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Pharmaceutical care

Medicines care plans proposed to join up NHS care

Individual medicines care plans to integrate care throughout the NHS and social care have been proposed in a report on the future of pharmacy in Wales.

An electronic pharmaceutical care plan with a patient's drug history and medication should be introduced to improve care integration

Source: Hero Images Inc. / Alamy

Under new proposals, pharmacists will create care plans with patients, agree treatment goals and identify medication needs

An electronic ‘pharmaceutical care plan’ detailing a patient’s drug history and specific medication needs should be introduced to improve the integration of care, according to a report on the future of pharmacy in Wales.

The care plans would link to existing patient records and track the pharmaceutical aspects of patients’ treatment as they travel through various health and social care systems.

Pharmacists would create the care plans with patients, agree treatment goals and identify medication needs. Named pharmacies would be responsible for maintaining the plans, which would be accessible to clinicians across the NHS where appropriate.

The proposal is one of a series of ambitions for the future of pharmacy in Wales detailed in a report by the Welsh Pharmaceutical Committee, which advises the Welsh Government. The report was supported by the Royal Pharmaceutical Society (RPS) with contributions from leaders from all sectors of the profession.

The report also encourages pharmacists to use online video calling technology, such as Skype, to give patients easy access to healthy living advice and support and to reduce pressure on general practice consultations.

The report, ‘Your Care, Your Medicines: Pharmacy at the heart of patient-centred care’, was launched on 15 October 2014, ahead of the 4th Annual Wales Medicines Safety Conference in Cardiff.

It calls for the full integration of pharmacy at all levels in NHS and social care, more pharmacist independent prescribers and greater powers for pharmacists to refer patients directly to specialists.

The vision of a pharmaceutical care plan as a dedicated electronic record of a patient’s medicines is central to these ambitions. Each care plan would “identify the medication needs and patient goals for their desired health outcomes” and be accessible across NHS IT systems.

The care plans would list allergies, administration requirements such as swallowing difficulties and a patient’s ability to self-administer medicines. Patient health outcomes and drug responses would also be monitored.

The idea aims to reduce fragmentation and repetition in healthcare professionals’ work, removing the need to re-take a patient’s drug history in each setting. This would also help to maximise time during GP consultations to discuss medical needs, and allow the “smooth and timely” movement of patient information through the NHS.

“The pharmaceutical care plan will play a key role in the reconciliation of medicines as patients migrate through the health and social care system, ensuring greater accuracy, safety and effectiveness in their medication and treatment regimen,” the report says.

The wider proposals for the future of pharmacy in Wales advocate a greater role for pharmacists in urgent and unplanned care, aligning with the aims of an English Pharmacy Board campaign also launched on 15 October 2014.

Minor ailments should be seen outside A&E where appropriate, the report says, and pharmacists should be used to triage patients in emergency departments seven days a week to relieve pressure on the services. In addition, every hospital team should include a pharmacist to support the medication needs of patients admitted.

The report outlines the need for pharmacists to visit patients who need support at home to live independently, to ensure safe and effective medicines supply and administration. It also highlights the potential involvement of pharmacists with a special interest in palliative care to initiate end-of-life care.

Jocelyn Parkes, RPS director for Wales, says the report is a “real accolade” to the commitment of pharmacy stakeholders and painted an “ambitious picture for the future of pharmacy”.

“It is an exciting plan for patient-centred care, rooted in the reality of the pressures facing healthcare and offering a strategic view of how the skills of the pharmacy team could be fully harnessed in the NHS in Wales to improve patient health outcomes,” she says.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20066839

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