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					             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
       Org_Name            Code                     Initiatives to improve Medicines PPI
Airedale NHS Trust        RCF   We now have a member of the patient and public involvement forum on
                                the Drugs and Therapeutics Committee. This will probably extend to a
                                further two members in 2006.
Basildon And Thurrock     RDD Patient surveys undertaken to evaluate extended role of pharmacy
University Hospitals NHS        technicians
Foundation Trust
Belfast City Hospital     Z1020 The Trust operates a medicines management scheme which incorporates
Health & Social Svs Trust       the assessment and use of Patients Own Drugs (PODs) on admission and
                                one-stop dispensing for discharge. The scheme, which operates on five
                                wards, facilitates patient education, patient concordance, reduction in
                                administration errors, reduction in pharmaceutical waste and a more
                                efficient discharge process. The scheme is underpinned by a Electronic
                                Patient Record which records and archives patient medication histories,
                                provides a patient medication history card and produces one-stop
                                dispensing requests for the dispensary. On discharge, the General
                                Practitioner also receives an accurate medication record with information
                                on medicines which have been initiated, altered or discontinued during
                                hospital admission. Allergy status is also documented on the
                                communication to the GP.
Berkshire Healthcare      RWX A patient rep is involved in the Drugs and Therapeutics Committee, risk
NHS Trust                       management, clozapine clinic organisation and we regularly review our
                                services through audit or survey. Information is distributed via emails
                                through two board directors for service users who co-ordinate service user
                                involvement in the majority of trust processes.
Bromley Hospitals NHS RG3       We have a non-executive director on the project board as we are part of
Trust                           the HMMC 3rd wave. We are developing the use of green medicines bags
                                to encourage patients to bring their own medicines into hospital and part
                                of this development will involve communication and feedback from
                                patients and carers within Bromley.
Bro Morgannwg NHS         RVD There are posters in Hospital and GP Surgeries advocating Patients Own
Trust                           Drugs schemes in hospitals and agreement with Ambulance services to
                                collect and bring medicines in with the patient. There is also a joint
                                approach with the LHBs campaigning to insure patients know why they
                                are taking their medicines to avoid unnecessary or not required repeat
                                prescriptions being asked for.
Buckinghamshire           RXQ Patients are involved in aspects of medicines management in cardiac
Hospitals NHS Trust             rehab and diabetes.
Calderdale And            RWY We have been a second wave member of The Hospital Medicines
Huddersfield NHS Trust          Management Collaborative and have had a patient representative as a
                                member of our project team who is also a member of our Medicines
                                Management Committee. The patient representative has undertaken
                                patient satisfaction surveys.
Cambridge University      RGT 1. Transplant patient information 2. Patient stories detail wish for Self
Hospitals NHS                   Administration.
Foundation Trust
Camden and Islington      TAF   User representatives are on the Clinical Governance Committee. Minutes
Mental Health and Social        of the PAC attached to CGC agenda. Also PALS have been asked if there
Care Trust                      are any clients who are indeed interested in attending the PAC.
Cardiothoracic Centre - RBQ New patient information leaflets written in house but shared amongst
Liverpool NHS Trust             wider healthcare economy were sent to the patient's forum by the Trust's
(The)                           PALS representative for comments prior to printing.
Causeway HSS Trust        Z1410 Introduction of 28-day dispensing - group was established which involved
                                hospital and community representatives including GP, Community
                                Pharmacist and Patient in order to agree terms of protocol. Steering group
                                for the regional emergency pharmacist steering group includes a patient
                                representative and GP



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            2005/6 Healthcare Commission Medicines Management Review Best
            Practice Sharing: Patient and Public Involvement
        Org_Name           Code                     Initiatives to improve Medicines PPI
Central and North West    RV3   The Trust is participating in the Hospital Medicines Management
London Mental Health            Collaborative which includes service user representatives reviewing use of
NHS Trust                       medicines within local health economy.
Chelsea And               RQM Ask about Medicines Week and AGM: Stand with patient information and
Westminster Healthcare          pharmacists in outpatient pharmacy waiting area. Medicine Helpline card
NHS Trust                       given to all outpatient and discharge patients
Chesterfield Royal        RFS   The Trust has successfully recruited patients to its Drug and Therapeutics
Hospital NHS Foundation         Committee where they take an active part in the work of the committee.
Trust
Christie Hospital NHS     RBV    We have patient representatives on the Information Forum who look
Trust                            through and comment on the leaflets, their views are incorporated
City Hospitals            RLN    Presentation to patient forum. Patient input and participation in survey of
Sunderland NHS                   service delivery for new Medicines Management scheme. Patient forum
Foundation Trust                 review of outpatient dispensary. Patient input into leaflet design. All
                                 patients given explanatory leaflet on medicines management on wards
                                 explaining system with a separate question sheet to self refer for
                                 information on medicines
Clatterbridge Centre For REN     The trust has a patients council set up that will provide feedback on
Oncology NHS Trust               services provided e.g. clarity of information leaflets. The Trust has
                                 completed a review of its chemotherapy services (including medicines
                                 management) and has feedback from patients on this services. This
                                 feedback is helping to shape the chemotherapy service of the future. The
                                 trust produces a patient prospectus which has a section on learning from
                                 incidents. This includes incidents concerning medicines and what action
                                 the trust has completed to prevent further incidents. The trust takes part in
                                 NHS patient surveys, in addition to this the trust adapted the forms to
                                 target chemotherapy and radiotherapy patients not included in original
                                 survey. This adapted form allowed feedback from patients on may issues,
                                 including medicines management. The trust runs various drop in
                                 medicines clinics e.g. a pharmacist is available for one week in a
                                 medicines surgery during 'Ask about medicines week'
Conwy And Denbighshire RT8       Patient representative invited to Drugs and Therapeutics Committee.
NHS Trust
County Durham And      RXP       Pharmacy staff attend patient forums to discuss issues. Patient
Darlington Acute                 questionnaires and interviews on medicine issues resulting in change of
Hospitals NHS Trust              practice. Pharmacy staff ran a workshop on patient involvement as part of
                                 a Safe Medicines Practice Conference held in conjunction with PCTs and
                                 neighbouring acute and mental health trusts - included patients in the
                                 workshop group. When Principal Pharmacist (Operations) left we replaced
                                 post with Quality and Performance manager who focuses on clinical
                                 governance and patient / public involvement for our directorate.
Dartford And Gravesham RN7       The local PPI forum visited the pharmacy department in early 2005 and
NHS Trust                        were given an accompanied tour of the department. The dispensing
                                 process was demonstrated so that the group could comprehend the
                                 checks and processes involved in dispensing a prescription. This exercise
                                 served us well in dispelling some myths around why the dispensing turn-
                                 around times are sometimes longer than those experienced in a
                                 community pharmacy. Cardiac rehabilitation medication tuition provided by
                                 pharmacists. OPD user satisfaction questionnaire survey. Pharmacy
                                 attend local school open days (held annually) and pharmacy services are
                                 portrayed.
Derby Hospitals NHS       RTG    We have considered Public Patient Involvement (PPI) as most appropriate
Foundation Trust                 at our 'Area' Prescribing Committee - the Southern Derbyshire Prescribing
                                 Advisory Group - no response to requests has been received. We will
                                 continue to try and 'recruit' an interested member. It may be appropriate
                                 for PPI on Drugs and Therapeutics Committee from a public member of



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             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
       Org_Name            Code                    Initiatives to improve Medicines PPI
                               the Foundation Trust.
Devon Partnership NHS RWV We have a service user representative on the Medicines Management
Trust                          Committee (Drugs and Therapeutic Committee). We are also involved in
                               the Prescribing Observatory for Mental Health Audit and have two service
                               users on our working party.
Down & Lisburn HSS       Z1060 During a time limited Medicines Management Project (June 03 - May 05)
Trust                          the Project Pharmacist proactively sought out a list of Community
                               Pharmacists who were engaged in the DHSS Managing your Medicines
                               Scheme and made recommendations to Community Pharmacists on
                               behalf of consenting patients on discharge.
Dudley Beacon And        5HV   Talking about medicines in the community - Pharmacists talking to
Castle PCT                     community groups about medicines generally and doing BPs etc
Dudley Group Of          RNA Attempted to appoint a lay rep to D&T over 12 months - finally found a
Hospitals NHS Trust            representative.
Ealing Hospital NHS      RC3   Ask about medicines week, streamlining PPIs, Statins, Ace inhibitors and
Trust                          angiotensin II inhibitors.
East And North           RWH 1 Poster developed and sent to all GP surgeries and out-patient clinics
Hertfordshire NHS Trust        advising patients to bring in their own drugs (PODS) when they come into
                               hospital.
                               2 POD bags purchased and sent to paramedics asking them to encourage
                               patients to bring in their PODs when they are admitted.
                               3 POD transfer bags distribute to all wards to try and reduce wastage
                               when PODs are lost in the system.
                               4 Posters in out-patient clinics reminding patients not to request repeats of
                               their medication during an out-patient clinic.
                               5 Letter to all consultants reminding them that they should not prescribe
                               repeat medication in out-patient clinics.
                               6 Patient information leaflet developed
                               7 Information leaflet regarding general med man matters goes in each bag
                               of discharge drugs.
East Kent Hospitals NHS RVV    Public involvement through our Interface Prescribing Committee (lay
Trust                          member). Public involvement through a patient panel as a part of the
                               Hospital Medicines Management Collaborative work.
East Kent NHS And        RTM Carer representative is an active member of drugs and therapeutics
Social Care Partnership        committee. Work with charitable sector, speaking to groups.
Trust
East Lancashire          RXR Dispensing for discharge. Taking medication histories. Pharmacy run anti-
Hospitals NHS Trust            coagulant clinics. Ad-hoc meetings with the Public and Professional forum
                               to discuss pharmacy issues. Lay member of Medicines Management
                               Board and Clinical Governance Committee. Meetings with Diversity and
                               Equality Group to discuss the needs of the blind and deaf in respect of
                               their medicines
East Somerset NHS        RA4   User on Medicines Management Board and Project Team, user on Drug
Trust                          and Therapeutics Committee and user on Clinical Governance
                               Committee. The Clinical Governance Committee discusses Medicines
                               Management issues especially in the area of risk management.
Epsom And St Helier      RVR Clean hands campaign
University Hospitals NHS
Trust
Essex Rivers Healthcare RDE Active patient involvement during Trust's participation in Hospital
NHS Trust                      Medicines management Collaborative.
Frimley Park Hospital    RDU We operate a dispensing for discharge scheme on selected wards.
NHS Foundation Trust
George Eliot Hospital    RLT   1. Patients interests are represented at Drug and Therapeutics Committee
NHS Trust                      by a Lay member. 2. 'Green-Bag' scheme to encourage patients and



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             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
      Org_Name            Code                       Initiatives to improve Medicines PPI
                                 carers to bring all medicines to the hospital to facilitate accurate drug
                                 history and avoid wastage of Patients Own Drugs 3. 'Health Holdall'
                                 launched to encourage patients to keep all medicines, health related
                                 records (SAP) and information in a single portable source. May be
                                 purchased for £6 each. First fifty were given free at launch of scheme.
Gloucestershire Hospitals RTE    Patients' own drugs campaign to encourage patients to bring in their own
NHS Foundation Trust             medicines. Low level meeting with Patients' forum, radio question and
                                 answer, public meeting.
Good Hope Hospital NHS RJH       Information is gathered through complaints and PALS. Annual national
Trust                            patient surveys – accident and emergency, outpatients, inpatients.
                                 Information on discharge project - patients and relatives participated in
                                 workshops and discussions which covered experiences of medication and
                                 administration. Participants views influenced the development of the
                                 discharge summary.
Guy’s And St Thomas'      RJ1    Links through PALS to expert patients to review patient information leaflet.
NHS Foundation Trust             Lead for PALS has right of attendance at Drug and Therapeutics
                                 Committee and gets the agenda and papers.
Gwent Healthcare NHS      RVF    The Stroke Unit at Nevill Hall Hospital runs a Carers Clinic where the Unit
Trust                            Sister or Staff Nurse meets with each patients main carer regularly
                                 throughout the patients stay, and just prior to discharge. The management
                                 of medicines is part of the discussions that take place, with particular
                                 emphasis on the preparation for discharge. This model of patient/carer
                                 involvement is deemed good practice and the Trust aims to replicate this
                                 model to other services.
Kettering General         RNQ    Through our PALS office, we worked with the local Parkinson's Disease
Hospital NHS Trust               Society to improve the administration of medicines to Parkinson's Disease
                                 patients. Our PALS office is developing a strategy to accommodate the
                                 needs of ethnic minorities including some medicine related issues such as
                                 medicines from animal sources.
Hampshire Partnership     RW1    Attendance by chief pharmacist at service user and carer reference group
NHS Trust                        to discuss atomoxetine and duloxetine.
Harrogate And District    RCD    PALS involvement in review of outpatient prescribing policy. Patient
NHS Foundation Trust             Forum involvement in supply of discharge medication
Heart Of England NHS      RR1    PPI representative has a seat on Trust Prescribing Committee. GP letters
Foundation Trust                 raised in outpatient clinics are copied to the patient, e.g., reasons for
                                 medication changes. PPI groups visit occasionally to view medicines
                                 management in action on wards and in Pharmacy, most recently Oct 05.
                                 PPI groups receive annual presentation on patient priorities in medicines
                                 management so we can test out planned actions and receive feedback. In
                                 some clinics, patients may choose where they would prefer the prescribing
                                 to be done - in clinic, or by the GP. The patient's commitment is spelled
                                 out in Shared Care Agreements and there will shortly be a tailored
                                 information sheet to support this. A database of procedure-specific and
                                 condition-specific information is available to medical staff in clinics and
                                 they can print off a sheet which is tailored to an individual patient's
                                 information needs, to ensure informed consent.
Heatherwood And           RD7    Survey undertaken on preference for hospital FP10 or outpatient
Wrexham Park Hospitals           prescription Survey undertaken on design of patient information leaflet for
NHS Trust                        deep vein thrombosis.
Hereford Hospitals NHS    RLQ    There is a lay member of the Drug and Therapeutics Committee
Trust
Hillingdon Hospital NHS   RAS    Lay representative on medicine's management committee
Trust (The)
Hillingdon PCT            5AT    Lay person on the committee to represent patient view (although not
                                 specifically mental health patient). Patient satisfaction questionnaire in



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              2005/6 Healthcare Commission Medicines Management Review Best
              Practice Sharing: Patient and Public Involvement
       Org_Name           Code                       Initiatives to improve Medicines PPI
                                 Mental Health covered medicine's management fields
Hinchingbrooke Health     RQQ    Working with Parkinson's Disease society on a policy for self
Care NHS Trust                   administration of medicines. Patient legibility group for information leaflets.
Hull And East Yorkshire   RWA    Patient representatives sit on Trust Drugs and Therapeutics Committee
Hospitals NHS Trust              and Safe medicines committee. Pharmacy have presented to patient user
                                 groups
Isle of Man               IOM    Patients are encouraged to bring their own drugs into hospital on
                                 admission to ensure that the correct drugs are prescribed and to avoid
                                 confusion on discharge.
Isle Of Wight Healthcare RR2     The Drugs Advisory Committee (predominantly drugs and island shared
NHS Trust                        formulary management) and the Clinical Standards Group (policies and
                                 guidelines, NICE and NSF) both report to the Trust Clinical Governance
                                 Committee and to the PCT Prescribing Committee. DAC and CSG have
                                 no direct patient involvement, but the CGC is an open meeting with a
                                 patient representative, and the Prescribing Committee has a patient
                                 representative.
Ipswich Hospital NHS      RGQ    Presentation made to annual PPI board meeting on medicines
Trust                            management. Clinical Pharmacists attend various user groups. Patient
                                 user survey carried out in pharmacy outpatients.
James Paget Healthcare RGP       We have a Lay Member of the Drugs and Therapeutics Committee.
NHS Trust
Kingston Hospital NHS  RAX       We have an interface prescribing committee with Kingston PCT and
Trust                            Richmond and Twickenham PCT which has shown to be a successful way
                                 of discussing and resolving interface issues. A forum was held for patients
                                 and the public to discuss local medicines management priorities.
Lancashire Teaching       RXN    The Drug and Therapeutics Committee feeds into to a Health Economy
Hospitals NHS                    prescribing and modernisation group which feeds into the LDP process.
Foundation Trust                 This group includes patient involvement.
Lancashire Care NHS       RW5    The trust in planning the implementation of non-medical prescribing
Trust                            carried out a consultation exercise involving users and carers. There is a
                                 user and carer panel who are consulted on the design and preparation of
                                 trust information leaflets. We have a user representative on Drugs and
                                 Therapeutic Committee who is supported by one of the voluntary bodies
                                 and also a carer representative The users and carers have been the
                                 driving force behind the Chief Pharmacist in obtaining investment for the
                                 Trust Clinical Pharmacy service
Leeds Mental Health       RGD    Focus groups set up with service users (patients and carers) to comment
Teaching NHS Trust               on level of information received about their medicines when treated by the
                                 trust.
Liverpool Women’s         REP    A Trust’s Membership Council member is to be invited to join and
Hospital NHS Foundation          represent the public at the new Medicines Management Committee.
Trust
Mater Hospital HSS Trust Z1100 Implementing integrated medicines management within the hospital over
                               the next six months as part of the departmental reform and modernisation
                               strategy. This will have a significant impact on medicines management
                               within the hospital and lead to improved primary - secondary care links
                               and patient involvement.
Mayday Healthcare NHS RJ6      Lay membership on major prescribing committees.
Trust
Mid Staffordshire General RJD  Pharmacy discharge service. Patients are visited by pharmacy team at the
Hospitals NHS Trust            point of discharge to clarify drug issues. We also identify if patients have
                               their own drugs which then reduced the need for a take home prescription
Milton Keynes General     RD8  Development of log book for Non Medical Prescribers. Development of
Hospital NHS Trust             pharmacy ward communication sheet between pharmacy and nursing staff
                               to help the process of self administration and one-stop dispensing. Patient


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             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
      Org_Name            Code                       Initiatives to improve Medicines PPI
                                 survey of medicines management. Press release and radio interview for
                                 introduction of green bag.
Moorfields Eye Hospital   RP6    One newly appointed directorate pharmacist to work within named
NHS Foundation Trust             outpatient clinic (Uveitis) and one specialist Glaucoma pharmacist (vacant
                                 at the moment) providing a fully comprehensive service including
                                 dispensing and development of medication review service.
Newcastle, North          RNP    A mental health services user is a member of the Trust DTC, 'Advance
Tyneside And                     Directives', and NICE Schizophrenia guideline project group
Northumberland Mental
Health NHS Trust
Newham University         RNHBefore installing patient medicine lockers next to each bedside, I attended
Hospital NHS Trust           one of the regular evening sessions we hold with patients and users.
                             There was unanimous support of the lockers and the benefits of improved
                             safety and discharge via the use of patient's own medicines were
                             acknowledged. We have tried and failed to get a member of the public to
                             join our Medicines Safety subgroup.
Newry & Mourne Health Z1630 The Trust has been involved in providing medicines education to parents
& Social Services Trust      of children with complex needs.
North Bristol NHS Trust RVJ  We have successfully engaged with the Leagues of Friends on both major
                             sites and explained our wish to improve the way in which we manage
                             patients’ medicines while they are in Hospital through the use of individual
                             patient medicines lockers. In November 2001 the Southmead League of
                             Friends donated £1,740 which funded 48 lockers; in September 2004 the
                             Frenchay League of Friends donated £8,200 which will fund a further 320
                             lockers.
                             Members of the HIV Pharmacy Team meet with the HIV Service Users
                             Group twice a year to discuss the services provided. In the past this
                             dialogue has resulted in the introduction of a satellite Pharmacy in the HIV
                             Clinic. More recently our proposal to adopt a Home Delivery service for
                             certain patients was discussed by the Group and a pilot subsequently
                             initiated.
                             A Clinical Pharmacist contributes to the monthly Cardiac Rehabilitation
                             sessions on both sites to help patients understand and manage their
                             medicines effectively.
North Cheshire Hospitals RWW Patients invited to be part of a focus group with professionals on improving
NHS Trust                    anticoagulation services. Patients and Public involved in North Cheshire
                             Health Community NSF Medicines for the Older People Group
Northampton General      RNS Patients Perception of Medicines Management Survey undertaken by
Hospital NHS Trust           Audit Commission in January 2005
North Glamorgan NHS      RRS Lay member representation on trust medicine management committee.
Trust                        Medicine management presentation to trust patient involvement liaison
                             group (PILG). All new patient information leaflets agreed by PILG.
North West London        RV8 The Trust and local PCT's have one overarching committee (MRG) to look
Hospitals NHS Trust          at identifying resources for medicines considered at the Drug and
                             Therapeutics Committee. The Committee also proactively looks at
                             medicines coming onto the market so that a position on its use can be
                             considered before launch. These drugs are first considered by the Drug
                             and Therapeutics Committee and if these are approved clinically, the drug
                             then goes to the MRG for consideration on the financial impact on the
                             local health economy. This clearly supports the work in the PCT's where
                             there is no mechanism for restricting the prescribing of drugs with little
                             evidence base other than enough to get the medicine licensed. The Local
                             PCT's and Trust have a shared formulary which is accessed via the Trusts
                             extranet (for GP's ) and the intranet for the Trust. The MRG has agreed
                             the need to have a patient representative and we hope to have someone
                             at our next meeting in December.



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             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
       Org_Name           Code                     Initiatives to improve Medicines PPI
Northumbria Health Care RTF    Trust was involved in the first wave of the Hospitals Medicines
NHS Trust                      Management Collaborative (HMMC). Our Patient, Carer and Public
                               Involvement Lead became an active member of the local action team and
                               chaired a subgroup looking at communication; as part of the HMMC we
                               conducted a patient survey allowing feedback from patients and relatives
                               on medicines management services; an awareness raising session for
                               patients was delivered by the Patient, Carer and Public Involvement Lead
                               - presentations were delivered from various members of staff including
                               pharmacists, technicians and nurses. Group work allowed discussions to
                               be raised on medicines e.g. what did patients feel they needed to know,
                               highlighting what causes wastage and how patients can prevent this. New
                               service developments such as One Stop Dispensing and Self
                               Administration of Medicines were introduced to the group. Also presented
                               to North Tyneside Coalition for Disabled People to inform them of current
                               developments with regard to medicines management in the Trust and also
                               how we have linked in with Primary Care Organisations to improve our
                               services. It was an opportunity for members of the group to raise their
                               concerns. Also undertaken Medicines Management Awareness Road
                               Show at the three main sites in the Trust. Topics which were displayed
                               included waste medications, education and training development and
                               current service developments. Competition was held to engage both staff
                               and patients highlighting the cost of wasted medicines. Leaflets were
                               available for patients to take and patients were encouraged to raise issues
                               and ask questions. This event will be repeated with sessions also being
                               held at the community sites; a quarterly newsletter has been devised to
                               communicate medicines management issues. Aimed at staff working in
                               the Trust but has been encouraged to be made available to patients in
                               waiting areas
North West Wales NHS RT7       Patient medicines information card. EPO and DMARD booklet.
Trust                          Clopidogrel PIL.
Nottingham City Hospital RCS The Pharmacy department has been involved in the first wave of the
NHS Trust                      Hospital Medicines Management Collaboration. One particular project has
                               been the introduction of the patients own medicines bag (green bag), to
                               encourage people to bring in their own medication from home to ensure
                               that an accurate drug history is available on admission. These have also
                               been used in pre-admission clinics, out-patients and GP practices.
                               Information on the bag reminds patients about managing medicines and
                               the need to make other health-care professionals aware of these. Patients
                               have been involved in the design and study of the bags. This won first
                               prize in the patient safety category in the regional finals of the health and
                               social care awards. The Trust has introduced self-administration of
                               medicines on three wards. Patient feedback had been obtained for the
                               pilots of this before roll-out to other wards. The department has a HIV
                               patient helpline and leaflets. All patients newly started on antiretrovirals
                               are given a card with details of the medicines advice line, and encouraged
                               to phone (the HIV specialist pharmacists) if there are problems with their
                               medication. The pharmacy department participates in cardiac and
                               pulmonary rehabilitation sessions for patients, providing information and
                               advice to enable them to manage their medicines more effectively.
                               Sessions are interactive and patients can ask any questions related to
                               their conditions. A patients' representative now attends the joint Drug and
                               Therapeutics Committee meetings
Nottinghamshire          RHA Open Space Event held in October 2004 intended to get service users and
Healthcare NHS Trust           carers views on how the Trust provides care. One topic, admission to
                               psychiatric wards, considered patients views on abuse and control, in
                               relation to medication, and lack of choice. Trust considering ways of
                               addressing this including use of Advance Directives.




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             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
        Org_Name           Code                     Initiatives to improve Medicines PPI
Nuffield Orthopaedic      RBF   Patient is member of Patients Own Medicines and Self Administration
Centre NHS Trust                Steering Group. Patient was a member of Medicines Advisory Committee
                                (Drugs and Therapeutics Committee) for a few months.
Oxford Radcliffe          RTH   Patient is a member of our Patients Own Drugs and Self Administration
Hospitals NHS Trust             working group. Patient was a member of the Medicines Advisory
                                Committee for a few months
Pembrokeshire And         RR6   Local campaign to bring own medicines into hospital, feature in local
Derwen NHS Trust                newspaper.
Pennine Acute Hospitals   RW6 The Trust Medicines Administration Policy group has a patient
NHS Trust                       representative on its membership who regularly attends the meetings and
                                provides a valuable contribution to the development of policy on e.g. use
                                of patients own medicines and self administration of medicines. The
                                provision of pharmacy services to specialist patient groups has also
                                benefited from the input of the patients, particularly in pilot schemes aimed
                                at reducing waiting times for outpatient medication at NMGH.
Pennine Care NHS Trust    RT2   The Trust has considered the involvement of a service user/ carer with the
                                D&T Committee (and indeed other committees within the Trust) and in
                                principle supports this approach. The practicalities of finding a service
                                user/ carer able to undertake such a role and issues around confidentiality
                                have precluded this happening to date.
Peterborough And          RGN Ward based teams are available to counsel patients and have direct links
Stamford Hospitals NHS          to practice-based medicines management teams to follow through any
Foundation Trust                issues identified and not resolved during the hospital visit. Appointed an
                                assessor for help with medication taking to ensure MDS systems are
                                provided appropriately or alternative help offered to ensure medications
                                are taken as expected, this post is joint with primary care
Plymouth Hospitals NHS    RK9   Recent discussion to include patient representative on committee.
Trust                           Awaiting outcome of report.
Powys LHB                 6C4   CHC community health council members invited and attend all Prescribing
                                and Therapeutics Committee meetings
Queen Elizabeth Hospital  RG2   Directorate road show Nov 2005 to promote pharmacy including use of
NHS Trust                       patients own drugs and to get feedback from patients.
Queen Mary’s Sidcup       RGZ Pharmacy stand at local community festival. Pharmacy one day seminar
NHS Trust                       for patient/public involvement forum
Queen's Medical Centre,   RFK   We have a patient rep on the Drugs and Therapeutics Committee
Nottingham University
Hospital NHS Trust
Robert Jones And Agnes RL1        Participating in the Hospital Medicine Management Collaborative (HMMC)
Hunt Orthopaedic And              which has a patient representative on the core team. Patient
District Hospital NHS             representative on the Drugs and Therapeutic Committee.
Trust
Royal Bournemouth And RDZ         Currently working to establish a joint Medicines Review clinic with the
Christchurch Hospitals            PCT. Patients are encouraged to bring all medicines into hospital on
NHS Foundation Trust              admission through posters in GP surgeries. Ambulance trusts are working
                                  on a 'green bag' scheme for patients own medicines
Royal Devon And Exeter RH8        There is a lay person on the area prescribing committee (known as the
NHS Foundation Trust              Effective Practice Committee). The Effective Practice Committee
                                  considers drugs for the whole of the local health economy (2 acute trusts,
                                  1 mental health trust and 4 PCTs) and covers much of what a normal trust
                                  Drug and Therapeutics Committee would addressed. A senior pharmacist
                                  is employed to undertake new product evaluations on behalf of the
                                  Effective Practice Committee.
Royal Free Hampstead      RAL     Consideration of lay member for Drug and Therapeutics Committee.
NHS Trust                         Presentations at patient forums are provided regarding Drug and
                                  Therapeutics Committee activity and medicines management activity. A



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             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
      Org_Name          Code                       Initiatives to improve Medicines PPI
                               patient medicines helpline has been in operation for a number of years at
                               the hospital. PILs are provided for all outpatient medication that is
                               dispensed in patient packs. A near patient dispensing scheme and a
                               patients’ own drugs scheme is in operation which provides patients with
                               the option to self medicate if this is considered appropriate. Medicines
                               Policy/Strategy incorporates, near patient dispensing and patient self-
                               administration. Pharmacy produce a medicines reminder chart for complex
                               treatments e.g. Renal and Care of the Elderly.
Royal Liverpool And     RQ6    Ask about medicines week stand in foyer - jointly presented with the
Broadgreen University          PCTs. A patient has just joined the Medicines Management Group (Drug
Hospitals NHS Trust            and Therapeutics Committee)
Royal Surrey County     RA2    Introduction of green bag use from community and ambulance services
Hospital NHS Trust             into and out of the hospital. Use of message in a bottle (in fridge) that
                               contains medication history and medical history for patients at home. Use
                               of patient group to inform a business case for a satellite pharmacy. Patient
                               information sheets for supportive care with chemotherapy. Patient
                               representative on Drug and Therapeutics Committee.
Royal United Hospital   RD1    Patient satisfaction with pharmacy services audit in 2004 Monthly
Bath NHS Trust                 interview of patients in discharge lounge. Accident and Emergency audit
                               work done re information about medicines provided
Royal West Sussex NHS RPR      There is a non-executive director representative on the local health
Trust                          economy modernising medicines management steering group. We are
                               seeking an expert patient representative.
Sandwell And West        RXK   The Non-executive Director who sits on the Drugs and Therapeutics
Birmingham Hospitals           Committee also sits on the Trusts’ Patient and Public Liaison Group,
NHS Trust                      enabling direct communications between the two groups.
Sheffield Children’s NHS RCU   There is a position on the Drugs and Therapeutics committee for a patient
Trust                          representative but despite several attempts we have been unable to
                               attract representation. This has been organised via the PALS service. The
                               committee has invited PCT representatives to attend the committee and a
                               place is reserved for them but their attendance is spasmodic and
                               unreliable. There is also a place for a junior medical staff representative
                               and a representative from the clinical effectiveness committee and
                               CPSAG (A South Yorkshire group looking at clinical developments).
Sherwood Forest         RK5    We are one of Trusts in wave 2 of the Hospital Medicines Management
Hospitals NHS Trust            Collaborative. Medicines Management profile has been raised via this
                               both internally and externally. Patients involved on the main group and
                               similarly patients involved in sub-groups. Work has evolved to produce
                               four work streams addressing themed issues: 1 - Discharge Process 2 -
                               Patient Partnership 3 - Ward Processes 4 - Primary/Secondary Care
Shrewsbury And Telford RXW     Service involves Medication History taking (and patient views on these
Hospital NHS Trust             medicines) from Pharmacy to all patients on RSH site, plus training for
                               relevant patients prior to discharge. Medicines Helpline.
Somerset Partnership    RH5    Two service users have been invited to join the Drugs and therapeutics
NHS And Social Care            Committee but have not yet attended.
Trust
Southend Hospital NHS   RAJ    Southend Hospital NHS Trust is participating in wave 2 of the HMMC. We
Trust                          have involved a patient in our HMMC working group since its inception in
                               June 2004. The patient has now been invited to join our Medicines
                               Management Committee (formerly Drug and Therapeutics Committee).
Southampton University RHM     Active participation in the Hospitals Medicines management collaborative.
Hospitals NHS Trust            Extensive Patients' Own Drugs / Technician Medicines' Liaison service
South Essex Partnership RWN    Lead Pharmacist visited two Patient representative groups to discuss
NHS Trust                      medication issues six months ago.
South London And        RV5    Two studies (both published) of patient involvement in choice of



                                                9
              2005/6 Healthcare Commission Medicines Management Review Best
              Practice Sharing: Patient and Public Involvement
       Org_Name           Code                     Initiatives to improve Medicines PPI
Maudsley NHS Trust             antipsychotic.
South Manchester         RM2 There is a help line for patients to call if they have any problems with any
University Hospitals NHS       of their medicines. A Medicines Information card is given with all
Trust                          medicines that are issued to patients on discharge or from our patient
                               clinics. We have all the statistics and a number of calls have resulted in
                               potentially life saving advice being issued. A number of senior pharmacists
                               run and contribute to patient education sessions regarding their
                               medicines.
Southport And Ormskirk RVY     We regularly present to patients within certain specialties, particularly
Hospital NHS Trust             Cardiac Rehabilitation - which gives us the opportunity to raise issues of
                               medicines management to these groups. Also we present occasionally to
                               Patient Forums.
South Staffordshire      RRE As part of Medicines Management Week all wards receiving a personal
Healthcare NHS Trust           visit from Senior Nurse (Medicines Management) to deliver and discuss
                               Ask About Medicines information leaflets. Our Clinical Risk Training
                               includes specific advise and discussion around practices to improve
                               compliance.
South Tees Hospitals     RTR   Have addressed the Trust's Patient Forum on medicines management
NHS Trust                      issues and working with Trust policy for involving patients. Some drugs
                               are purchased before formal approval as one off supplies on
                               compassionate grounds or more usually patients are admitted to hospital
                               on medication not routinely stocked and where it is inappropriate to
                               change the medication.
South Tyneside NHS       RE9   Trust Board Visit - including executive director, non-executive director and
Foundation Trust               representative from board of governors. Lay members on the local
                               implementation team for the NSF for Older persons.
South West London And RQY Carer representation on Drugs and Therapeutics Committee
St George’s Mental
Health NHS Trust
South West Yorkshire     RXG The pharmacy at St Luke's Huddersfield provides a dedicated service to
Mental Health NHS Trust        the Assertive Outreach Team and Consultant teams with a dispensing
                               service that meets the requirements of the individual patients e.g. daily
                               dispensing, instalment dispensing, dispensing into compliance aids
                               following assessment. This service has been evaluated to ensure it is
                               directed at the most needy clients. As well as the legal leaflets in individual
                               packs the UK Psychiatric Pharmacy Group Leaflets are issued to patients
                               with their medication. Although there is no official helpline as yet clients
                               are encouraged to contact the pharmacy and/or make an appointment
                               with a pharmacist to discuss their medication needs. Clozapine is classed
                               as a red drug and is only available via secondary care. Efforts are made to
                               ensure clients can get their clozapine in the most appropriate way for them
                               with pharmacy staff involved in care planning. The medicines
                               management pharmacist is running a campaign to encourage the
                               involvement of patients and carers in their medication is starting with Ask
                               About Medicines Week.
Sperrin Lakeland HSS     Z1830 Patient questionnaire (diabetes service)
Trust
St George’s Healthcare RJ7     Two patient representatives attend the Medicines Resource Group (that
NHS Trust                      assesses funding), and the Medicines Risk Management Committee
St Helens And Knowsley RBN Our Trust's Patient Council discusses issues such as antibiotic use and
Hospitals NHS Trust            MRSA with patients. We have a pulmonary rehabilitation pharmacist who
                               educates patients on drug use as part of a multi-disciplinary outreach
                               team. In a number of specialities e.g. respiratory, diabetes, rheumatology
                               we have established systems for patient education and involvement in
                               their prescribed medications
Stockport NHS            RWJ An open day for Foundation Trust members was recently held with each



                                                   10
             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
      Org_Name             Code                      Initiatives to improve Medicines PPI
Foundation Trust                Clinical Division providing a manned stand. A poster was included briefly
                                describing opportunities for PPI in Medicines Management. Although
                                interest was shown this has not yet resulted in any direct involvement.
Swindon And               RN3   An audit in 2003/04 of Medicines Management undertaken by local
Marlborough NHS Trust           auditors included a patient questionnaire. This showed that overall there
                                was patient satisfaction whilst in the hospital and at the interface during
                                discharge but that there is potential to improve the provision of
                                information.
Tameside And Glossop RMP The Chief Pharmacist is invited along on an ad-hoc basis to the Trust
Acute Services NHS              Patient User Reference Group to discuss medicines management
Trust                           initiatives and developments
Trafford Healthcare NHS RM4 Patient representative on our Medicines Management Committee. Monthly
Trust                           survey of 50 patients as part of Hospital Medicines Management
                                Collaborative.
Ulster Community &        Z1110 Integrated Medicines Management Initiative for elderly patients - funding
Hospitals HSS Trust             approved 2005, due to commence January 2006.
(The)
United Bristol Healthcare RA7   Public representative on Area Prescribing and Therapeutics Committee
NHS Trust
United Lincolnshire       RWD Patient Representative on Committees e.g. Ethics Committee, Clinical
Hospitals NHS Trust             Governance, Drugs and Therapeutics Committee, Public and Patients are
                                on Information for Patients Forum. I shall be asking the advice of the latter
                                group on the best presentation format for updating our information on
                                usage and safe handling of medicines, and leaflets to explain benefits of
                                bringing Patients Own Drugs into hospital for bedside storage and Self
                                medication
University College        RRV A lay member has been appointed to and regularly attends the Use of
London Hospitals NHS            Medicines Committee. A patient medicines help line run by the pharmacy
Foundation Trust                Medicines Information Centre is available to patients with medicine related
                                queries. All patients receive patient information leaflets with their
                                dispensed medicines and are counselled to ensure that they understand
                                how to use their medicines. Patients with specific medicine concordance
                                problems receive a pharmacy prepared medicine reminder chart prior to
                                discharge. Near Patient Dispensing (NPD) has been implemented across
                                many areas of the trust. NPD encourages patients to take ownership of
                                their medicines through continued use of patients own drugs during
                                hospital stay. It also increases contact between ward based pharmacy
                                staff and patients thus providing a framework for in-patient self
                                administration.
University Hospital       RRK In 2003, a series of Away Days were held to develop a strategy for
Birmingham NHS                  Medicines Management within the Trust. Attendees at the days included
Foundation Trust                representatives from our Patient Councils and the issues raised by
                                patients and carers were reflected in the development of our strategy.
                                Since April 2005 the Trust has been a member of the national Hospital
                                Medicines Management Collaborative and the local project team includes
                                a patient representative. This gives access into the Patient Councils to
                                discuss medicines management proposals and to listen to issues and
                                concerns raised by our patients.
University Hospitals      RKB   Our Patient Counsel discusses medicines information and we will have a
Coventry And                    computerised PILs facility in the new patient library that will print PILs at
Warwickshire NHS Trust          the request of patients
University Hospitals Of   RWE The trust is participating in the 3rd wave of the Hospital Medicines
Leicester NHS Trust             Management Collaborative; the Trust participated in an audit in 2004
                                conducted by the Audit Commission and commissioned by the 6
                                Leicestershire Pact’s into the perceptions of the patient of medicines
                                management within University Hospitals Of Leicester.



                                                   11
             2005/6 Healthcare Commission Medicines Management Review Best
             Practice Sharing: Patient and Public Involvement
       Org_Name           Code                    Initiatives to improve Medicines PPI
University Hospital Of   RJE   The Trust has been accepted into the third wave of the Hospital Medicines
North Staffordshire NHS        Management Collaborative for 2005-6. Part of the project will be to include
Trust                          patient and public involvement in the work that is being done towards
                               modernising the pharmacy service
Velindre NHS Trust       RQF 1) Multidisciplinary group looked at all aspects of chemotherapy including
                               aspects of the Pharmacy services and information on chemotherapy
                               drugs. One of the team was a patient and we surveyed 30% of the
                               patients undergoing chemotherapy for their views.
Walsall Hospitals NHS    RBK   Pharmacy subject of specific review by Patient and Public Involvement
Trust                          Forum. Visit to the department, question and answer session and follow
                               up session - very positive and supportive report from the group to the
                               Trust Board. Involvement of patient representatives on Hospital Medicines
                               Management Collaborative working groups - positive contribution in all
                               areas. Particularly helpful and pro-active work on system changes and
                               modernisation of medicines management systems - PODs, One Stop etc.
                               Really helpful in choice of lockers, design of bags and documents.
                               Regular updates to patient groups throughout the year and presentations
                               to the League of Friends have promoted a supportive approach and
                               funding for bedside lockers has been made available by the League of
                               Friends
West Dorset General      RBD Regular talks by senior pharmacist to cardiac rehabilitation and
Hospitals NHS Trust            rheumatology patients. Special compliance aid record cards for renal
                               patients, elderly care patients (and any other patient on request).
West Hertfordshire       RWG There is a PALS representative on both the Drug and Therapeutics
Hospitals NHS Trust            Committee and Medicines Management Committee.
West Middlesex           RFW Patient/lay representation on the Drugs and Therapeutics Committee has
University Hospital NHS        been considered and the Patient and Public Forum have been consulted
Trust                          on this. It was however decided that input into medicines management
                               would be via the Trust's Governance Committee where there is such
                               representation. The mechanism for this being the minutes of the Drugs
                               and Therapeutics Committee are routinely reviewed at the Governance
                               Committee which is also attended by the Chief Pharmacist. The Patient
                               and Public Forum is also accessible for key staff involved with medicines
                               management to attend.
Whipps Cross University RGC There are two patient representatives in the Pharmacy Clinical
Hospital NHS Trust             Improvement Group
Whittington Hospital NHS RKE   Appointment of a lay member to the Drugs and Therapeutics Committee is
Trust (The)                    under consideration
Winchester And           RN1   The Trust is participating in the Hospitals Medicines Management
Eastleigh Healthcare           Collaborative (HMMC). An expert patient is a member of the HMMC
NHS Trust                      steering group. The trust operates a patient help line.
Wirral Hospital NHS      RBL   Improving prescribing practice group layperson invited - did not attend
Trust
Wolverhampton City PCT 5MV     We have a service user involved in our POMH-UK audit of antipsychotics
                               planned for January 2005
York Hospitals NHS Trust RCB Introduction of widespread self-medication scheme which engages and
                               educates patients.




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