post discharge from hospital and work by the WM Patient Safety Collaborative (see attached documents) has identified transfer of care as a specific area of concern for medicines related errors. The need to address these issues during the pandemic has led to interest in the project nationally with uptake in Wessex and West of England AHSNs and interest from many other systems. This in turn has allowed the AHSN to commission the services of an experienced researcher.
