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Hospital pharmacy

Care of older people at two hospitals in South Wales is ‘simply unacceptable’, says report

A review into the provision of care for elderly patients at the Princess of Wales Hospital, Bridgend, and Neath Port Talbot Hospital, Wales, has criticised pharmacy staff, doctors and nurses.

There were instances of patients being sedated for non-medical reasons, such as helping staff cope with the pressures of caring for patients overnight, according to the report on the review conducted between December 2013 and April 2014.

Patients with dementia were also prescribed antipsychotics without a risk assessment being conducted. And nurses were unaware of hospital policy for dealing with patients without mental capacity who refuse their medicines.

“There are aspects of the care of frail older people which are simply unacceptable and must be addressed as a matter of urgency,” says the report led by June Andrews, director of the Dementia Services Development Centre at the University of Stirling in Scotland.

Nurses would sign to say that the medicines had been administered without witnessing whether this had actually happened. Pharmacy staff at both hospitals were aware of this practice but failed to act.

“This report is very concerning,” says Duncan Rudkin, chief executive of the General Pharmaceutical Council (GPhC). “Our standards of conduct, ethics and performance state very clearly that pharmacists and pharmacy technicians have a duty to make the care of patients their primary concern, as well as having a duty to raise concerns appropriately.”

The report makes several recommendations, including the provision of a 24/7 pharmacy service. Pharmacy staff should ask nurses routinely whether there were any problems in giving a patient their medicines.

Other recommendations include nurses signing for medicines and discarding medicine pots immediately after use.  Doctors should also be quicker to respond when patients refuse medication.

A spokesperson for the Abertawe Bro Morgannwg University Health Board (ABMU), to which both hospitals belong, says that the board accepts all recommendations in the report and will take immediate action on medication, hydration, night-time sedation and continence care. The health board will also investigate how pharmacy services can be extended.

The board also stipulates that “ABMU has not at any point been another Stafford” and that “the situation is remediable if our recommendations are accepted and implemented”.

ABMU issued a statement saying it wished to “apologise unreservedly to patients, and their families or carers, who have been let down by the poor care described in the Andrews report”.

The GPhC will be studying the report carefully and liaising with ABMU to make sure “any necessary action” is taken, says Rudkin.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11138411

Readers' comments (1)

  • Hospital pharmacists failing to act in the best interests of patients? Before any rush to expand our supervisory/policing role, pause to reflect on this paragraph in Trusted to Care report:
    It is not too great a stretch to see current muddled management structures, lack of clinical cohesion and failures to have sufficiently skilled and oriented staff working in front-line settings, as being directly traceable to an overemphasis on short-term operational and financial delivery at the expense of the underlying core purpose of providing best possible care and treatment to local people.

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