Healthcare professionals in primary care support the health needs of people living in care homes.
NHS England and NHS Improvement have developed a framework for more structured support. It aims to improve the safety and outcomes for people taking medicines in a care home.
In 2014, the NHS Five Year Forward View identified areas where it wanted to develop new models of care. One of these was the Enhanced Health in Care Homes (EHCH) Model. This aimed to provide joined up primary, community and social care to residents of care homes.
Primary Care Networks (PCNs) are geographic groups of GP practices working together. From October 2020 PCNs can deliver version two of the EHCH model.
As part of NHS England Covid-19 response GPs and their teams were asked to help support care homes. This included regular assessments of people with the highest clinical need. These assessments could be held virtually.
Pharmacy and medicines support to care homes
Pharmacy professionals can support care homes in different ways.
- supply of medicines - prescribed and over the counter
- supply of medicines records
- advice and support
Primary care or community healthcare pharmacy
- from a GP practice, PCN, NHS community trust or NHS Medicines Optimisation in Care Homes (MOCH) programme
- help with medicines supply, including with end of life medicines
- delivering structured medication reviews
- supporting medication reviews of new residents or those recently discharged form hospital
- supporting care home staff and residents with medicines queries
- prescribing medicines for people living in care homes
Terms you might hear
- a framework to help people take their medicines safely in a person-centred way
- prescribing of many medicines to one individual
Appropriate prescribing for a person:
- for complex conditions or for multiple conditions
- prescribed following best evidence
- involving the person to achieve the best outcome
Problematic prescribing for a person:
- inappropriate prescribing of multiple medicines
- where the intended benefits of the medicines are not realised
- a process of safe and effective reduction or stopping of inappropriate medicines
- reducing harm and the use of unnecessary medicines
- a structured, critical examination of a person’s medicines by a healthcare professional
- includes the persons’ views and understanding about their medicines
- where appropriate, includes family members or carers
- answers concerns, questions or problems with the medicines, including side effects or reactions
- at least once a year but more often based on the health and care needs of the person
Considerations for providers and staff
Include the person and/or their family members in medicines reviews. Support people to make informed decisions about their medicines.
Some people do not have capacity to make decisions about their treatment. Relatives or advocates should be involved when making decisions about medicines.
Use your knowledge and medicines records to inform a medication review.
Care staff may be asked to monitor people before a clinical review. For example, using pulse oximeters to measure blood oxygen levels. Care staff must be trained and competent to do this.
Promote safe and effective use of medicines by working with all pharmacy professionals.
Ask for a medication review when there are problems or changes in the way a person takes their medicines.