I am currently involved with the development and implementation of the NHS Direct Enhanced Service Structured Medication Review (SMR) Framework within the Lancashire region, for the benefit of our patient population.

This is an exciting project that essentially aims to get the best from prescribed medication in terms of treatment outcomes whilst minimising the financial burden to the NHS.

Although the overarching objectives have been laid down by the NHS, I have been involved with the real-world development and project roll-out within the community healthcare setting.

Key aspects for consideration include for example:

SMR delivery in care homes, with related MDT inclusion
Consideration of patients with complex polypharmacy (i.e. >10 medications)
Those experiencing severe frailty
Those prescribed medicines that have commonly associated medication errors

Important considerations along the way have involved the determination of caseloads, the listing of appointment slots, achieving a personalised review of the patient’s status and allowing for appropriate signposting to specialist services as necessary.

I now have a set series of questions in play that have been informed by the literature. My question set is robust, as is my recording template for audit purposes.

The great joy from work of this nature is interacting with the patients, especially those in care homes (i.e. by virtual means), to add value to the pharmaceutical care provided in Lancashire.

Please get in touch if you think that I can help you and your SMR delivery in any way; consultancy is always available at Pharmascholar for this or any other project.