Sefton’s medicines management team (MMT) have devised and rolled out innovative approaches during the COVID-19 pandemic, resulting in significant additional support to vulnerable patients, as well as general practice, community pharmacy and care homes in the area, this good practice has been shared with counterparts across the country to improve medicines safety elsewhere.
The joint NHS South Sefton CCG and NHS Southport and Formby CCG team is made up of clinical pharmacists and pharmacy technicians who work with a range of partners across health and care to improve patient safety as well as providing the Primary Care Network (PCN) Direct Enhanced Service (DES).
The team quickly responded to the COVID-19 pandemic by further developing existing schemes and implementing new developments, to improve medicines management for patients. At the core of these developments was the further strengthening of the team’s medicines management ‘hub’. The hub was established just over a year ago to provide medicine reviews to some of the most vulnerable patients on discharge from hospital and to provide support to practices, pharmacies and patients around medicines issues and queries.
In a 10-week period between March and May this year the MMT hub handled 1,994 medicine related queries from GPs (55% increase), 1,921 pharmacy queries regarding medicines (211% increase) and 1,868 hospital discharges (22% increase). This was in addition to the team’s work supporting care homes, primary care hot sites and working with out of hours providers.
In the first weeks of the lockdown, the MMT team reviewed 8,500 patients eligible for a post-dated prescription across the borough. This generated a great deal of positive feedback from patients and specifically from community pharmacies and GPs for relieving pressure on their services during a difficult time.
To further support patients and practices, the team searched GP practice systems to identify patients prescribed medication without a pharmacy nominated for the Electronic Transfer of Prescriptions (EPS).
The team phoned vulnerable patients to discuss the benefits of EPS along with the NHS App and to check how they were coping with the collection of their medication, food supplies and if they needed support with loneliness. As well as EPS nominations being arranged for 1,000 patients, reducing footfall in practices and pharmacies, the team was also able to, where appropriate, make referrals to the council helpline for additional support. This meant that for those patients who could not easily contact their surgery or pharmacy, for example, because of shielding, were assured that for at least three months their medications would be automatically sent to their local community pharmacy. By post-dating prescriptions, the duration of prescriptions was kept the same and hence protected medicine supplies while also helping to relieve pressure in community pharmacies and primary care.
A community pharmacy COVID-19 medicines service was commissioned in two pharmacies – one for each CCG area – to hold a protected stock of end of life drugs and drugs used for the symptom management of COVID-19. Also, the pharmacies offered a 1-hour fast track delivery service through a request from the prescriber. This meant that in addition to the services that the team provided to all Sefton residents, during the period March – May 2020, it supported a staggering individual 18,000 of our most vulnerable patients to improve their care too.
A major area of work for the MMT has been their support for local care homes. The team produced a COVID-19 Homely Remedy Policy which allowed care homes to administer paracetamol and codeine linctus for patients showing symptoms suggestive of COVID-19 without delay. The team provided general medicines management training and COVID-19 Homely Remedy Policy training and dedicated support online for care homes across Sefton.
The MMT in Sefton has been regionally and nationally recognised for its work during the pandemic much of which can now be utilised by other medicine management teams across the country. As a result of their work, the CCGs’ head of medicines management has also been nominated to take part in a national review of the pharmacy response to COVID-19.