P 63
Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon
Inquiry into the Priorities for the Health, Social Care and Sport Committee
Ymateb gan: Cymdeithas Fferyllol Frenhinol
Response from: Royal Pharmaceutical Society
|
|
|
Health, Social Care and Sport Committee
National Assembly for Wales
Pierhead Street
Cardiff
CF99 1NA
31st August 2016
Dear Sir / Madam
Priorities for the Health, Social Care and Sport Committee
The Royal Pharmaceutical Society (RPS) Wales welcomes the opportunity to respond to the consultation into the priorities for the Health, Social Care and Sport Committee in the 5th Assembly.
Over the next 12 to 18 months we consider that the following should be a priority for the committee:
1. Long term and chronic conditions management
With a growing and ageing demographic in Wales, the demands on the NHS from long term and chronic conditions is projected to increase by around 181,000 or 32 per cent between 2010 and 2026[1]. As well as affecting an individual’s health, there can be associated wider social and economic challenges for the individual along with implications for family members, who may be providing care for a loved one.
People with a long term condition (LTC) are twice as likely to be admitted to hospital as a patient without such a condition[2]. This indicates a failure to effectively manage LTCs in the community and closer to people’s homes. Not only is this distressing for the patients but puts unnecessary and avoidable pressure on secondary care resources.
The development of 64 cluster networks, provides new opportunities to think differently about how health and social care is delivered. Ensuring increased multidisciplinary working along with effective sharing of information and resources between healthcare professionals within clusters will help to maximise the access to and the quality of primary care to deliver improved local health and wellbeing therefore contributing to a reduction in health inequalities.
The RPS strongly believes that better utilisation of the clinical expertise of the pharmacist will have a positive impact on care and outcomes for patients with LTCs. The diverse skills within the whole pharmacy team can support people throughout their whole care journey, from maintaining good health through to intensive coaching and medicines advice. Full utilisation of the pharmacy workforce will enable resources to be used more efficiently to deliver the standard and level of care that patients deserve. Pharmacists can work in partnership with healthcare colleagues and can make an immediate difference, for example by freeing up the time of GPs to manage more complex or demanding cases.
As it is predicted that the cohort of people with chronic conditions will increase significantly in the future, we recommend a review of the services available to support people with chronic conditions, ensuring they are fit for purpose now and in the future in Wales.
2. Enabling better communication by utilising IT
Harnessing the benefits of new technologies must be a priority for NHS Wales to help transform healthcare delivery in all settings. We believe the use of IT to enable appropriate access for health and social care professionals to a single patient record is critical and is one key area where a quicker pace of transformation is needed.
Each healthcare professional will record important information about a patient’s care on separate records. Currently, as these records are not joined-up or integrated, they cannot be accessed by other healthcare professionals. We advocate that a single patient record would overcome the current barriers and delays to health care that result from poor information exchange between professions. A single accessible record would importantly enable more informed and safer health decisions to be made by practitioners and patients at the point of care.
RPS Wales recommends that one single patient health record is necessary where all essential information is stored for the individual. All registered health and social care professionals involved in the patient journey must have appropriate access to the patient health record with the patient or their designated carer’s explicit consent.
Access to the patient health record will allow pharmacists to make more informed clinical decisions, in partnership with patients and other health and social care professionals, about the pharmaceutical care that patients receive. It will support improvement in the treatment of individual patients and help the NHS to maximise the value of the significant investment it makes in medicines.
3. Mental health and reducing the inappropriate use of antipsychotic medication
People with mental health needs must be able to access support and treatment in a timely way and with dignity, just as a person presenting with physical health needs would be. Appropriate use of medicines to support the patients with mental health needs is essential. The RPS is concerned by reports of inappropriate use of medicines, for example unjustified use of antipsychotic medications in individuals with dementia.
There are 850,000 people living with dementia in the UK and this is forecast to increase to over a million by 2025[3]. Often dementia begins with short-term memory loss and can lead to changes in the way people think, speak and do things. Antipsychotic medicines are used for some types of mental distress or disorders. There are increased risks of harm from prescribing these medicines in patients with dementia and they are often inappropriately prescribed to alleviate the symptoms of Behavioral and psychological symptoms of dementia (BPSD). Only one antipsychotic medicine is licensed for treatment of BPSD in certain circumstances in the UK.
Multidisciplinary team input including the utilisation of a clinical pharmacist would benefit patients through the elimination of potentially inappropriate prescribing and optimising patient care.
4. Care for older people including care homes and domiciliary provision
All individuals living in a care home must feel safe, supported and encouraged to maintain as much independence as possible. There is a great deal of good care and support available to individuals living in care homes and inspiring examples of current good working practice across Wales. These are acknowledged in RPS Wales’ recent policy document, Improving Medicines Use for Care Home Residents, and it is important that we can learn from these good examples. Recent reports however have revealed pockets of poor standards and unacceptable practice which need urgent attention.
Care home residents, as well as older people living in their own homes, may be less likely to have direct contact with a pharmacist or a GP themselves. It is critical that those individuals should still expect to receive primary care services including information on their medicines (addressing polypharmacy). The same principle applies for access to other services such as the influenza vaccine or advice on giving up smoking.
There is evidence that unintentional changes to medications are occurring during transfer of care when a patient moves from one care setting to another. These discrepancies have the potential to cause harm. Better communication and appropriate sharing of information will help to assure safe and effective transfers of care and minimise the risk of medicine related harm.
RPS Wales’ recommendations for improving the use of medicines for care home residents can be accessed at;
http://www.rpharms.com/wales-pdfs/improving-medicines-use-for-care-home-residents-(wales).pdf
This policy addresses issues highlighted by a number of recent reports, in particular those raised by the independent voice and champion for older people across Wales, the Older Peoples Commissioner for Wales in the report A Place to Call Home.
I trust this helps to outline the issues we believe are important and require further exploration by the Committee.
RPS Wales look forward to working with the new Health, Social Care and Sports Committee on these and many other issues over the next 5years. Please do not hesitate to get in touch if you require any further information.
Yours sincerely
Suzanne Scott-Thomas, Chair, Welsh Pharmacy Board
The Royal Pharmaceutical Society (RPS) is the professional body for pharmacists in Great Britain. We represent all sectors of pharmacy in Great Britain and we lead and support the development of the pharmacy profession including the advancement of science, practice, education and knowledge in pharmacy. In addition, we promote the profession’s policies and views to a range of external stakeholders in a number of different forums.