Pharmaceutical care in care homes should be recognised as a specialist area and resourced accordingly, Alex MacKinnon, the Royal Pharmaceutical Society’s (RPS) director for Scotland, has said.
Speaking at the launch of RPS Scotland’s updated care homes policy, ‘Putting residents at the centre of pharmacy care home services’, held at the Scottish parliament on 24 April 2019, McKinnon warned guests that “care homes have not been prioritised, or indeed treated, as specialist areas in the way that they should”.
While the number of care home residents in Scotland has decreased slightly over the past decade — from 37,702 in 31 March 2007 down to 35,989 in March 2017 — the proportion of residents with physical disabilities and dementia has increased. The RPS’s policy document says 13% of residents have a physical disability and as many as 54% have dementia.
In a press release accompanying the report’s launch, Aileen Bryson, deputy director at RPS Scotland, said: “Anyone now entering a care home is generally frailer and nearer the end of their life than might have been the case previously”. She added that care home residents often have several long-term conditions and take an average of 7.2 different medicines.
“Funding must be made available to provide residents with the highest standards of pharmaceutical care, led by pharmacists working with a multidisciplinary team,” she said.
Included in the policy’s nine recommendations is a call for pharmacists to lead the provision of pharmaceutical care in care homes, including regular medicines reviews to reduce inappropriate polypharmacy and medicines waste.
RPS Scotland also calls for a national programme of training for care home staff to standardise the administration of medicines; for pharmacists in care homes to have access to electronic patients records; and for undergraduates to undertake experiential learning in care home environments.
The latter point was emphasised by Rose Marie Parr, chief pharmaceutical officer in Scotland, who spoke at the parliamentary event.
Parr told guests that it was “really important” that pharmacy undergraduates “have training to get [care home] experience”.
Among those contributing to the updated policy were Angela Groome, a care services pharmacist at Boots, and Pauline McIntyre, deputy director of care at Erskine, a charity that runs four care homes for military veterans in Scotland.
Asked what she thought the most urgent priority for pharmacy in care homes was, Groome highlighted a “recognition of the dedicated role” that pharmacists can play in care homes.
“It is a specialism — the work that pharmacists do in care homes: from the community pharmacist to the practice based pharmacist, and specialist roles like palliative care.”
McIntyre added that working together across the sectors helps reduce inappropriate polypharmacy among care home residents. She also flagged the importance of using safe and efficient medicine administration systems.
“If you use a paper system, a lot of things can go missing. If you’re on an electronic system, like [an electronic medication record system], there’s nothing hidden.”
Also speaking at the event was Karen Hedge, national director at Scottish Care, which represents independent social care services in Scotland, who said: “As outlined in the policy, the inclusion of pharmacists at a strategic planning level in health and social care partnerships (HSCPs) is imperative, given the need to do more for less”.