An army of experts have been recruited by NHS England to help prevent care home residents being given too many medicines as part of a package of measures to improve older people’s health and care in the NHS Long Term Plan.
Care home residents are prescribed an average of seven medicines a day, with many taking 10 or more, costing the NHS an estimated £250 million each year, with charities voicing fears that a generation of older people is being subjected to a ‘chemical cosh’.
The NHS is putting in place medical and clinical experts, including 200 new clinical pharmacists and pharmacy technicians, who will support care home residents to improve quality of life, cut hospital stays and reduce over-medication.
They are working as part of a £20 million programme to reduce unnecessary medication of patients and make sure they are getting the right treatment that is being rolled out across the country. The additional staff are being brought in alongside the national roll-out of a programme in the NHS Long Term Plan – and already in place in 14 parts of the country – giving everyone living in a care home improved GP support and more visits from specialists like dieticians and clinical pharmacists.
Professor Alistair Burns, National Clinical Director for Dementia and Older People’s Mental Health at NHS England, said: “Older people deserve the best possible support and with many care home residents living with complex conditions, bringing in extra expert health advice will mean the NHS can reduce avoidable drug use, improve care and free up vital funding for better treatment.
“People want to know their mum or grandad is being properly looked after and helping them to live well and with the best possible quality of life is key to that.
“Strengthening the ties between GPs and care homes made a huge difference to residents’ health when we tested the scheme and the NHS Long Term Plan will mean older people in every part of the country soon will benefit from tailored, specialist support in their care home.”
Around 400,000 people live in England’s 17,000 nursing and residential care homes with one in seven residents aged 85 or over.
Elderly residents in particular often have one or more long-term health conditions – for example dementia, high blood pressure, diabetes and heart disease.
They spend around two million days in hospital each year and account for about 250,000 emergency hospital admissions.
Some 35%-40% of these admissions are thought to be avoidable through action such as tackling over medication. The new programme will also help to reduce the number of visits to A&E caused by older patients’ medicine use – studies suggest one in 10 older people’s admissions to hospital is linked to their medicine intake, with the majority of these thought to be avoidable with better care and support. England’s Chief Pharmaceutical Officer Keith Ridge said: “Too many patients are prescribed medicines they may no longer need or may need adjusting, which is why the NHS Long Term Plan is funding expert pharmacy teams across the country to give tailored advice to care home residents and extra support to staff to increase the safety and quality of older people’s care. “Rather than assuming there’s a pill for every ill, increasing the availability of specialist health advice in care homes will mean residents get more personalised treatment, reduced chances of being admitted to hospital and people will have a better quality of life, for longer.”
Failing to understand properly residents’ care needs can mean health problems get missed, which among older people risks frailty and falls, leading to long-term problems and lengthy hospital stays.
Across the country, 14 areas have Integrated Care Systems (ICS) which join up NHS and local government services simplifying systems between GPs, hospitals, councils and charities and improving lives, have trialled the scheme so far.