High street stores pharmacists are to be sent to older people’s homes to stop the trouble of their taking too many useless pills. This is the assignment given by the UK’s leading pharmacist.
An immense number of older people around the country are hospitalised month by month because of the side effects of the medicines they don’t even need to take. The number goes up to hundreds of thousands, according to Keith Ridge, chief pharmaceutical officer of NHS England.
Pharmacists were “trapped” in their high street shops, he said, as he promised reforms to allow them to visit patients.
Simon Stevens, chief executive of NHS England, has promised 1,500 pharmacists in GP surgeries to help take the pressure off family doctors by doing medicine reviews, blood pressure checks and dealing with minor ailments. Dr Ridge told The Times that from next April a 42 million fund would also help find ways to get “a pharmacist attached to every care home” by making better use of the high street businesses.
He wanted chemists to use their clinical expertise to work in a number of locations alongside other professionals. It would take time, he admitted, but would allow them to deal with issues that had previously been missed.
These included the monitoring of older people’s medication which was often inadequate. Dr Ridge cited studies that showed about one in seven hospital admissions in the over 75s was the result of drug problems.
An estimated 20 per cent of medicines were unnecessary and half were not taken properly.
“I really do think there are some issues around how we use medication in this country,” he said. “I’m challenging [pharmacists] to say ‘what the hell are you doing about it?’ They have to have some professional accountability and responsibility for the outcomes which are generated from medicines in this country. They are the experts in medicines and their use and they need to show more leadership.”
Anne Joshua, head of pharmacy strategy at NHS England, said that care home staff were often overrun, and pharmacists could assess individual residents’ needs. “Are they just on too many medicines? Now that they are stabilised in the care homes do they need all these medicines?” she said.
Ms Joshua said some people just accepted they needed to be on several medicines that had been prescribed over time by different organisations, but perhaps only needed two or three.
She added that some older people might no longer be able to swallow pills, unless of course they are gelatin capsules or something more slippery, but also they might be taking them at the wrong time of day.
Dr Ridge said that patients and even GPs often did not give pharmacists enough credit for their knowledge, adding: “They do four years of undergraduate training, one year’s clinical training; it’s at an academic level which is the same as medicine.”
He wanted to change the “feel” of high street shops so that they had more consulting rooms and were made to look more clinical in nature. His deputy, Bruce Warner, said: “There are a number that do look more like shops than pharmacies and we want to help them get to the point where they are all practising out of very clinical, professionally oriented premises.”
Rob Darracott, chief executive of Pharmacy Voice, which represents community pharmacies, said that the industry wanted to do more in care homes but said that NHS England needed to find a way to make it happen. “Kicking it off with a funding challenge is probably not the best way to get people focused on what needs to be done,” he added.