It is known that vulnerable and housebound patients have a high burden of illness yet poor access to healthcare services – a clear example of the inverse care law.
These co-morbidities and complex medication needs place these patients at high risk of medication related adverse events and hospital admission.
The complexity of often having several organisations across health care and social care involved in caring for an individual, working in isolation from each other, meant that little was known about exactly what the potential problems were, let alone how to address them.
It was recognised that a joint systems response was required. Through an innovative collaboration between Sheffield City Council and Sheffield CCG (now South Yorkshire ICB) a jointly funded post of Pharmaceutical Lead for Health and Social Care was established.
This post aimed to scope and identify the needs of vulnerable and housebound patients, and lead on a response to drive a focused effort to deliver medication improvements.
Outcomes include improving medication guidance for care workers in Sheffield, improving training for both adult and children's services, and reducing hospital admissions arising from gaps in training. Data has also been collected and analysed which clearly demonstrates the health inequality experienced by housebound patients. This resulted in targeted medication reviews for this cohort being added to the local Quality Improvement Productivity and Prevention (QIPP) Programme.
