TWELVE community pharmacies in Scotland have entered into a pilot project looking at the feasibility of care bundles being applied for medicines related to certain health conditions. A Scotland-wide collaborative has been initiated to develop three care bundles and test their use in community pharmacies across different health boards.
A working group consisting of specialist interest group chairs, public health and primary care leads and Community Pharmacy Scotland has initiated a work plan to deliver feasible care bundles for respiratory disease, type II diabetes and depression.
Care bundles have been utilised through the Scottish Patient Safety Programme (SPSP) as a way of measuring processes for prescribing and monitoring in certain areas to help identify how practitioners can deliver safer healthcare for patients. This principle has been extended to test how short, sharp quality interventions, within the three clinical areas identified, by pharmacists and their teams can help patients get the best from their medicines.
Evidence-based care bundles provide a structured way of improving the processes of care. Care bundles are a small, straightforward set of evidence-based practices, generally three to five, which when performed collectively and reliably, have been proven to improve patient outcomes.
Application of care bundles has repeatedly been demonstrated to improve patient safety and define a minimum standard of acceptable care. The use of care bundles within pharmacy practice may potentially provide a range of benefits in terms of assurance of the quality of care and provision of a structured process of clinical governance around the use of medicines.
For this project, three multi-disciplinary groups used a consensus technique to review the available evidence and to define a care bundle that was practical to deliver in community pharmacy. Review of the care bundles that were developed independently by each group demonstrated that each care bundle followed a generic structure.
The 12 community pharmacies met for a workshop at the Queen Street Headquarters of Community Pharmacy Scotland. The group reviewed the work that had been completed to define the care bundles and developed plans for implementation in the pharmacies.
The three-month pilot is due to finish at the end of June, when the participants will be brought back together to share their experiences of using care bundles to structure the pharmaceutical care they provide for patients. It is hoped that an implementation study across a larger group of pharmacies will be taken forward in 2018.
Matt Barclay, Director of Operations at CPS told Pharmacy in Practice: “This pilot is exactly the type of area that should be looked at to measure the impact of community pharmacy interventions. It fits neatly into the principles of CMS and provides structured interventions to support pharmacists in their daily efforts to support the public with their medicines. Anecdotally we have had some encouraging feedback from the early stages of those pharmacies taking part so it will be interesting to see the results of the evaluation.”
Andrew Radley, Consultant in Public Heath Pharmacy at NHS Tayside said: “I have been impressed by the enthusiasm of the pharmacies in undertaking this work. Our discussions with the pharmacies up to now have shown tangible benefits from using a structured approach to pharmaceutical care. We have heard about some very impressive case studies where the pharmacist, using the care bundles, has improved the way people use their medication.”
Elaine Paton, Lead Pharmacist, SPSP Pharmacy in Primary Care Collaborative, NHS Greater Glasgow and Clyde added: “This is an important piece of work as it allows community pharmacy teams to develop their own knowledge and skills within quality improvement and apply them into their daily work; discussing medicines with patients. This care bundle work brings together so many strands of our pharmacy practice over the past 10 years, and it is has been a privilege and a pleasure to work with everyone in the pilot. There will be some key learning from this that we can use to determine how we deliver pharmaceutical care in the future.”
The 12-week pilot will be evaluated to determine whether it would be worth investigating the value of these type of interventions further.