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Having pharmacists in care homes could save the NHS £135 million a year

The NHS could save £135 million a year through the widespread introduction of a pharmacist for every care home across Great Britain according to a new report by the Royal Pharmaceutical Society (RPS).

The Right Medicine – Improving Care in Care Homes‘ concludes that pharmacist led medicine reviews in care homes can not only improve safety for elderly care home residents but also save the NHS money by preventing avoidable hospital admissions.

In response to the report’s findings, the RPS, Alzheimer’s Society, Patients Association and Care England have called for a pharmacist, as part of the healthcare team, to take charge of the whole system of medicines and their use within a care home to improve patient care, reduce the waste of NHS medicines and prevent the serious harm that can be caused by inappropriate medicines use in elderly residents.

Sandra Gidley, Chair of the RPS English Board said: “Care home residents take an average of seven medicines a day with some taking double or treble this amount. Without a regular review of what’s still needed, this cocktail of drugs can cause poor health, a lower quality of life and costly unnecessary admissions to hospital.

“At a time when GP workloads are overwhelming and the NHS needs every penny, pharmacists can provide the solution by stopping the use of unnecessary medicines, upgrading residents to newer types of medicines with fewer side-effects and reducing the amount of wasted medicines. Having a pharmacist responsible for the use of medicines in a care home as part of the team of health professionals would also bring significant savings through regular reviews. The evidence is clear: now is the time for the NHS to act and improve the care of residents by ensuring a pharmacist has responsibility for the whole system of medicines and their use within a care home.”

There are currently 405,000 care home residents in the UK aged over 65 with approximately 97 per cent being prescribed at least one medicine. Nearly three quarters are exposed to a minimum of one potential medicine administration error . The RPS estimates that pharmacist-led medicine reviews with residents and their families can save up to £60 million per year as a result of a pharmacist stopping, reducing, starting or changing medication.

Pharmacist-led medicine reviews in care homes have also been calculated to save £190 per resident by preventing avoidable hospital admissions caused by potential drug related adverse events.*5 When the RPS applied this cost saving to the number of elderly care home residents across the UK taking at least one medicine, it was estimated that over £75 million per year could be saved5.

Laurie Thraves, Senior Policy Officer at Alzheimer’s Society said: “With 70% of people in care homes estimated to have dementia, having a pharmacist on hand to support people with the condition to manage and review their medication on a regular basis would be a welcome measure. Many people with dementia live with other long-term health conditions and there is a danger that, without effective management, they could end up on a number of drugs which could interact negatively with each other, exacerbating the symptoms of their dementia. Having a visiting pharmacist in care homes has the potential to both save money and improve quality of life.”

The number and proportion of older people continues to rise, with over 11.4 million (18 per cent of the population) aged 65 and over in mid-2014, up from 11.1 million (17 per cent) last year . The number of older people using care homes rose by 21 per cent from 135,000 to 164,000 from 2005-13 .

The RPS have also developed a hub page about care homes which hosts useful resources for pharmacists.

RCGP response to RPS report on pharmacists in care homes

Responding to the Royal Pharmaceutical Society’s report ‘The Right Medicine – Improving Care in Care Homes’, Dr Maureen Baker, Chair of the Royal College of GPs, said:

“We welcome the opportunity to further develop the constructive and valuable relationship that GPs have with our pharmacist colleagues, in a way that can increase our patients’ safety and save the NHS money.

“Our patients who live in care homes are invariably living with multiple, long-term conditions, and as a result are often taking multiple medications, which can lead to health problems in itself. Managing polypharmacy effectively is key to ensuring our patients in care homes are kept safe and only taking medicines that they need to – this also reduces medicine waste, and at a time when the health service is running with scant resources, this is particularly important.

“With GPs and our teams under incredible resource and workforce pressures, the suggestion that pharmacists to take on some of the medicine management responsibilities in care homes is definitely worth exploring – and we thank the Royal Pharmaceutical Society for putting these propositions forward.”