1. TORFAEN MEDICATION ADMINISTRATION SCHEME Val Bessell Wendy Tyler-Batt

2. Background Care staff instructed to prompt only Reality – administration to help out No approval or support if problem arose Medication: Health or Social Care Task?

3. Background Wanless report: –Balance of care skewed towards secondary care ie too many people in hospital TMAS was a logical development –Administration of medication by carers to help vulnerable adults remain in their own homes

4. In the beginning TMAS started in May 2005 – with Wanless funding Just with TSS carers Medication Policy Medication Training

5. Extension to other Care Providers Scheme securely established with the in- house service providers Training extended to the four block contract external providers Opportunity to be a part of the scheme eventually extended to spot providers

6. Medication Administration Training Over 340 carers have received training Course has received OCN approval Refresher Courses offered

7. Making Best Use of Medicines ‘The costs associated with waste medicines are not just financial. There is also a cost to patients: effective use of prescribed medicines delivers improved health outcomes for patients, which may be foregone if medicines are not used to best effect.’ * * Kings Fund DOH report July 2011

8. NICE CG076 Medicines Adherence Cost statement £8.1 billion Medicines on prescription cost in 2007–08. If 50% of patients don’t take their medicines as recommended, this could mean that £4.0 billion of medicines are not used correctly. Estimated costs of admissions resulting from the above between £36 million and £196 million in 2006–07. These admissions and associated costs would be expected to decrease as medicines adherence increases.

9. NICE CG076 MEDICINES ADHERENCE The current costs to the NHS associated with patients not adhering to prescribed medicines are large and the potential savings from reducing hospital admissions associated with non-adherence are also large. There is the potential to reduce the costs associated with non-adherence, perhaps by redirecting some of these resources into additional training in consultation skills and interventions.’

10. Referral process Generic referral form to HB pharmacist Pharmaceutical Care Plan (PCP) = risk assesment MAR chart & medication supplied

11. Referrals Over 400 successful referrals to the scheme Over 170 referrals on the scheme now Multiple Sources

12. Successful referral rate

13. Source of referrals

14. Progress Development of TMAS MAR chart Extension to other care providers All pharmacies in Torfaen participate All GP practices in Torfaen Increase in referrals Decrease in processing time Being used as example of good practice

15. TMAS An excellent example of joint working across the health & social care interface Referenced in ‘Pharmacy and Integrated Chronic Conditions Management in Wales’ Paper published in Pharmacy Management journal

16. Funding SHARED –Social Care – medication administration as part of integrated care package –Health Care part time HB pharmacist payment to community pharmacist to provide MAR chart

17. Hurdles to overcome Communication and understanding –Between services in the community –Across the primary and secondary care interface Continued funding of TMAS by Aneurin Bevan Health Board Funding of medication only calls

18. Governance Constantly looking at practice Reviewing and making changes Medication Policy updated & revised 2011

19. Conclusion Improved Health & Social outcomes for the individual and society: –People remain in their own homes for longer –Staff are trained and more confident in their role –Medication administered as prescribed –More cost effective use of medication