Mental Health Medicines Management Pilot Project: HSCB and SHSCT
Mental Health Medicines Management Pilot
Community Pharmacy Service Specification
1. Mental Health Medicines Management Pilot Background information
The Mental Health Medicines Management (MHMM) pilot study is an initiative to help
patients with severe enduring mental illnesses to use their medicines more effectively. The
initiative involves a pilot pharmacist (hospital-based clinical pharmacist, specialist in mental
health medicines) leading and developing a pharmaceutical service to link between
secondary and primary care. The pilot pharmacist role is twofold:
1. To develop pharmaceutical advisory services through working with Trust home
treatment, crisis response and community mental health teams, community pharmacists
and voluntary organisations.
2. To lead and develop community pharmacy-based services for patients with mental
health conditions.
The pilot pharmacist will work in both the Hospital and Community pathways of the pilot. The
role includes the following functions:
a. Identify the patient populations for inclusion in the pilot
b. Develop a local network of healthcare professionals (HCP) including GPs, CMHTs,
charity/voluntary organisations, community psychiatric nurses and develop and
maintain a formal communication strategy
c. Develop and provide training on mental health medicines for local pharmacists and
healthcare professionals
d. Develop information resources and mentoring support for community pharmacists
e. Develop project documentation and a referrals/signposting processes and resources
f. Provide a medication review service within the home treatment/crisis response teams
Outcomes related to improving adherence to medicines and medicines safety will be
evaluated during the pilot project.
2. Community Pharmacy MHMM Pilot Pathway Service Description
In the community pharmacy MHMM pilot pathway (Southern LCG area) the following
services will be offered to specific patients visiting community pharmacies:
2.1 Lithium support service
The service will support existing monitoring provided by secondary care and GP services
and ensure that National Patient Safety Agency (NPSA) recommendations are followed
minimising the risk of harms to patients on Lithium therapy. Adherence to medicines and
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Mental Health Medicines Management Pilot Project: HSCB and SHSCT
recommended laboratory monitoring will be checked. Where appropriate, patients may be
referred or signposted to other services.
2.2 High dose antipsychotic screening, education and advice
The service will support patients visiting the pharmacy who receive high dose antipsychotic
medication by providing them information and education about their medicines. Where
further support and advice is required and this cannot be provided by the pharmacy, the
patient will be referred or signposted to other health and social care providers or support
organisations that may be able to assist them.
3. Community Pharmacist Resources and Training
Mandatory training for all community pharmacists participating in the pilot will be provided on
all aspects of the pilot services by the Trust-based MHMM pilot pharmacist and HSCB
pharmaceutical adviser. Mentoring and support will also be available from the pilot
pharmacist and from the HSCB pharmaceutical advisory team.
A specialist mental health medicines resource, an information website entitled “Choice and
Medication” has been commissioned for the duration of the pilot and is freely available to all
healthcare professionals and patients in NI. Links are available on the local HSC websites to
facilitate easy accessibility for hospital and community pharmacists and other healthcare
professionals. Training on the appropriate use of this resource will be provided to
participating community pharmacists.
4. Aims of the Community Pharmacy MHMM Pilot Pathway Service
The community pharmacy MHMM pilot service aims to maximise benefits of mental health
medicines to patients by:
a. identifying people taking specific medicines for mental health conditions
where issues of concern exist;
b. providing better access to medicines advice
c. optimizing adherence to prescribed medicines;
d. improving clinical outcomes;
e. reducing medicines waste
f. reducing the risk of harm through non-adherence to mental health medicines
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Mental Health Medicines Management Pilot Project: HSCB and SHSCT
5. Service Specifications
5.1 Lithium Support
A Lithium support service (LSS) can be carried out for all patients who are having Lithium
dispensed. This should be carried on each occasion a new prescription is presented by the
patient for dispensing up to a maximum of six occasions during the pilot project.
5.1.1
5.1.2
5.1.3
5.1.4
5.1.5
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5.1.6
5.1.7
5.1.8
5.1.9
All patients receiving the LSS service must sign a consent form which allows the
pharmacy contractor to share information from the LSS care plan with the patient’s
GP as necessary, healthcare and social care practitioners and other health and
social care bodies for the purposes of administering and managing health and social
care services, the MHMM pilot pharmacist as part of the pilot evaluation, and HSCB
officers to verify that the service has been delivered by the pharmacy as part of postpayment verification.
All pharmacists providing the service will have attended the mandatory training for
the Community Pharmacy MHMM Pilot Pathway Service.
The pharmacist will use the LSS care plan to help assess any problems patients
have with their lithium therapy and check the patient’s Lithium monitoring card to help
develop the patient’s knowledge of their medicine and the importance of monitoring
to ensure safety.
The pharmacist will use the Choice and Medication (C&M) website resource to help
develop the patient’s knowledge of their medicine and the importance of monitoring
to ensure safety.
With each new prescription the pharmacist will check the that the following
information is recorded in the patient’s Lithium Therapy Record Book and is up to
date :
Current lithium blood level.
Thyroid function test results
Renal function test results.
Weight and BMI.
The pharmacist will remind the patient or their carer to take their Lithium Therapy
Record Book when they visit the clinic/GP and the pharmacy.
The pharmacist will provide medicines management advice to the patient or carer to
support their lithium therapy (See guidance notes and SOP template).
The pharmacist will complete the MHMM pilot LSS care plan for the patient at each
encounter and where necessary, e.g. if there are concerns about side effects or
interacting drugs, contact the prescriber to ensure appropriate follow up. The
pharmacist will refer any patients to the MHMM pilot pharmacist using a written
MHMM pilot referral form.
Records of referrals should be made on the MHMM pilot referrals record and may be
made on the patient’s pharmacy record when the pharmacist deems it to be of clinical
significance.
Pharmacy staff will inform or advise people visiting the pharmacy of other health and
social care providers and support organisations, such as patient groups, when
appropriate.
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Mental Health Medicines Management Pilot Project: HSCB and SHSCT
5.1.10 The pilot pharmacist will provide pharmacies in their area with details of health and
social care providers to whom patients can be referred e.g. GPs, Dentists and Trusts.
Likewise contact details for local patient and support groups can similarly be provided
to pharmacies.
5.1.11 The pharmacy will collect data on the provision of this service and provide this to the
pilot pharmacist for the purpose of evaluating the pilot.
5.2 High dose antipsychotic screening, education and advice
An education and advice support service can be carried out for all patients who are taking
high dose antipsychotics.
5.2.1
The pharmacist will use the High Dose Antipsychotics screening tool to help identify
any patients on high dose antipsychotics.
5.2.2 All patients receiving the High Dose Antipsychotic screening service must sign a
consent form which allows the pharmacy contractor to share information with the
patient’s GP as necessary, healthcare and social care practitioners and other health
and social care bodies for the purposes of administering and managing health and
social care services, the MHMM pilot pharmacist as part of the pilot evaluation, and
HSCB officers to verify that the service has been delivered by the pharmacy as part
of post-payment verification.
5.2.3 Pharmacists providing the service will have attended the mandatory training for the
Community Pharmacy MHMM Pilot Pathway Service.
5.2.4 The pharmacist will use the Choice and Medication (C&M) website resource to help
develop the patient’s knowledge of their medicine and the importance of monitoring
to ensure safety.
5.2.5 The pharmacist will refer any patients to the MHMM pilot pharmacist using a written
MHMM pilot referral form.
5.2.6 Records of referrals should be made on the MHMM pilot referrals record and may be
made on the patient’s pharmacy record when the pharmacist deems it to be of clinical
significance.
5.2.7 Pharmacy staff will inform or advise people visiting the pharmacy of other health and
social care providers and support organisations, such as patient groups, when
appropriate.
5.2.8 The pilot pharmacist will provide pharmacies in their area with details of health and
social care providers to whom patients can be referred e.g. GPs, Dentists and Trusts.
Likewise contact details for local patient and support groups can similarly be provided
to pharmacies.
5.2.9 The pharmacy will collect data on the provision of this service and provide this to the
pilot pharmacist for the purpose of evaluating the pilot.
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