Working at scale to improve medicines management

Guidance on medicines optimisation is not in short supply. But at AT Medics – a provider of GP services to over 240,000 patients – a business intelligence tool demonstrated there was a significant gap between best practice and practical application.

To address this, a central pharmacy team was created. The mission of its members: to enhance and optimise medicines management and improve the quality of prescribing and prescribing safety.

“We recognised there was a huge opportunity to develop a centralised approach around medicines safety and long-term conditions outcomes,” explains a spokesperson for the organisation.

“We also recognised the opportunity for previously overlooked clinical areas to be addressed remotely in a systematic and widespread way.”

Through further analysis of business intelligence data, the team identified patients whose medicines had been managed sub-optimally.

These individuals’ records were reviewed by pharmacists, who either contacted the patient to offer advice over the phone – with follow-ups at result intervals – or invited him or her to a face to face appointment. This consultation is, again, typically with a pharmacist.

Through further analysis of business intelligence data, the team identified patients whose medicines had been managed sub-optimally

Since the introduction of the approach, there have been significant improvements.

Among them: a 53 per cent reduction in the number of people with asthma who are taking beta blockers; a 43 per cent reduction in patients with a long-term repeat prescription for non-steroidal anti-inflammatory drugs; a 26 per cent improvement in the monitoring of patients on disease-modifying anti-rheumatic drugs; a 64 per cent improvement in the completion of lithium monitoring; and a 71 per cent improvement in the number of patients on warfarin who are receiving appropriate monitoring.

The achievements were such that AT Medics were named winners in the Optimisation of Medicines Management category at the HSJ Awards 2018. There were multiple motivations for entering.

“We wanted to share with others within general practice what can be done and the impacts of working at scale and in a standardised manner,” the spokesperson reports.

“We have subsequently supported colleagues outside of our organisation to work similarly and believe the award has been the impetus behind such opportunities.”

But it was also about celebrating the hard work of those involved in the project. “It was an attempt to give our colleagues the additional recognition we believe they deserved,” says the spokesperson.

It seems it’s worked. “Winning the award has been a great team motivator; it has positively impacted staff retention and recruitment.” 

Positive work across the NHS

Ask Nadine Miles why Spirit Health Group chose to sponsor the Optimisation of Medicines Management category at the HSJ Awards and she speaks first of the clear brand impact.

“We always knew that sponsoring an HSJ Award would bring with it a positive association for our brand, and our hope was that sponsoring a category that was closely associated with what we do would showcase our commitment to delivering the very best to the NHS,” explains Ms Miles, the company’s director of market development.

What they hadn’t expected, she says, is the “tremendous privilege” that was interaction with those in the running for the award. 

“We had 11 finalists who each presented their unique project to us in one day in London. It was fabulous to meet the teams who have done so much in the medicines optimisation field and to hear what their efforts had done for their patients and their local health economy.”

She says the day made clear that there is already a significant amount of positive work taking place across the NHS. “However, it is also clear that there is a lot of room for the promotion of best practice and we are keen to be a part of this,” Ms Miles explains.

For more information on the winning entry visit HSJ Solutions