1. Care Home Team – Medication Reviews Prina Sahdev – Medway CCG

2. (Medway Foundation Trust)
Advanced Nurse Practitioners and EoL Facilitators (Medway Community Healthcare)
Geriatrician
(Medway Foundation Trust)
Pharmacist (Medway Clinical Commissioning Group)
The Integrated Care Home Team

3. Patient Care Consultant Geriatrician (Medway Hospital)
Nursing Home Staff (Including Carers)
Care Home Team (CHT) Nurses GP
Pharmacist (CHT and Community)

4. The Review Process Examine MARR chart Speak to patient
Speak to Nurses and Carers
Check Patient notes within Nursing Home
Attempt to fill in blanks with GP notes
Consolidate notes
Liaise with Consultant Geriatrician
Make changes / Recommendations
Follow up with GP/ Nursing Home/ CHT Nurses

5. Factors affecting the review process
Nursing home notes
GP notes
Care Home team and community team notes
Hospital discharge notes / Outpatient letters
Information Everywhere
Computer systems
Paper files – varies across each home
Independent Systems
Policies vary
Procedures vary
Capabilities vary
Duplicate information
Independent Stakeholders
Lack of defined roles
Leadership
Patchy / Non existent
Transfer of Information
Who does what?
Follow up/ Review

6. Are there any additional local issues around medicines reconciliation?
Where are the main pinch points in the system?
What are the possible harms (both direct and indirect) of poor medicines reconciliation?
Do you know of any other work going on to address any of these issues?