The rate of prescribing errors in primary care is at least 11%, and 1 in 10 patients may experience a medication error while in hospital; it is crucial that medicines governance processes are in place to support the safe use of medicines. Communication is an essential element of medicines governance; however, it is recognised that delivering effective communication across a large and diverse health board is a challenge.
NHS Greater Glasgow and Clyde (NHSGGC) is the largest NHS organisation in Scotland, and one of the largest in the UK, serving a population of more than 1 million. Communication is relevant to all healthcare professionals (HCPs) involved with medicines. The health board includes 35 hospitals and is contracted to more than 240 GP surgeries (almost 800 GPs) and more than 300 pharmacies. Finding an effective method of communication that suits this diverse audience is a challenge. Medicines Update (MU) blogs are one of the key methods used to communicate important medicines-related information to HCPs in NHSGGC.
MU blogs aim to promote safer prescribing practices and minimise harm, and it has evolved to become an important resource to keep NHSGGC staff, GPs and community pharmacy staff up to date. Prior to the development of MU, a monthly, four-page bulletin was published; however, in 2014, it was recognised that this was an outdated model that would benefit from a more accessible and concise format. There are several benefits to this method, including reduced cost, improved accessibility and the quicker dissemination of critical information. Informal feedback also indicated a more concise format would be beneficial for busy HCPs.
The blogs are written by local experts and are reviewed, edited, and approved by a multidisciplinary group under the auspices of the NHSGGC Area Drug and Therapeutics Committee. The work is led by the NHSGGC Medicines Information service, and pharmacists play a key role in the development and promotion of the resource amongst clinical teams.
Around 100 blogs are published each year. The topics are varied and cover themes such as patient safety, changes in clinical practice and cost efficiencies. There are educational blog series on topics such as clozapine and iron replacement therapy. In response to the COVID-19 pandemic, NHSGGC developed an accelerated process for the development and update of guidelines, which was key to ensure timely communication of this information. This resulted in 27 blogs being published between April 2020 and June 2020 with COVID-19-related information.
Over the past few years, there have been targeted efforts, using email and social media, to widen the reach of MU across all sectors within NHSGGC; this has resulted in a substantial increase in followers and subscribers. The MU email updates are sent to more than 1,000 subscribers (an increase of around 50% in the last 2 years) and the number of Twitter followers has trebled since 2018 to more than 1,300, with an excellent engagement rate for tweets, averaging 2.5% over the past year.
In 2019, an online survey was carried out to assess whether MU was meeting audience needs and to inform future development. The survey was sent to all subscribers and to staff within NHSGGC pharmacy services via email. Overall, the results were incredibly positive, and this success was recognised within NHSGGC with a Pharmacy Services award. Out of 98 respondents who answered:
- 94% would recommend MU to colleagues;
- 97% indicated that MU blogs are reliable;
- 95% reported that they are up to date;
- 77% thought the blogs are relevant.
Quotes from free text option in the survey include:
- Given the challenge of how to get medicines related information out to clinical staff the blogs provide a simple to access, easy to understand summary of issues to staff;
- Great range of information — excellent concise presentation;
- Interesting and helpful not only to my own specialty but also for general knowledge of other related areas;
- They are a perfect way of helping us keeping up to date;
- I find Medicines Updates really useful — they are to the point but very informative.
The survey results and the award reflect the dedication and commitment of all committee members and contributors. Despite this success, promotion and continued awareness is an ongoing challenge. As new staff join the organisation, it is imperative to carry out regular promotional activity, including events for junior doctors at induction, mass email campaigns across the organisation and advertising via the NHSGGC intranet.
The delivery of effective communication to a wide and diverse audience may be a challenge shared by other trusts/health boards across the UK. It is hoped that this article inspires pharmacy professionals to become involved in similar activities, such as the dissemination of information that users value, which is not only critical, but also extremely rewarding.
We would be keen to hear from others to share our learning and experiences. If you would like to get in touch, please email: firstname.lastname@example.org.
Cristina Coelho, senior pharmacist, clinical effectiveness and Elaine McIvor, senior pharmacist, medicines education; both at NHS Greater Glasgow & Clyde