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Integrated Care Pharmacist Project


The brief was to review the benefits of a clinical pharmacist working with and supporting community teams including district nurses, social services, community matrons and other specialist community support such as Macmillan nurses and physiotherapists to develop the local future model for clinical pharmacy input.

We were tasked with the aim of improving patient safety, potentially reducing hospital admissions whilst increasing the provision of care closer to home and improving the patient experience. Our aim was to optimise patients’ medication regimes and try to identify efficiencies within the current services through drug costs, drug administration and safety interventions.


MLCSU Medicines Management and Optimisation (MMO) team decided to integrate and co-locate three MMO pharmacists with three local cluster community care teams for one day a week over a three month period. The placements were to support teams with medication reviews and professional advice regarding medication.

Our pharmacists were able to attend multidisciplinary team meetings and support reviews of individual patients. We completed medicines-related audits, reviewing high-risk drugs prescribed to patients within the community teams’ current caseloads and optimised patients’ medication. We were able to reduce the number of nursing visits required, making better use of nurse time and rationalising medication regimes to attain the best outcome for patients.

Our team was on hand to answer any medicine-related queries raised by the community teams; queries were frequently linked to injectables and medication storage issues. We also provided bespoke education sessions at the request of the community teams in the areas of antibiotics and simple pain management.

Due to our team’s established links with GP practices and the local trusts we were able to support the community care teams develop closer working relationships across the locality. By connecting to surgeries in satellite locations we could quickly access records, resolve problems and seek GP advice.

We worked with our colleagues in the local hospital to develop an EMIS template for use in GP surgeries that would enable recording of outcomes across the two teams and also support GP practices by ensuring all interventions were read coded.


We improved patient care following our reviews and interventions. A summary of the outcomes is detailed below – examples include reviews of high risk medicines such as co-prescribing DOACs and antiplatelets, reducing patients’ falls risk by stopping drugs likely to increase the risk of falls, stopping prescribing of interacting medicines, ensuring regular blood monitoring and altering doses in elderly or those with renal problems.

A number of cost improvements have also been realised by optimising patients’ medication and ensuring the use of cost-effective alternatives. A reduction in nursing visits was demonstrated by optimising drug dosing schedules and a potential reduction in hospital admissions due to GI bleeds and AKI from reviewing inappropriate drugs was suggested.

Outcome measureOutcome Comment
Potential cost savings from drug interventions£7,640 (pa)
Number of medication reviews completed153
Reduction in potential hospital admissions19 potential hospital admissions avoided. Estimated saving £33,000Potential admissions due to high risk of bleeds (DOACs and antiplatelet), falls, AKI and PEG blockage
Using cost of  £1,739 per ACSCs admission
Number of nurse visits saved or timing optimised2 visits per day giving approximate associated cost saving = £17,520 annually


Using figure £24 per nurse visit therefore £24 x 2 visits x 365 days = £17,520
Education sessions delivered6
Number of queries answered3928 hours spent
Number of MDT meetings attendedTotal = 17Included meetings with COCH

Testimonial from feedback surveys:

When asked ‘overall, how would you rate having an integrated pharmacist as part of your team?’, all responses were ‘excellent’ (over 50%), ‘very good’ (over 25%) or ‘good’.

When asked ‘How would you rate the quality of the service provided by our integrated care pharmacist?’, all responses were ‘very high quality’ (over 50%) or ‘high quality’.

Comments received include:

  • “The pharmacist has been an asset within the team… We have managed with pharmacist support to encourage two patients to self-manage medication via a syringe driver, saving one hour of two nurses’ time per day.”
  • “As a matron I found the input invaluable and extremely supportive.”
  • “Both pharmacists that have worked within the team have been very responsive.”
  • “I’m amazed how much work was done in the time frame.”

Get in touch

Sandwell Council House
Freeth St
B69 3DB
Jubilee House

Midlands and Lancashire CSU
Lancashire Business Park
PR26 6TR

01772 214200
Bevan House

3rd Floor
Stephenson Way
Wavertree Technology Park
L13 1HN

0151 295 8612/8619
Cardinal Square

3rd Floor North Point,
10 Nottingham Road,
Derby DE1 3QT
East Midlands

01332 868700
St Johns House

St Johns House
30 East Street
United Kingdom

0121 611 0100



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