Medicines

What was delivered in 2020-21?

Our work to secure the safe transfer of patients' medicines when they move from hospital to home continued. This 'Transfer of Care around Medicines' work helped support the safe discharge of patients from hospital prior to each Covid wave. In February 2021, the national Discharge Medicines Service (DMS) was launched, and the five Wessex acute trusts previously using TCAM were able to seamlessly move to the new national service. 

Transfers of Care Around Medicines (TCAM) and Discharge Medicines Service
Our work to ensure the safe, secure, digital, clinical handover of patients’ medicines from the hospital to pharmacists in the community continued this year.

• Over 8,500 referrals made in Wessex this year
• Five of seven trusts in Wessex are benefiting from a TCAM referral process
• Successful re-launch of the service at Dorset County Hospital, and 1,088 referrals made (to date) and expansion to Salisbury District Hospital
• Worked with Hampshire and Isle of Wight ICS to get Portsmouth University Hospitals NHS Trust service live
• Working with Southern Health NHS Foundation Trust to launch DMS (TCAM) in Lymington Hospital.

“There was a lightbulb moment for us. This was about patient medication safety, improving integration and seamless discharge.  We saw it as an opportunity for community pharmacists to engage so a win-win.  A great opportunity to be involved.” - Trust contact about TCAM

“Very beneficial during Covid. Because good relationships already existed, it was much easier for transition. Lots of conversations around patients being discharged. Change of doses, lots of awareness of meds optimisation and patient safety.” - Trust contact about TCAM 

PINCER (Pharmacist-led Information technology iNtervention for the reduction of Clinically important ERrors in medicines management)
We continued our work to embed this pharmacist-led programme to reduce harm from medication errors in primary care across Wessex, and nationally.

• 3,444 fewer patients at risk from harm from medicines in Wessex (13,387 nationally)
• All nine CCGs in Wessex engaged with PINCER 
  
• 236 practices completed the PINCER audit and uploaded their data to CHART online
  
• More than 60 clinicians completed PINCER Action Learning Sets over the last 12 months (have been adapted to run virtually and feedback has been 100% positive)
• PRIMIS published the progress report on the National Rollout of PINCER
• PRIMIS and the AHSN Network shortlisted for the 2020 HSJ Patient Safety Award.

Electronic Repeat Dispensing (eRD)
Around 1.2 million extra electronic repeat prescriptions (in Wessex) have been issued since March 2020 – supporting social distancing and saving more than 5,600 GP hours. Our webpages for this work have had over 10,000 views. 

• Reached a clinical audience of over 800 nationally, and 90 locally, through our educational webinars
• We partnered with the NHS Business Services Authority (BSA) to work on a rapid turn around of a local pilot into a successful national Covid-19 response programme
• Built upon our existing library of eRD resources to ensure all GP practices and pharmacies could learn how to deploy eRD successfully. 
• Chaired national and local steering groups to ensure comprehensive network input and programme coverage.
• Presented multiple national and local webinars, covering the full implementation guide to eRD.

“Due to many problems with the buses, plus difficulties obtaining doctors appointments, I find it helpful. Plus I find it saves my GP work and while I can collect prescriptions in person at the pharmacy, thus saving the delivery service time, effort and expense, hopefully helping the NHS, too.” - patient quoted in the eRD evaluation report

Polypharmacy
Our work to ensure multiple medicine safety saw 106 GPs and pharmacists trained using in shared decision making and using the Polypharmacy Prescribing Comparators; with an update to the comparators published February 2021.

• £46,000 funding agreed for six additional polypharmacy cohorts (from Health Education England South)
• 2,697 web page views for the comparators; and 1,042 views for polypharmacy
• New polypharmacy comparators published Feb 2021
• Developed a local training programme that has been positively evaluated and funded for spread by HEE South. 
• September 2020, Bath Geriatrician Dr Robin Fackrell joined the Wessex-led Polypharmacy Action Learning sets. Hear Dr Fackrell talk to the medicines clinical lead, Clare Howard, in this special podcast.
• A number of projects and studies have been started. In collaboration with local researchers, we submitted a bid to run the MOIRA study which will aim to understand which interventions better support older patients, who live with frailty, with polypharmacy. The bid was successful and we link forward to this exciting project with the Wessex ARC.