National Assembly for Wales
Health and Social Care Committee

Follow-up inquiry on the contribution of community pharmacy to health services

Evidence from Carers Trust Wales – CP 15

Health and Social Care Committee

Response to the follow up Inquiry into the contribution of community pharmacy to health services in Wales

Background:

Carers Trust is a new charity which was formed by the merger of The Princess Royal Trust for Carers and Crossroads Care in April 2012.

Carers Trust works to improve support, services and recognition for anyone living with the challenges of caring, unpaid, for a family member or friend who is ill, frail, disabled or has mental health or addiction problems. With our Network Partners, we aim to ensure that information, advice and practical support are available to all carers across the UK.

General Comment

Our main reflection, which was and still remains, is the lack of recognition with regard to the influence, impact and value community pharmacy can and should play in the lives of carers. Our original submission (CP 19 – The Princess Royal Trust for Carers[1]) made reference to many of these points in relation to reach, advice/information, medicines management, very few of which were realised in the report. It is disappointing that carers have largely remained an untargeted group within pharmacy. Further work with pharmacies and their staff to put in places strategies for identifying more carers, more effective signposting/referring on for

help, for how medication reviews and other key interventions could help carers and those they care for, and how better links could be made between local carers services and pharmacy staff, needs explored.

Our recommendations for strengthening the Community Pharmacy Contract to achieve maximum impact for patients and their carers still stands (as set out in the original response)

• Developing a clear patient carer identification and referral process

• Ensuring carers are offered medicine management training where necessary

• Initiating medication reviews and including carers as potential beneficiaries

• Targeting carers via Public health campaigns and referring to health & well-being services

• Signposting to local carers services for further advice and support

Specific points with regard to Recommendations

Recommendation 1 (pg 27)

• Prominent notices in Pharmacies regarding services. Not sure this is a reality yet in all pharmacies - feedback from carers suggest there is still some confusion about what services are on offer where.

Recommendation 2:

• It remains unclear if a National lead has been appointed as stated, if so this needs more clearly communicated

• Acknowledgment of carers needs must be a consideration in any National priorities set inc. a consistent approach to carer identification, consultation and planning

• We welcomed the redistribution of RPS guidance re: Young Carers collections by the Chief Pharmacy officer.

Recommendation 4:

• Point 177 - We welcome the inclusion of carers as a target group for Flu jabs.

Recommendation 5:

• Point 162 - Carers Trust are currently in a similar position as regards a National Carer Awareness campaign thru' PHW - although it has been acknowledged and assurances given it will go ahead, it is largely 3rd sector driven. The outcome of the local Pharmacy Public Health Campaign in Sept. thru'out BCUHB will be a valuable driver.

Proposition 7:

• Issue of carer inclusion in MUR's needs addressing ideally along lines of DMR. This will require a change of primary legislation but will improve carer medicines management and potentially reduce mis-use of medication and waste. Any evaluation of the current system needs to consider the impact of carer inclusion.

Point 99 – Discharge Medicines Reviews - Many carers are unaware of the discharge protocol, inc. their right to a copy of the discharge letter. Correct and timely info. could help alleviate the est. 38% of hospital readmissions related to medicines. Whilst there is potential for this to be addressed as part of the Carers (Wales) Measure, it is unclear if it has been on a national level.

Point 209 - This would be welcomed especially if carers were flagged

Point 212 – improved access to patient records would enable pharmacists to better identify those patients who are also carers to give appropriate advice and support

where necessary avoiding potentially unsafe medicines management practice (especially true in the case of YC's)

Point 217 – We would ask that carers be taken into consideration as part of this debate.

Response prepared by: Gill Winter, Development Manager on behalf of Carers Trust