Background East Sussex has two hospices, St Wilfrid’s Hospice(SWH) and St Michael’s Hospice(SMH), sandwiched between one acute trust(ESHT), that spans community services as well as the Clinical Commissioning Group. The clinical pharmacist role has seized the collaborative opportunity with organisations investing in this approach offering continuity, scanning opportunities for co-creation of projects and an understanding of issues across the health and social care space. The need for this role within hours is self-evident but the out of hours need is uncertain.
Method Data was prospectively collected, identifying frequency, nature and context of call as well as caller details, over a four month period (August - November 2021) where the pharmacist was not within their contracted hours but advice sought.
Results 18 contacts were made out of contracted hours; 28%(5/18) from SMH, 55%(10/18) from SWH and 17%(3/18) other (CCG, GP and ESHT) with 44%(8/18) contacts being doctors (4(senior clinician)) and 56%(10) from other healthcare professionals. 39%(7) calls were procurement related calls with calls ranging from 2 to 65 minutes. (39%)7 of the calls were made for non-hospice community patients and 61%(11) from in-patient units. Calls varied from 3- 6 per month, with 61%(11/18) of calls answered needing a clinical pharmacist involvement whilst others (7/18), could be dealt with by another healthcare professional.
Conclusion The data supports the need for clinical pharmacist advice out-with their contracted hours but across the wider health and social care space. As Integrated Care Systems (ICSs) evolve, the need for access to emergency medications particularly, in managing a patient at the end of their life is critical, needs careful consideration. Specialist commissioned access to specialist pharmacist advice across organisations and out-of-hours is a great opportunity to co-create a system wide service that aims to service the very professionals, patients and their families at the very heart of wider integration.
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