Understanding more about the pressure that care homes are under can help us improve the service that pharmacy offers to them, says Noel Wicks

In recent years, our pharmacies have had the opportunity to increase the amount of care home business we do. It’s been a fascinating process that has been both interesting and challenging for a whole variety of reasons. From this personal experience, I’d say that the article published in this edition of P3 discussing nursing homes is a fair reflection of what looking after care homes is really like (see here).

It’s been really interesting spending time in a range of different care homes. I’ve been able to visit a multitude of facilities, from large nursing homes with high-dependency units right through to small rural facilities with only a handful of residents. One thing I’ve found to be universal among all of the sites I’ve visited was the immense amount of pressure faced by staff and managers at these homes.

I’d say their experience feels very similar to a community pharmacy in that we both operate in a highly reactive and accessible environment. Most other healthcare professionals operate on an appointment basis and are able to plan and structure their day.

In a care home, just like in a pharmacy, there are multiple things going on at any one time, and care home residents (or service users as they are referred to these days) and patients in the pharmacy have instant access to services. We all have a lot going on all at once often with little control.

Also similar is the backdrop of increasing regulation and a greater expectation around the quality and personalisation of care, delivered with the same (or indeed less) funding. In fact, it was working with homes that prepared me for the new GPhC regulatory model, as this is not dissimilar from that which care homes work with. So, while unannounced visits and interviewing staff about their roles may have come as a shock to some pharmacies, their care home customers were already used to it.

In addition, each care home has its report and subsequent gradings published for all to see, covering all areas of the home, including facilities, care (including medicines), the residents and their families. The size and scope of their inspections makes for very interesting reading and, by comparison, pharmacy inspections have a much narrower focus. I do think that having an understanding of this common ground has helped us to grow and change the way we service our care homes.

There’s a substantial amount of focus on medicines policy, audit trail and administration in homes, and this is where pharmacists can really provide added value. To do this, though, you need to spend time getting to know the individual needs of the home, the staff and the residents in it.

As is highlighted in the article, this is something that takes investment in time and resources, but it’s very fulfilling when you see your input making a difference. However, it continues to be an area of concern that the NHS doesn’t fund a proper national service for pharmaceutical care in care homes. I’ll be putting that on my Christmas wish list for sure!

Noel Wicks is an independent pharmacist.