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Monitored dosage system: ‘We get patients asking for MDS all the time’

Pharmacy shelves

By Saša Janković

06 Dec 2021

Meng Yap, pharmacist manager at Everetts Pharmacy in Cosham, Portsmouth, talks to Saša Janković about his community MDS service.

Service type: Community Monitored Dosage System (MDS)

Name and location of pharmacy: Everetts Pharmacy, Cosham

Name of pharmacist: Meng Yap

When did you start offering this service?

We’ve always offered an MDS service in this branch and it’s expanded since I joined 11 years ago.

Why did you start offering this service?

Our main MDS customers tend to be people who are still at home and look after themselves – rather than those who go to nursing homes and have people to look after them.

Our community MDS patients are primarily people living with disability, poor memory or dementia, or people who are just generally not managing well with their medications, especially the elderly group. In most cases it’s people who are on polypharmacy, needing to take medicines at different times of the day, and who can’t manage to do this at home by themselves.

How much did it cost to set up the service?

It does come with an extra cost, which when we first started was something we as a pharmacy had to absorb. We have to source the MDS trays and the seals, and more importantly it’s a very time-consuming job. We have three members of staff – one tech and two assistants – purely concentrating on these MDS trays just for our branch. In the last four to five years, Portsmouth CCG has paid for a concordance service, but before that we did it without any funding apart from the dispensing fees on the prescription.

What, if any, training did you or other team members have to undergo?

We do in-house training for our staff who work on this as there are various pieces of paperwork they need to know how to check.

In a nutshell, what does the service involve?

We get patients asking us for MDS all the time. We then need our local Medicines Advice at Home team to go to their home to assess the conditions and check that the patient is in general need for MDS trays. If so, they’ll send a referral letter to us to let us know when to start the trays and if the patient can come in to collect it or if we need to deliver.

We can also take people referred to us by the hospital, and again we will let the Medicines Advice at Home team know we have done this. And when a patient is admitted to hospital and then comes out they are supplied with a week’s worth of medicines and we can continue to supply after that, which can fit with the discharge medicines service (DMS).

How have patients responded to the service?

They get on with it really well and it takes a lot of pressure off families, especially if their family don’t live with them. Patients and their families can call us to get a bit of reassurance if the person gets a new prescription or antibiotics or cream, and if they can’t come out we know the patient well and we deliver. We are always here to help out and our patients say they are really grateful for the service.

Roughly how often each month do you carry out the service?

We started with 50 and now do around 180 a month, with an average of around 6-8 medicines in a tray.

How much do you charge for the service?

It’s free for the patient.

Would you recommend offering this service to other contractors?

In the community there a lot of requests for it which means people need it, but you have to have enough staff. I don’t like to say no to people who need help, but you need to think if you have enough resources to offer a quality service and make sure the rest of your business is also running well. For us, it’s a very satisfying job that keeps us really busy, and is a genuine help for patients in need.

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