Published Fri, 2010-04-16 12:48; updated 38 weeks ago.
Medicines management is about enabling people to make the best possible use of their medicines – according to Richard Seal, programme consultant in medicines management for NHS West Midlands.
Put like that, it sounds simple but consider the following scenario: A mum-to-be goes into hospital to have her baby.
Any medicine she is already taking needs to be recorded in her notes, including any allergies she might have. She ends up having a Caesarean section for which she has an epidural.
During recovery on the ward, she needs medicines for pain relief, to help her prevent her blood from clotting and to compensate for the blood she has lost. These are prescribed by the consultant, dispensed by the pharmacist and administered by the team on the ward.
The next day she is sick. She tells the ward team, who, in consultation with the pharmacist, suggest her dose of morphine is lowered.
This is recorded on her prescription, in her notes and at the pharmacy. When she is ready to be discharged, the pharmacist checks and dispenses all the medicines she needs for the following week. She is given a medicines list to take home.
Her GP calls her within a few days to congratulate her on the birth of her baby and ask how she is getting on with her medicines.
She says she is still in pain, so the GP writes her a prescription, which her partner picks up from the GP’s reception and takes to the community pharmacist where the new medicine is checked and dispensed.
This is a straightforward procedure for a routine operation but at any point, if it is not carefully managed, the system through which the patient receives her medicine could go wrong.
- The notes she brings to the hospital might not be accurate or legible
- The hospital pharmacy might not have her usual medicines in stock The patient might not have told the ward staff she had been sick
- The ward staff might not have made the connection between her sickness and the morphine
- The doctor might have overlooked reading her notes and prescribed a drug which is incompatible with her other medicine
- The GP might not have received the woman’s discharge notes from the hospital in time and so be unaware he has a patient who might need more medicine
- The community pharmacist might make a mistake when entering the data from the GP’s prescription and dispense the wrong quantity of painkiller
- In the blur of new motherhood, the patient might forget what pills she has already taken and end up having more than she should Getting it right at each point from the medicines being prescribed to the patient taking them is that art of medicines management – and it’s a complex business.
The National Prescribing Centre has another definition of medicines management.
It says: "Medicines management is a system of processes and behaviours that determines how medicines are used by patients and healthcare services."
The NHS in the West Midlands has decided to make medicines management a priority over the next few years. It aims to make the use of medicines in the West Midlands as effective, safe and efficient as possible.
Through good medicines management NHS organizations in the West Midlands aims to:
- Maintain well-being
- Improve health
- Enable people to care for themselves
- Offer better access to pharmaceutical services Improve choices for patients
- Make better use of the skills of healthcare professionals such as doctors, pharmacists and nurses Give more information to patients
- Reduce waste and save money
It is estimated that up to £100 million could be saved through patients taking the medicine correctly and as much as £40 million could be saved through reducing errors made my health professionals.
Specifically NHS organisations in the West Midlands want to:
- Reduce the number of people who have to be admitted to hospital as a result of something that has gone wrong with their medicines
- Find ways to improve medicines safety and so reduce the number of problems that people have with their medicines
- Support people to make the best possible use of their medicines by providing better access to information about medicines and medicines management services
Due for review October 2013