Become a team player to improve patient care

So concluded RPS director for Wales Paul Gimson at the end of a thought-provoking conference session on improving patient outcomes through cross-sector working on Sunday (11 September 2011).

The session showcased some inspiring examples of projects that have promoted multidisciplinary working, including work in Cardiff, Wales to improve medicines reconciliation at hospital discharge, a Hampshire project to deliver targeted respiratory medicines use reviews and a UK-wide drive to reduce antipsychotic prescribing.

Paul Jerram, head of medicines management at the Isle of Wight NHS Primary Care Trust said the respiratory MURs project started with a call from GPs to put a stop to MURs — which they didn’t see the value of. This triggered a bid to make MURs more valuable by targeting them at the large number of respiratory patients in the area and focusing on the main barriers to effective condition management.

“Relations improved incredibly, and our GPs realise now that community pharmacists and hospital pharmacists are equal clinicians in many areas,” he said.

Adopting a fun approach to training helped to get the team on board, said Mr Jerram. Staff were also motivated by the project’s positive outcomes — such as falls in emergency hospital admissions, bed days and deaths — which started to be seen early on.

Teamwork not without its challenges

The discussion session also teased out some of the inherent pitfalls and barriers to working as part of the wider pharmaceutical care team.

Chief pharmacist at Derbyshire Healthcare NHS Foundation Trust David Branford spoke about the Government’s drive to reduce antipsychotic prescribing, which involves a commitment by pharmacists to review every patient with a prescription for antipsychotic drugs by 31 March 2012.

“What worries me a bit is what’s going to happen after March 2012. What we need is to embed a system whereby this becomes a part of [pharmacists’] routine,” he said.

He also called for mechanisms to be put in place to ensure GPs are given feedback on prescribing issues that are identified during medicines management projects such as these.

RPS director for England Lindsey Gilpin, who attended the session and joined in the discussions, added: “If we’re going to have multi-professional work like this, I think we need to think about multi-professional messages … it would be nice if we were talking together and working together, and I’m not always in the position of querying [doctors] when they have absolutely no idea why I’m doing it.”

By Francesca Rivers