1. Service Redesign Care Home Services
Paul Jerram
Head of Medicines Management
Isle of Wight CCG

2. The Health & Care of Older People in Care Homes July 2000
A comprehensive interdisciplinary approach
A report of a joint working party
Royal College of Physicians
Royal College of Nursing
British Geriatric Society

3. Causes of Concern
Inappropriate usage of prescribed medication has been demonstrated in care homes. SEVERAL STUDIES HAVE SHOWN THAT 20-25% OF CARE HOME RESIDENTS RECEIVE AT LEAST ONE INAPPROPRIATE PRESCRIPTION
Millard et al found that only 25% of GPs in nursing homes regularly reviewed the medication of each resident.

4. Recommendation
To introduce a specialist pharmacist for homes (and medication review of the elderly and specific high risk populations)

5. Analysis of Authorised Repeats for Medication & Dressings Before Review

6. Project
Following medication review, trained nurses, working to a protocol, can treat residents for minor conditions and use appropriate dressings without referral to a GP

7. Six Months Later
Improvement in prescribing against a number of quality indicators
Improved medication regime for residents
Reduced workload for GPs, care home staff & pharmacists
Reduction in cost of medication & dressings
Empowerment of nurse clinical team
Increased remuneration of pharmacists

8. Effect on Laxative usage

9. Effect on Medication & Dressing Costs

10. Service Redesign Brainstorm how we may improve existing services
Select most appropriate updates
Test concept and pilot
Evaluate
Roll out

11. Updates Patient passport Bar code patients
Remote access to medical records
E communication/records replaces paper
Increased patient safety via Radar/scheduled and ad hoc monitoring
Proteus ingestible sensors for compliance check in non care home patients
Carer or patient self monitoring

12. Patient passport

14. Patient Passport

17. Viewing other results

20. Helius Project

22. Home Hypertension monitoring Project
The Isle of Wight is already introducing the innovative Patient Passport , a service that allows the healthcare team access to the patients health records safely, securely and efficiently.
It allows access to the ‘essential aspects’ of patients medical records:
Clinical Conditions
Medications & Allergies
Blood Results & Investigations
Health Plans