We speak to the Pharmacist/Pharmacy Team of the Year Award shortlisted pharmacists ahead of this year’s General Practice Awards, to be held on 8 December in London.

The fourth entry under the spotlight from this year’s shortlist of six is the Haringey GP Federation clinical pharmacy team.

Among the significant work of the Haringey team is the piloting of the STOMP-STAMP structured medication reviews (SMRs) project.

The STOMP-STAMP initiative was designed to reduce the dependence on psychotropic medication for patients with learning difficulties (LD) and/or autism in North Central London (NCL). STOMP (Stopping Over Medication of People with a learning disability, autism or both) and STAMP (Supporting Treatment and Appropriate Medication in Paediatrics) are national projects.

An estimated 6,400 patients with LD and/or autism, are prescribed psychotropic medication in NCL, of which approximately 1,200 reside within Haringey.

An NCL integrating pharmacy and medicines optimisation (IPMO) STOMP-STAMP working group was tasked with identifying pharmacy-specific change ideas to support the initiative and following a driver diagram session, a clinical pharmacist-led structured medication review (SMR) initiative was agreed with Haringey as the pilot site.

The Haringey pilot of the IPMO STOMP-STAMP SMR project involved three elements: education and training of the Haringey Clinical Pharmacy workforce; the Haringey Clinical Pharmacy team conducting GP practice system (EMIS) searches and SMRs; and SMR data collection.

Three out of seven Haringey Primary Care Networks (PCNs) and nine out of 37 practices actively participated in the STOMP-STAMP audit. Within the nine GP practices, 602 patients prescribed psychotropic medication for LD, autism, or both underwent SMRs. Over six months, Haringey GP Federation clinical pharmacists conducted 160 SMRs, covering 26.5% of the target patient cohort, with 36% conducted face-to-face.

The outcomes revealed that 85% of these patients had documented indications for psychotropic medication, and 92% were deemed clinically appropriate. Some 12% of patients experienced changes to their psychotropic medication, with 32% undergoing dose reductions and 68% cessation.

Shared decision-making was a prominent feature of the process, and individualised management plans were formulated for 56% of patients. Additional actions taken during the SMRs included blood tests, referrals, health checks and contraception reviews.

The Haringey Clinical Pharmacy workforce attended a training session developed and delivered by an LD specialist pharmacist in collaboration with a Haringey GP Federation senior clinical pharmacist, the local adult and Child and Adolescent Mental Health Services (CAMHS) teams and the IPMO programme team. The training session considered current learning needs and increased confidence in de-prescribing within this cohort of patients.

What they said

A PCN clinical director said: 'The clinical pharmacy team has shown substantial improvements with a fantastic achievement across the whole borough through their hard work and have strived to instill ongoing safety principles to a wider clinical audience through educational sessions and discussions with PCN member practices directly.'

And a practice manager commented: 'The work done has been a great help for the practices as it has freed up significant clinical time which has been spent more with patients. The tracking through dashboards provided reassurance in relation to progress and appropriate prescribing.

One of the effective outcomes of the SMRs is demonstrated in a pharmacist testimonial, which read: ‘Carbamazepine dose reduced as causing low sodium. Sodium is back to normal and patient stable on lower dose (no seizures).’

Last year, West Midlands-based pharmacist Helen Kilminster won the Pharmacist of the Year Award after demonstrating she is an advocate for fair and equitable access to healthcare.

See here for more information about this year’s General Practice Awards and the gala dinner and ceremony, which will be at the Novotel London West on Friday 8 December.