Medicine Support in Domiciliary Care
The Medicine Support in Domiciliary Care project is designed to tackle the complicated relationships that exist between patients, GPs, pharmacists, hospitals, carers and family members in terms of medicine management to understand the role digital has to play.
This multi-partner project has been driven with the primary purposes of reducing patient risk and improving care, alongside the business case, efficiencies and savings that could be achieved. The project is based on the premise that a digital approach could offer significant improvements for people delivering and in receipt of care, resulting in reduced admissions to hospital and improved outcomes from their medicinal and care plans.
With a backdrop of increased digitalisation within prescription management and the NHS more widely, the Social Care Digital Innovation Accelerator 2019/20 brought together by CC2i on behalf of the Local Government Association and match-funded by NHS Digital, has worked with five co-funding and collaborating councils through discovery, commercial discovery and project delivery phases.
DISCOVERY PHASE (Aug - Dec 2019)
The discovery phase began with a workshop which included the five collaborating councils, domiciliary care partners, the Institute of Public Care (IPC) and CC2i was led by digital meds management experts MED e-care. The day-long session raised many issues and difficulties currently experienced by councils and their health and care partners, and tried to surface their areas of ‘pain’, as well as identifying what they felt ‘good look like’.
Key areas of challenge and complexity were identified:
- Medication Administration
- Self Administration & Prompting
- Medicine Administration Records (MAR Charts)
- Medication Instructions & Dosage Times
- Blister Packs versus Boxes & Bottles
- Turnover of Staff & Training
- Previous Digital Experiences/Trials
- System Failure
- Carer Rostering Systems
Following on from the workshop a digital approach was outlined in terms of critical functionality and next steps and a discovery report published.
COMMERCIAL DISCOVERY PHASE (Jan - Feb 2020)
The initial discovery phase proved that there was a need and a will to further investigate a digital approach in this area. The Social Care Digital Innovation Programme Board agreed in January 2020 to move on to a focused ‘commercial discovery’ phase and further investigate this complex arena.
The commercial discovery phase assessed existing technology players in the market and engaged more widely with responsible bodies in the medicines management domain. There were five distinct work packages:
- WP1: Provider & technology review
- WP2: Further develop the local authority (and partner) business case
- WP3: Engage with key stakeholders and professional bodies
- WP4: Assess Local Authority & provider culture change challenges
- WP5: Assess wider local government appetite to develop a digital solution
STAKEHOLDER SPECIFICATION & BUSINESS CASE PHASE (March 2020 - July 2020)
The final phase of the project has delivered two key work packages, which when combined it is hoped will drive this market forward by supporting both providers and commissioners.
- STAKEHOLDER SPECIFICATION
The Stakeholder Specification outlines the requirements of a holistic digital medicines’ solution for domiciliary care. The document has been peer reviewed by stakeholders across care providers, local government, pharmacies, service users, strategic and policy organisations including (but not limited to) the PRSB, NHSx, NHSD, CQC, as well as a range of technical providers.
Excerpt from the Stakeholder Specification Introduction:
“Integration of digital technology into the delivery of domiciliary care will support changes to the way they operate and deliver value to clients, care organisations and councils. New digital-driven products are impacting on all industries, the data enabling reshaping, restructuring and creating value creation along with enhancing user experience.”
“Many parts of the social care system are becoming digitalised and significant efficiencies have already been proven by their use. However, although significant benefits of a digital system for medicines support have been identified, no commercially available software solution that currently exists was identified that can fully address the needs of the domiciliary care system. This document seeks to address this need and specify the requirements for a digital system that specifically directly supports the needs of the domiciliary care sector.”
- LOCAL AUTHORITY & PARTNERS BUSINESS CASE
Following extensive efforts to locate data to support the creation of a business case tool, the local authorities steering the project suggested that a ‘pre-business case’ video be developed to help commissioners understand the challenge in terms of medicine management in domiciliary care. This co-designed, short video is intended to support councils to make the case internally – as well as with care providers and health partners – to invest in a digital approach to this complicated challenge.
PROJECT ASSETS & ONGOING WORK
Both the stakeholder specification and video can be found on the Digital Social Care site here: https://www.digitalsocialcare.co.uk/social-care-technology/digital-medicines-support-in-domiciliary-care/
Ongoing consideration is being given to standardising the data and information elements included in the specification with the Professional Records Standards Body (PRSB). If taken forward, care providers and organisations interested in collaborating with service users and families and health and care partners will have the opportunity to contribute to this digital standard for implementation across domiciliary care.
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