A Digital Approach to Multi-Agency Domiciliary Care Medicine Management






The Proposal

This project will tackle the complicated relationships that exist between patients, GPs, pharmacists, hospitals, carers and family members in terms of medicine management. To both decrease the patient risks that currently exist within the system, as well as reduce wastage both in terms of carer time and pharmaceuticals.


Undertaking a multi-partner discovery phase to detail and map the interconnections that surround medicine management, the project will then move to co-design an accessible, usable digital solution to effectively track patients and their medicines and meeting stakeholder requirements.


This will be a collaboration of leading developers in digital medicinal management sector, five co-funding local authorities and their health and care partners, supported by the Local Government Association’s Social Care Digital Innovation Programme (SCDIP). The project will be undertaken in two phases - discovery and development/implementation - with a SCDIP Programme Board approval post the discovery phase.


Project Background

This project was originally submitted as a bid by Halton Borough Council to the LGA’s Social Care Digital Innovation Programme (SCDIP) in Spring 2019. It has been prioritised alongside the core funding programme as it has the potential to really drive both frontline financial savings, as well as offer a holistic cross public sector solution to a national, growing challenge. As such there is real value and significant potential to drive transformation across numerous councils and health and social care partners.


As such the LGA has agreed to part fund this project alongside their wider SCDIP programme and is keen to see a group of councils join Halton BC to progress the work. The project will report into the SCDIP Board as it progresses and be independently evaluated by the Institute of Public Care.


Headline Business Case

Halton BC and their care partners have identified - but not as yet fully quantified - financial savings that would be generated from the whole process and which would benefit all organisations involved (the council, primary care partners, community pharmacists, care workers et al).


They have provided supporting figures around time spent managing medicines in different care settings, which are often extended due to lack of clarity around the full scope of patient medicines, changes in medication and/or providence of medicines. These start to illustrate the significant time and costs involved.


Headline figures suggest that across Domiciliary Care, Supported Housing and Reablement the annual cost of medicine management in Halton is around £320,000. If the digital system outlined in this bid saved a conservative 25% of time alone, Halton would see an annual saving of £80,000.


Halton Borough Council’s Project Context

In line with the national picture, it is estimated that Halton will experience an increase in its ageing population with expanding health and social care needs. In particular, there will be significant increases within the older age group of 85+, which is often characterised by having the highest and most complex needs. In the context of reduced funding from central Government, there will be a need to be efficient and innovative, to ensure that the needs of the population can be met now and further into the future.


The administration of medication by domiciliary care agencies in the borough currently involves multiple partners, a range of delivery systems and complex pathways. Ongoing changes to the way services are delivered and the local demography has resulted in increasing numbers of people with complex needs and complex medication needs living in their own home and receiving care.


Where people are unable to administer their own medication domiciliary care providers undertake this role. The prescription, supply and administration pathway involves multiple partners and poses significant challenges in relation to the timely administration of planned and unplanned medication. There are also challenges with medication wastage through the use of metered dosage systems whereas moving to original packaging may reduce this.


Halton would like to use a number of different methods to explore the issues that are faced by service users and their carers, domiciliary care agencies, GPs, pharmacies and hospitals and look at innovative technological solutions that could streamline processes, reduce errors, reduce wastage, leaving staff more time to provide direct care, supporting timely medication reviews and improve outcomes for users, including reduced safeguarding concerns.


Financial Requirements


* £15,000 in MVP phase with a further £35,000 for the implementation phase subject to NHS Digital/SCDIP Board approval.