Background

A national programme to support the roll out of proxy ordering - which allows care homes to order online repeat medication on behalf of their residents - has been launched to help reduce the current high workload of primary care and care home staff. The Black Country and West Birmingham Clinical Commissioning Group (CCG) deployed extra pharmacy staff to work with GP practices and care homes to set up a local system.

Action

Midlands and Lancashire Commissioning Support Unit (MLCSU) supported the CCG with proxy ordering for four weeks in March 2021. The successful service was then extended until the end of June. During the project, the MLCSU medicines team worked with GP practices and care homes to:

• provide additional pharmacy technician staff to complete the setting up of proxy ordering with MLCSU pharmacist oversight

• develop partnership working with all stakeholders and ensure regular reporting

• use knowledge and outputs from wider MLCSU teams, avoid repetition of work and support education by developing a resource pack

• provide strategic leadership support for the additional pharmacy response across the region. This included technical and workforce planning and ensuring that processes for safe and effective implementation of proxy ordering systems were developed in both care homes and GP practices.

Impact

A resource pack was developed and distributed to CCG medicine leads at the end of March 2021. This pack has since been shared with GP practices across the Black Country and West Birmingham to support the implementation process.

Our effort was concentrated on working with care homes to get staff trained and prepared for the system to go live, while local CCG leads worked with GP practices to finalise the set up of proxy ordering.

During the project we contacted 79 care homes at least once a week. As a result, 14% of the care homes that were contacted (11 homes) are now actively using online proxy ordering and a further 37% (29 homes) are in the process of implementing online proxy ordering. When our work ended in June 2021, we arranged a handover to the local CCG teams to help them with future implementation. We also provided a status report on the uptake of proxy ordering in all care homes across the area and shared our learnings with all partners.

Sonia Bigra [Senior Pharmacy Technician at MLCSU] has been supporting care homes in Dudley to implement proxy ordering with some success. Although the timeline for the project was quite short, we have had a lot of interest from our care homes which we are aiming to take forward in the near future.  Sonia has approached the project in a very professional way and communicated effectively with all local stakeholders.”

Rachael Thornton | Older Persons Specialist Pharmacist, Dudley Integrated Health and Care NHS Trust