Yogita Dawda is the Lead Pharmacist for Brent and Harrow Mental Health Services for Central & North West London NHS Foundation Trust. Here she writes about the feedback received from patients and carers following the implementation of Point of Care Testing (POCT) across the Trust’s clozapine clinics.
Clozapine is a medicine used to help people with symptoms of schizophrenia. It requires close management and regular check-up appointments.
Before implementing the POCT model, the Brent and Harrow Mental Health Services’ clozapine patients were required to attend a clinic twice a week: once to visit another department for a blood test as, at that time, the clinic’s nurses were not trained to take blood and a second time, two days later, once the blood test had been processed to collect their clozapine supply.
As part of implementing POCT, our nurses were trained to take blood. The clinics now focus on physical health monitoring and wellbeing of patients as well as the immediate, and safe, supply of medicines - all in one 30 minute appointment.
This ‘one stop’ service - which also engages and motivates patients with an enduring mental illness in healthy living and awareness programmes - has had positive feedback from both patients and carers.
The two stories below outline the major impact this initiative has had on service users’ experience of mental health services.
For five years, a mother accompanied her son to his clozapine appointments - twice a week, every four weeks. Her son suffered anxiety – heightened by unfamiliar faces and waiting for long periods which were common features of visiting the phlebotomy department as part of the mandatory blood tests required for clozapine. To alleviate her son’s anxiety, the mother would collect a ticket for his blood test and drive around the hospital grounds (often for up to 90 minutes at a time) while they waited for his turn. Today, her son attends the clozapine clinic independently and engages with some groups. His mother reports feeling delighted with her son’s recovery journey and attributes this to the new service run by familiar staff, who are experienced in mental health with whom her son has built up trust.
Another patient who had taken clozapine for many years suffered numerous physical health problems as a result of increased weight gain. In 2012, he weighed 212kg – contributed by increased appetite, apathy, low self-esteem and a lack of confidence. His weight gain caused significant mobility problems and required him to use a wheelchair. In May 2012, he started engaging with the new service and a diet and exercise programme which led to him losing 38kg and becoming more mobile and more independent.
One staff member also said: “I was sceptical that this model would be workable - I love the autonomy, the increase in my professional knowledge and the patient and carer engagement is wonderful”.