1. Remodeling the Model for Care Home Patients
Transfer of Care –
Remodeling the Model for Care Home Patients
The Lewisham Integrated Medicines Optimisation Service (LIMOS) work across the primary, secondary and social care interface to ensure patients medicines use is optimised and made safe. Development of this model enables the LIMOS team to ensure quality and safety of care for a vulnerable group of patients, and potentially prevent or reduce future hospital admissions. The care homes team aims to improve this by adopting a patient centred, collaborative approach and embedding medicines optimisation into core practice in both primary and secondary care.
Patel, H and Howes K, Lewisham and Greenwich NHS Trust, London.
Overview and Setting
The Lewisham Integrated Medicines Optimisation Service (LIMOS) supports patients to get the most out of their medicines and bridging the gap between the hospital, community, and health and social care interfaces. Care Home Use of Medicines Study (CHUMS) identified that almost 70% of care homes patients will have at least one medicines related error and it has been well documented in literature that there is a significant risk that patients’ medicines will be unintentionally altered when they move from one care setting to another. Following the success of an integrated model of medicines optimisation for patients needing medicines support in their own homes the LIMOS team has expanded into care homes to extrapolate this collaborative approach across the interfaces and improve the care for another highly vulnerable cohort in our population.
The Model
Supporting Care homes/ GPs with medicines while maintaining a patient centered approach
Patient Centered medication reviews for all care home residents
Work collaboratively with hospitals and care homes to prevent future incidents
Reduce avoidable harm by post discharge follow up within 2 weeks of discharge
Conclusions
The LIMOS model, working both across and within the care home and secondary care setting has enabled medicines issues around transfer of care to be identified and key  challenges across the whole system further understood. These results facilitate  prioritisation of work streams to implement the required service improvement to support high quality and safe care for vulnerable patients residing in the care home setting.
References: Lai, K., Howes, K., Butterworth, C. and Salter, M. (2014). Lewisham Integrated Medicines Optimisation Service: delivering a system-wide coordinated care model to support patients in the management of medicines to retain independence in their own home. European Journal of Hospital Pharmacy, 22(2), pp Nice.org.uk. (2014). Managing medicines in care homes | Guidance and guidelines | NICE. [online] Available at: [Accessed 16 Dec. 2016]. Sps.nhs.uk. (2016). Report of the collaborative audit on the quality of medication related information provided when transferring patients from secondary care to primary care and the subsequent medicines reconciliation in primary care – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice. [online] Available at: [Accessed 16 Dec. 2016]. Barber, N., Alldred, D., Raynor, D., Dickinson, R., Garfield, S., Jesson, B., Lim, R., Savage, I., Standage, C., Buckle, P., Carpenter, J., Franklin, B., Woloshynowych, M. and Zermansky, A. (2009). Care homes' use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people. Quality and Safety in Health Care, 18(5), pp QCS. (2016). CQC Fundamental Standards. [online] Available at: [Accessed 18 Dec. 2016].