The United Kingdom is actively implementing all sorts of schemes for redistribution of functional responsibilities and effective interaction of specialists providing primary and secondary medical care. These include multidisciplinary teams, expert rapid response teams, the ability to provide emergency medical care on the same day, and support for early discharge from hospitals.
The Royal Pharmaceutical Society (RPS) in Wales and the Royal College of General Practitioners (RCGP) have jointly created a resource to help local multidisciplinary teams (MDT) working in primary care.
Launched on February 12, 2020, the Multidisciplinary Team working in a general practice setting: the practicalities of making its work, describes the roles and responsibilities of each MDT member. The relevant manual outlines the basic values and behaviors needed to build an effective team and includes tasks to be addressed.
In particular, the role of the pharmacist working as one of the team members may include:
- providing advice and support directly to patients regarding the correct and safe use of drugs and all pharmacotherapy management processes;
- doctor-independent prescription and management of pharmacotherapy for a range of conditions (from mild to long-term illness), as part of their competence;
- identification and management of patients with increased risk of unsafe use of medicines, including elderly people with multiple pathologies or unavoidable polypragmatism;
- support patients in managing their own health, including adherence to medication;
- provision and support of drug use in long-term care centers and support of patients with the risk of polypragmatism;
- addressing drug-related problems in general practice, helping to reduce the frequency of adverse reactions that require emergency care;
- working with pharmacy technicians to optimize reappointments and patient records, as well as performing prescription reviews, patient monitoring and prescription safety checks in accordance with guidelines.
- In addition to the responsibilities of the pharmacist, the manual focuses on other team members: the general practitioner, nurse, physiotherapist, foster nurse, ergotherapist (specializing in recovery and daily activities), and paramedics.
Other primary care optimization initiatives in the UK also attract attention.
Support for early discharge from inpatient care
“Why not home?”, “Why not (statement) today?” – campaigns under these slogans are being conducted by the English National Health Service (NHS), drawing attention to the need to reduce hospital bed occupancy.
Preventing Hospitalization
Rapid Response Teams will be on site for 2 hours to help older people stay home and avoid hospitalization according to the new plans outlined by the NHS on January 23, 2020. The teams will provide quick access to a range of trained professionals who can meet both medical and social care needs, including physical therapy and rehabilitation, prescription drugs and pharmacotherapy reviews, and assistance with nutritional and fluid needs. “In this way, we are implementing this innovative new approach that will help treat our aging population in a comfortable home environment, helping them to live independent lives longer,” explained Matt Hancock, Secretary of State for Health and Welfare.
One Day Hospital
All examinations, consultations with senior doctors, start treatment – in one day. Since spring last year in England, pilot projects of emergency care on the same day (SDEC) are being tested. According to experts, every year about half a million patients in England can be examined, diagnosed, treated and returned home without the need to spend the night in hospital. This experience is also good for our reality. Our inpatient facilities are really not able to provide decent living conditions for all patients. The emergency medical service is also able to transport and support the treatment of patients at home in a state of moderate severity.