RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

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of pts 72h MR of pts 72h MR Admissions 1413 62.8 15.2 22.0 1436 47.8 26.2 26.0 Medical 3127 53.8 36.6 9.6 3004 50.2 38.0 11.8 Surgical 2962 47.3 39.5 13.2 2789 44.3 45.7 14.1 Older People 1338 46.8 44.5 8.7 1334 47.3 42.7 10.0 Other 261 50.2 26.8 23.0 252 36.9 32.5 30.6 Total 9101 51.9 35.2 12.9 8815 47.1 37.8 15.1 Conclusion: The timescale standard set for delivering pharmacy-led MR was not achieved. This may mean the patient benefits from pharmacy-led MR are not fully realised. There was little difference in the level of delivery of MR achieved in each of the care areas audited; however, it was recognised the areas audited were chosen by the participating trusts. Most pharmacy departments offered a weekday service only. Although there was less difference than anticipated in the data collected pre and post the weekend period, the audit did not collect information on numbers of patients admitted and discharged over the weekend period when pharmacy-led MR was unavailable. Although reduced staffing levels impacted minimally on the time scale and extent of MR delivery, the variation in staffing establishment between trusts was not explored and may be of more importance. Trusts can use these data to benchmark their MR provision and review whether their MR services could be improved. The collaborative data can also be used to support discussion between commissioners and providers who are agreeing performance or quality account metrics with respect to MR delivery. References: 1. NPSA/NICE. Technical patient safety solutions for medicines reconciliation on admission of adults to hospital. National Institute for Health and Clinical Excellence, London 2007. www.nice.org.uk. 2. Clinical Directorate, East and South East England Specialist Pharmacy Services. Template Policy for Medicines Reconciliation v11. www.londonpharmacy.nhs.uk (Accessed April 4 <strong>2010</strong>).
42 Medication access in primary care for paediatric home-patients: involvement and opinions of medical staff in a UK paediatric hospital David Terry 1 , Anthony Sinclair 1 , John Marriott 2 , Keith Wilson 2 , Penny Davis 1 1 Birmingham Children's Hospital, Birmingham, United Kingdom, 2 Aston University, Birmingham, United Kingdom • Objective is to identify the involvement and opinions of hospital medical staff in supporting medication access for paediatric patients at home. • Half of respondents wrote prescriptions for home-patients in a 3 month period, with 44.7 % describing the risk to patients if they did not provide this service as high or very high. • Hospital doctors act frequently to assist paediatric patients outside hospital who are largely cared for by primary care services (home-patients) to obtain the medicines they need. • We define a home-patient as a patient not in hospital and largely cared for by primary care services where prescribing reponsibility remains with the GP. Introduction: Medication related problems are frequently encountered as a patient moves from one healthcare setting to another, and may lead to poor patient care. [1, 2] This may be enhanced for paediatric patients since children needing regular medication may require unlicensed medicines or receive licensed medicines used outside the license conditions (“off-label”). Clinical units in hospitals may provide support for patients in primary care, often via telephone helplines. [3, 4] The Department of Health endorses a fee of £26 for telephone consultations. Support may include providing prescriptions, including those that can be dispensed in the community usually described as FP10hps.This study seeks to identify the involvement and opinions of hospital medical staff in supporting medication access for paediatric home-patients and estimate service costs. Method: Descriptive, cross-sectional survey using an electronic questionnaire constructed and piloted with the support of hospital doctors, using LimeSurvey software (version 1.71) and sent via hospital email addresses to all medical staff (n=340) at Birmingham Children’s Hospital. The survey was tokenised to ensure that one invitation elicited one response only and sent commencing January <strong>2010</strong> with 2 reminders if necessary. The 30 point questionnaire included: demographics; frequency of prescribing; reasons for medication access problems; interaction with community pharmacists; and improving current arrangements. Responses were entered into MS Excel 2003 and SPSS v16 for analysis. Results: Response rate of 48.5% (n=165) from 24 paediatric specialties. Nearly half of respondents (n=81) wrote urgent prescriptions for home-patients in a 3 month period. Respondents providing this service describe the clinical risk to patients if they did not provide this service as: small 9.2% (n=7); moderate 46.1% (n=35); high 35.5% (n=27); very high 9.2% (n=7). Respondents were asked to identify the most likely reason for medication access problems from a list of possible reasons with the following results: GP issue 44.5% (n=65); Communication issue 17.1% (n=25); Carer issue 13.0% (n=19); Pharmacy issue 6.2% (n=9); Formulation issue 1.4% (n=2). Respondents were asked to assess the likelihood (very unlikely, quite unlikely, sometimes, quite likely, very likely) of a list of possible reasons why GPs may decline to provide repeat prescriptions for children with the following results for very likely or quite likely: clinical concerns 56% (n=84); communication issues 52% (n=78); PCT influence 47.3% (n=71). Annual service costs for this institution are estimated as £120,000 based on a service fee of £26 per event. Conclusions: Hospital doctors act frequently to assist paediatric patients outside hospital who are largely cared for by primary care services (home-patients) to obtain the medicines they need. This activity is not covered by existing contractual arrangements between the hospital
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RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

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