Collaborative Solutions: Enhancing Medication Support for Care at Home in Partnership in South Lanarkshire

Background: National Policy changes have supported people in Scotland to live at home for as long as safely possible. This has led to increasing complexity for Care at Home providers who highlight medication support as one of the biggest risk areas they experience. A growing proportion of care at home is delivered by the independent sector. A unique collaborative approach led by Lynsey Allan, Independent Sector Lead for Scottish Care, and Jacqueline Kelland, Specialist Pharmacist for Social Care, has explored challenges faced in relation to the safe and effective delivery of medication support and identified actions to equip the social care workforce, enhance clinical outcomes and maintain patient safety.

 

Approach: We gathered qualitative data by designing a survey for care at home providers as well as engaging with other stakeholders who interface with this sector. This scoping exercise provided insight to the challenges encountered as part of care at home delivery and was used to design and deliver an in-person Development Day. Approximately 50 stakeholders came together to discuss, analyse and agree actions which would address challenges.

 

Attendees included providers (including frontline /operational staff), Health and Social Care Partnership colleagues, the Care Inspectorate, NHS Lanarkshire Pharmacy, and Scottish Care. This integrated approach to identifying and addressing challenges actively involved stakeholders at all stages of design and implementation to support effective solutions and reduce risk associated with medication.

 

Results: From the initial survey and Development Day we identified 3 common themes to challenges in relation to medication support. These include (1) challenges relating to hospital discharge and prescribing, (2) policy and process and (3) communication. Our engagement allowed identification of challenges and stakeholder agreement of actions to address these.

 

As a second phase, we developed a full day workshop for independent providers to support best practise in relation to medication support by improving consistency of policy and practise and access to workforce development opportunities. We aim to develop a baseline standard for medication support and provide access to specialist pharmacy services. Additionally we have supported ongoing conversations in South Lanarkshire around hospital discharge, allowing for further exploration of issues through improved data collection. Crucially, we have engaged with stakeholders from across Scotland to share our findings and develop a National Care at Home Medication Support Special Interest Group to review common challenges and share good practise.

 

Implications: Our crucial engagement with the care at home workforce along with a broad range of stakeholders who interface this sector has identified solutions to address challenges which provide practical and supportive implementation increasing the likelihood of success. We have strong support from regulatory and commissioning colleagues and, together with our unique collaborative partnership, this has enabled an opportunity to bring colleagues from both Health and Social Care together for true partnership working. We have had the opportunity to consider the scalability of this work to share best practice through development of a National Special Interest Group, demonstrating both appetite and opportunity for further work in this area of care at home delivery.