By Dr Mark Spencer, co-chair of the NHS Confederation’s PCN Network and clinical director, Fleetwood PCN
The spectre of COVID-19 has certainly brought care homes into the spotlight, as has the forthcoming primary care network Directed Enhanced Service (PCN DES) provisions for enhanced health in care homes, structured medication review (SMR) and medicines optimisation.
I fully support the care homes and SMR services and can absolutely see the role for clinical pharmacists and what this brings to improving patient care, as well as the importance of a named clinician to co-ordinate care across a PCN.
I believe though that there is much more to be gained than simply putting in place service specifications. Maximum benefits will only be achieved by bringing care homes fully into PCNs, alongside other independent providers such a GP practices, community pharmacies, dental surgeries and optometry.
As ever, this can only be achieved by the building of relationships. Relationships that are based on a foundation of understanding and trust. Without those relations being in place, care home managers may be suspicious of what they could interpret as outside interference, and NHS clinicians may undervalue the dedication and commitment of care home staff.
Meaningful relationships are built on listening; the purpose of which is to understand the position of the speaker. This means giving care home managers, staff, residents and their families a platform from which to be listened to. For example, having a care home manager as part of the PCN leadership team.
‘Joint sense of purpose’
I believe that it would also be useful to have regular get-togethers for staff leads from across each of the care homes within the PCN, together with clinicians from organisations who directly provide health care, as well as the local authority and NHS commissioners. This helps to build a common understanding and a joint sense of purpose, both of which are essential drivers for bringing about sustainable change for the better.
Even more importantly is to actively engage care home residents and their families in what good looks like, not just where they reside, but across all the homes within the PCN geography.
Finally, there needs to be education. Bringing care home staff into mainstream PCN education events, as well as undertaking jointly agreed audit cycles, and all the other essential ingredients of good and positive clinical governance, will also help to drive continuous improvement.
Why? Because we want high quality care for an increasingly ageing population, within finite financial and human resources.
What? Integrated working that not only includes clinical pharmacists, pharmacy technicians and named clinicians, but also all of the health and care clinicians across the PCN.
How? Relationships. Relationships. Relationships.
The NHS Confederation has published briefing on how pharmacy professionals can help in a collaborative, multi-professional team approach to supporting care homes.