A review in 2007 by the Healthcare Commission into effective medicines management showed that 92% of mental health service users contacted had taken medicines.
It also recognised that mental health trusts invested less in pharmacy services compared to acute trusts.
Improving Medicines Management by Extending the Roles of Pharmacy Technicians in Mental Health (2008), a briefing document published on behalf of the DoH, identified roles pharmacy technicians could undertake to support the safe and cost effective use of medicines.
Supported by these reports, Sussex Partnership Foundation Trust has invested in medicines management technicians (MMTs) on admission wards across West Sussex and Brighton & Hove. MMTs are specially trained pharmacy technicians who make daily visits to admission wards, Monday to Friday, taking on a number of roles to maximise the benefits from medicine.
One innovative service introduced by one MMT is now well established in Worthing, West Sussex. A morning medicine round is undertaken once a week by her on two acute adult admission wards. This provides an opportunity to; meet all the patients and invite them to her medicines education group; answer any questions they may have at the time and it provides an educational resource to the accompanying nurse on the medicines being administered.
Work has been done to quantify the benefits of introducing MMTs to the wards. An audit of 43 consecutive admissions showed the MMTs identified 203 medicines being taken on admission by the patients compared to 144 initially recorded by the doctors. Of the 144 medicines recorded by the doctors only 111 had the dose recorded unlike all 203 recorded by the MMTs. The recording of the patients’ allergy status rose from 67% for the doctors to 87% for the MMTs.
In early 2009, all wards receiving a service from a MMT were given questionnaires to complete by nurses. The questions covered ratings for how valuable the services provided by the MMT were perceived to be and how well they were being delivered. The results from 43 returned questionnaires showed an overwhelming support for the roles and the individuals delivering the service. When it came to how valuable overall the service was, the service scored an average of 9.0 out of 10. How well the service delivered scored an average 8.8 out of 10.
These results and the complaints we received when one service was restricted due to long-term sick, have helped show how dependent wards have become on MMTs once employed.
If we are to get the better outcomes from the medicines prescribed for inpatients, investing in MMTs, who help minimise mistakes, reduce waste, speed up medication related processes and improve knowledge of medicines, seems a very cost effective option.
Ray Lyon is chief pharmacist at Sussex Partnership Foundation Trust