‘My memory isn’t always brilliant and sometimes I need to have a quick reminder of key points. Here’s a bottom line summary of the NICE guidance on patient experience (the kindness guideline) ; medicines optimisation and managing medicines in care homes. I’ve laminated this on two sides of A4 so I have it handy’ – Steve

NICE ‘Kindness Guidelines’ QS15 Patient experience in Adult NHS Services

Statement 1. Patients are treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty.
Statement 2. Patients experience effective interactions with staff who have demonstrated competency in relevant communication skills.
Statement 3. Patients are introduced to all healthcare professionals involved in their care, and are made aware of the roles and responsibilities of the members of the healthcare team.
Statement 4. Patients have opportunities to discuss their health beliefs, concerns and preferences to inform their individualised care.
Statement 5. Patients are supported by healthcare professionals to understand relevant treatment options, including benefits, risks and potential consequences.
Statement 6. Patients are actively involved in shared decision making and supported by healthcare professionals to make fully informed choices about investigations, treatment and care that reflect what is important to them.
Statement 7. Patients are made aware that they have the right to choose, accept or decline treatment and these decisions are respected and supported.
Statement 8. Patients are made aware that they can ask for a second opinion.
Statement 9. Patients experience care that is tailored to their needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.
Statement 10. Patients have their physical and psychological needs regularly assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety.
Statement 11. Patients experience continuity of care delivered, whenever possible, by the same healthcare professional or team throughout a single episode of care.
Statement 12. Patients experience coordinated care with clear and accurate information exchange between relevant health and social care professionals.
Statement 13. Patients’ preferences for sharing information with their partner, family members and/or carers are established, respected and reviewed throughout their care.
Statement 14. Patients are made aware of who to contact, how to contact them and when to make contact about their ongoing healthcare needs.

Medicines Optimisation Guidance [NG5] key priorities for implementation (edited)

Systems for identifying, reporting and learning from medicines related patient safety incidents

Medicines related communication systems when patients move from one care setting to another
• …share relevant information about the person and their medicines when a person transfers from one care setting to another. This should include…
o contact details of the person and their GP
o details of other relevant contacts identified by the person…
o known drug allergies and reactions to medicines or their ingredients, and the type of reaction experienced…
o details of the medicines the person is currently taking (including prescribed, over the counter and complementary medicines)…
o changes to medicines, including medicines started or stopped, or dosage changes, and reason for the change
o date and time of the last dose, such as for weekly or monthly medicines, including injections
o what information has been given to the person, and their family members or carers where appropriate
o any other information needed – for example… review dates, ongoing monitoring needs and any support the person needs to carry on taking the medicines…
• Consider sending a person’s medicines discharge information to their nominated community pharmacy, when possible and in agreement with the person.

Medicines reconciliation

Managing Medicines in Care Homes NICE Quality Standard QS 85

Statement 1. People who transfer into a care home have their medicines listed by the care home on the day that they transfer.
Statement 2. Providers of health or social care services send a discharge summary, including details of the person’s current medicines, with a person who transfers to or from a care home.
Statement 3. People who live in care homes are supported to self administer their medicines if they wish to and it does not put them or others at risk.
Statement 4. Prescribers responsible for people who live in care homes provide comprehensive instructions for using and monitoring all newly prescribed medicines.
Statement 5. People who live in care homes have medication reviews undertaken by a multidisciplinary team.
Statement 6. Adults who live in care homes and have been assessed as lacking capacity are only administered medicine covertly if a management plan is agreed after a best interests meeting.

Author: Steve Turner date: 13/5/15