Delivering an Integrated Service for Care Homes

Project Aim

The aim of this project was to prove a concept of delivering an integrated GP and medicines management service to the residents of care homes that will: deliver a quality service to increase patient choice through to end of life; reduce inappropriate admissions; and rationalise prescribing, including anti psychotic drugs, and identify and eliminate errors of medication administration

Project Benefits/ Outcomes

The benefits of this project were:

  • Improved resident and relative satisfaction
  • Improved medicine management
  • Repeat prescription management
  • Reduction in medication errors
  • Reduced antipsychotic prescribing
  • Reduced prescribing costs
  • Quality end of life:
    • Increased proportion of residents dying ‘at home’
    • Establishment of advanced care plans, allow natural death and end of life pathways for residents
    • Specialist training for care home staff and clinicians
    • Integration between stakeholders, research organisations and primary and secondary care health providers
    • Reduced inappropriate hospital admissions and ambulance call out
  • Production of validated, measurable, sustainable and replicable data for future use


There is substantial evidence of issues with service provision within care homes which has led to the following consequences:

  • Inappropriate hospital admissions
  • Medication errors
  • Inappropriate prescription of antipsychotics
  • End of life episodes that are not in accordance with the individual’s wishes.

The Thames Valley HIEC funded a project delivered by The Practice plc that implemented an integrated GP and Medicines Management Service to the residents of care homes that included a dedicated clinical team comprising specialist GPs and pharmacy staff who delivered:

  • Routine visits
  • Medicines Management
  • Urgent Care
  • Management of EOL pathways
  • Advance care planning
  • Out of hours advice


For a summary of the report:   HIEC summary CAREHOMES eversion

For a copy of the full report contact:-

In December 2013, The Social Care Institute for Excellence reviewed the project report for this piece of work and included it in their guide to best practice called “Evidence Review on Partnership Working between GPs, Care Home Residents and Care Homes.”  Their report can be found here:

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