GPs should review care home medication every six months

Question: Who’s keeping a finger on the pulse of care in care homes for the elderly? was a question I asked recently.

Answer: Older People’s Specialists’ Forum (OPSF) and the British Geriatrics Society

The Older People’s Specialists’ Forum (OPSF) is a group of healthcare professionals specialising in the care of older people. Its members include representatives from: The British Geriatrics Society, the Royal College of Speech and Language Therapists (RCSLT), the Department of Health, the National Association of Primary Care, the Society and College of Radiographers, the College of Occupational Therapists, the British Association of Art Therapists, the Chartered Society of Physiotherapists, the Royal College of Nursing, the Royal College of General Practitioners, the Royal College of Psychiatrists (Faculty of Old Age Psychiatry).

Nearly seven out of ten (68%) care home residents do not get a regular planned medical review by their GP and 44% are not getting a regular planned review of their medication a survey said today.

The survey was launched by the Older People’s Specialists’ Forum (OPSF) and asked care homes across the UK about their experiences of accessing healthcare services for their residents.

The survey also found that 59% could access specialist dementia services such as memory clinics and community mental health teams. Most care homes could request input from specialist nurses when a problem had arisen but very few homes appeared to have access to input from specialists to prevent problems arising.

According to PULSE, the British Geriatric Society will publish GP guidance next April to improve care in nursing and residential homes by tightening up medicines-management arrangements, following disturbing findings uncovered by Pulse’s recent special investigation.

The guidance will highlight the importance of six-monthly medication reviews by GPs or pharmacists, and the need for a medical and nursing care plan within one month of admission to a care home.

About time too, would be the reaction of every single person who has experienced sloppy, slapdash, uncaring medication control in a residential care home with nursing, specialising in dementia.  About time too.

CHUMS  Care Homes Use of Medicines Study looked at Medication errors in nursing & residential care homes, studying 256 patients in 55 homes. Patients were on a mean of 7.2 medicines each and 69.5% of patients had at least one error.  The field work was carried out in 2006‐7 .

The prevalence of errors was: prescribing 8.3%, monitoring 14.7% (for relevant medicines), dispensing 9.8% and administration 8.4%; these figures represent the likelihood that each act (prescribing a medicine, for example) will be an error. In terms of patients receiving errors: 39.1% received a prescribing error, 18.4% (of those who needed it) a monitoring error, 36.7% a dispensing error and 22.3% observed to receive an administration error.

The great majority of monitoring errors (91%) resulted from a failure to request monitoring. There was considerable variation between areas, with three‐quarters of monitoring errors occurring in London.

Conclusions: There is an unacceptable prevalence of medication errors in care homes, affecting some of the most vulnerable members of society.   Action is required from all concerned.

Questions:

Why should it take so long for caring care to be provided?

Why should it take so long for ‘required action’ to take place?

Why should it take so long for sensible measures to be seen to be in place to protect vulnerable elderly people?

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Filed under care, care homes, growing older, NHS

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