Pharmacy pressures impacting care homes, suggests CQC survey

Medicines shortages and unavailability of community pharmacy staff are affecting adult social care providers in the UK, a survey by the Care Quality Commission (CQC) and Ipsos has suggested.

Some 49% of adult social care providers responding to the survey said the medication support they receive from community pharmacies fully meets their needs and 39% said it meets their needs 'to some extent'.

But almost one in 10 (8%) said the support they received did not meet their needs.

Respondents who felt their needs weren't met identified difficulties and delays with medication, including delivery and shortages; communication and availability of community pharmacy staff; and challenges around administration and training provided.

Participants who had faced challenges when requesting medicines-related information from healthcare professionals said the most common issue was receiving medication, the CQC noted.

Lack of responsiveness and difficulties in contacting healthcare professionals was a common theme, it said.

And not being able to access or receive medicines support had the biggest impact on service delivery, the CQC noted.

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Respondents said a lack of access to support causes delays in receiving medication and providing care and impacts medication reviews and changes to medications.

It can also 'directly impact' the health, quality of life and safeguarding of the people cared for under adult social care services, as well as leading to increased errors with medicines, respondents said.

Less than half of survey participants (49%) said they have always been able to access the medicines support they need.

And where help wasn't available within primary care, some participants said they had looked to other sources of support, including emergency services and NHS 111.

Around two-thirds of adult social care providers said that the support they received to monitor and review medicines errors fully meets their needs, while 28% said it meets their needs to some extent.

And around medicines governance and audit, 59% said the support they receive from community pharmacies fully meets their needs, while 33% said it meets their needs to some extent.

Malcolm Harrison, chief executive of the Company Chemists’ Association, told The Pharmacist that the CQC survey's findings 'show the impact on patients caused by years of underfunding' in community pharmacy.

Ashley Cohen, owner of Pharm-Assist (Healthcare) Ltd, an independent community pharmacy which works with more than 50 care homes and intermediate care units in north and west Yorkshire, told The Pharmacist: 'Pharmacy teams are spending considerable amount of time sourcing stock. Care home residents are not immune to medication shortages.

'It is frustrating for all of us that what have been historically easy to source medication are short in the market and huge amount of extra resource is being diverted from care home staff, pharmacy teams and general practice to find alternatives so that our most vulnerable members in the community can continue to receive the health care that they need.

'We are often having to find last minute alternative temporary solutions to ensure that they get effective medication for complex diseases. This situation has been ongoing for a number of years and there is no signs that the market will return to normal. Urgent attention is required.'

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Alastair Buxton, director of NHS services at Community Pharmacy England, said that the community pharmacy sector was 'working at full capacity with significant financial pressures preventing pharmacy owners from developing their businesses'.

'The work community pharmacy teams do day in, day out is of great value to patients, local communities and the wider health and care system,' he said.

'To protect the health and wellbeing of local communities and the public, these issues must be urgently addressed.

'Pharmacy teams will always do as much as they can to support patients and their fellow health and care professionals, but the extreme pressures they are under make that an increasingly tough ask. Investing in community pharmacy will not only benefit pharmacies but also all those who rely on them, including other health and social care providers,' he told The Pharmacist.

The CQC survey was sent to a sample of 26,644 adult social care providers including care homes, domiciliary care providers, extra care housing services and community-based services in February to March. Some 2,331 participants fully completed the survey and an additional 153 providers partially completed the survey. The results were then weighted to be representative of eligible providers.

Care homes were more likely than other types of adult social care services to say the medicines support they receive meets their needs.

Care providers in London and the East Midlands are also more likely to say the support they receive fully meets their needs (61% and 57% vs 49% on average).

The CQC also noted that less than a third (30%) of respondents had reported receiving support with encouraging people they care for to self-medicate, while 41% said they had not received support.

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'It is notable that a quarter reported that it was not relevant to them, even though self-medication is potentially applicable to most providers,' the CQC said.

Patience Bamisaye, care home nurse and senior lecturer in international and adult nursing noted to our sister title Nursing in Practice that support from pharmacy teams could be variable, with particular difficulties accessing advice and controlled drugs during the weekend.

And she suggested that there were issues with medicines wastage, particularly when a resident had passed away and the medicines had been dispensed before the pharmacy was informed.