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National Assembly for Wales
Health and Social Care Committee
Post-legislative scrutiny of the Mental Health (Wales) Measure 2010
Evidence from Royal Pharmaceutical Society – MHM 10
Committee Clerk,
Health and Social Care Committee,
National Assembly for Wales,
Cardiff Bay,
CF99 1NA.
4th September 2014
Dear Colleague
Post-legislative scrutiny of the Mental Health (Wales) Measure 2010
The Royal Pharmaceutical Society (RPS) welcomes the opportunity to respond to the Post-legislative scrutiny of the Mental Health (Wales) Measure 2010. The RPS is supportive of the measure that was introduced in 2010. We recognise that patients needing mental health support require advocacy and a high level of support from a multi disciplinary care team.
We are aware that there are many inpatient care pathways and extensive documentation that is completed as a part of the measure; however, currently none of these documents are focused on the patients’ medicines. Now the measure has had time to be embedded in practice, we feel that it should evolve and incorporate a medicines reconciliation section to be used during the admission process and that all patients’ medicines management needs are considered and documented.
The community pharmacy contract incorporates an expectation that pharmacies will signpost their patients to other care and support facilities. We are aware that a document was produced in 2011 that mapped all local mental health services across Wales, this document should be shared with community pharmacies. Community pharmacies need to have access to information about local services. Pharmacists have regular contact with their patients and are able to detect if a regular patient is feeling low or acting in a manner that is out of character and causing concern. These patients may benefit from further counselling and support regarding mental health issues that pharmacy cannot currently offer. It would be beneficial if patients could be directly referred from pharmacy to a counselling service.
Pharmacy is not included in section 2 of the measure as a profession that can act as a care coordinator. Medicines however play an important role in mental health therapy and it is important that access to a specialist mental health pharmacist should be available to all patients and referral for support should be considered with any medicine related issues. We strongly advocate a red flag referral to pharmacy process is embedded into the current system, giving patients further advice and support regarding their medicines.
We are aware of a pilot project that is currently being undertaken in Betsi Cadwalader University Health Board which is looking at ways of developing the medicines management process within a home treatment team. The evaluation of this project is due to be completed in three months time. The initiation of other pilot projects like this may be beneficial in deciding how to best support patients with mental health needs.
The medicines used to treat mental health issues need careful consideration, allowing a balance between controlling symptoms and managing any potential side effects or issues. Funding must be available to allow patients to spend time with a pharmacist in a care setting or in the patients’ home to discuss treatment options so that decisions can be made in a co-productive manner. We would also advocate that investment should be made to support the development of pharmacist independent prescribers in mental health who will be able to develop an individual pharmaceutical care plan with each of their patients and prescribe medicines as necessary.
I trust this information is helpful. Please do not hesitate to get in touch if you require any further information.
Yours sincerely
Jocelyn Parkes
RPS Director for Wales
The Royal Pharmaceutical Society (RPS) is the professional body for pharmacists in Great Britain. We represent all sectors of pharmacy in Great Britain and we lead and support the development of the pharmacy profession including the advancement of science, practice, education and knowledge in pharmacy. In addition, we promote the profession’s policies and views to a range of external stakeholders in a number of different forums.