"I'm a practice pharmacist and, together with the GP learning disability lead, we look after 40 residents of an adult care village who all have severe learning disabilities and autism. I am the first point of contact at the surgery for all their questions. They have a consultant psychiatrist who does a weekly clinic there and we approached him to arrange a meeting, because we were concerned about overuse of antipsychotics. This developed into a regular monthly joint clinic which we all attend, plus the lead nurse from the care village and sometimes the epilepsy specialist nurse. It's a great opportunity to discuss all sorts of issues relating to our patients.
We all believe we are making a difference to the care of the patients, but withdrawing antipsychotics and other CNS medicines is not easy.
We have also had some success with a healthy eating programme for the patients, which started in January. We decided that if we can't stop the antipsychotics we can try and reduce the side effects."
Diana Taylor, practice pharmacist, Flying Scotsman Health Centre, Doncaster
"It doesn’t need to be big projects that make the difference. The most impactful part of the learning campaign has been the real life testimonies of people and their families and carers.
It is often the little things, the small gestures that make the biggest impact. Recognising, appreciating and understanding the specific needs on any given occasion. First impressions are so important, a welcoming smile, and introduction and gentle eye contact can set the tone, asking directly how someone would like to be communicated with etc, adapting your behaviours to meet their needs and never, ever assume.
I have recently had the opportunity to provide vaccinations to children; some have had learning difficulties of varying types and severity. They have all been successful encounters, but I needed to subtly adapt the environment and my approach each time to ensure the best outcome. Parents and carers can often be more apprehensive than the young person.
On a more practical level, I have recently supported the management of a school for young people with learning difficulties in developing a robust medication policy. Enabling the needs of the individual child to be met, underpinned by a secure governance and risk management framework from a pharmaceutical care perspective. I have promoted the ways in which community pharmacies can support young people who need to take medicines to school."
Lorraine Crawford, community pharmacist
"As part of the Northumberland Integrated Care Vanguard, the pharmacy team have been involved in the review of anti-psychotics as part of the STOMP campaign at one GP surgery in Blyth. The review was conducted as part of a mutlidisciplinary team consisting of a GP, pharmacist, mental health specialist pharmacist and a community learning disability nurse. Six patients were reviewed from a possible 12 and patients or their carers were asked to complete a questionnaire prior to the review. Reviews took place in their own home, care homes and in the surgery itself.
Of the six reviews, we managed to agree a plan for the reduction of potentially two psychotropic medications and will attempt to stop another psychotropic over the coming weeks once stability with carers has been achieved. Taking a multidisciplinary approach to review allowed us to take a holistic approach to patient care and other issues regarding social and emergency planning issues were also rectified as part of the review.
We hope to revisit these patients periodically in order to ensure a continual review process and the pharmacy team are looking into further expanding this review model to other GP practices in Blyth."
Stuart Spence, senior clinical pharmacist, Northumbria Healthcare NHS Foundation Trust.
"Allocating enough time, patience and vocabulary, with right level of details, is very much appreciated as per my experience.
Leaflets are of value; however, there is nothing that can replace empathy."
Rahela Penovski, pharmacist