What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

Some older people are still adapting following long periods of isolation during the pandemic lockdowns. 30.6% of all GP appointments in England in January 2023 were not face to face. Older people are also more likely to have multi-morbidity and polypharmacy so more likely to need support with taking multiple medicines but hesitant to ask for support.

A local Medicines Cafe would offer older people a face to face opportunity to discuss their medicines/ concerns/ queries/ non-adherence with a pharmacist in a non-clinical environment over a cup of tea!

With agreement from system partners and building on existing collaborations, Medicines Cafes could be run in local church halls, community centres or other ‘comfortable’ places of choice for the person. This would improve access but also provide a more relaxed environment to feel more open to discuss medication related problems or concerns.

What does your project aim to achieve?

• Improves access for face to face consultations with clinicians to discuss medication related concerns
• Improves access and reduces delays for older people to have structured medication reviews
• Promotes person-centred care and personalised care
• Improves patient safety
• Provides older people, that would benefit from structured medication review, to alternative informal opportunity to access medicines related support within Frimley ICS
• To offer people more choice and reduce pressures on existing services eg reducing risks of adverse effects from medicines or preventing medicines related hospital admission
• Reduces risk of medicines related harm and medicines related hospital admissions
• Makes medicines related support equitable and accessible for all

How will the project be delivered?

QI methodology: PDSA

• Pilot site to be identified
• Suitable venues for medicines cafes to be agreed with Frimley ICS partners and communities e.g church halls, community centres, or older people day centres
• Clinical pharmacists (Independent Prescribers) with a specialist interest in older people or frailty trained to deliver the service and run the medicines cafe sessions
• MedOptimise tool to be used as an audit tool to monitor and evaluate medicines related interventions including preventing medicines related harm and hospital admissions

Process:

• Medicines Cafe service details shared through local communities
• The consenting person brings along a bag containing all their medication and list of their questions/ problems/ concerns to discuss over a cup of tea – appointment or drop-in options available
• Any actions agreed would be shared with the patient’s GP and/or referral for a follow up structured medication review

How is your project going to share learning?

• The project will be shared with the Q Community through updates on the online platform.
• We will also promote the project through regional and local QI forums including the Oxford patient safety collaborative at OXAHSN and the OXAHSN Polypharmacy programme.
• We will also take opportunities to share findings through professional forums; present at relevant webinars or conferences such as the Clinical Pharmacy Congress.
• Share with other medicines optimisation teams through other medicines optimisation forums and networks e.g. NICE Medicines and Prescribing Associates network group and also through service development networks the team are involved with.
• Information regarding service developments and quality improvements will also be shared widely via various social media platforms and forums.