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We run three services for the management of patients with polypharmacy:

  • Polypharmacy clinic – to see patients with complex or problematic polypharmacy
  • Advice and Guidance service – to support healthcare professionals to manage their own patients
  • Polypharmacy multidisciplinary team meetings – to discuss complex cases in a safe and supportive environment with clinicians from a range of specialties

Polypharmacy clinic

We run a weekly clinic in order to review patients, their health conditions, medicines and their priorities for treatments.  We offer face-to-face and telephone appointments.  We can see patients in follow up appointments to assess their progress, or give detailed recommendations for follow up in primary care.

Who to refer

We are happy to see any patient that you have concerns about.  Suggested reasons for referral include:

  • High number of medicines
  • Potentially inappropriate medicines
  • Drug interactions
  • Adverse drug reactions or side effects
  • Difficult prescribing decisions
  • Dependency or addiction to prescribed medicines
  • Frequent hospital admissions related to medicines
  • Concerns raised by the patient or their next of kin

How to refer

Internal staff

Refer via iCLIP:

  1. Open the patient’s records
  2. Click Orders
  3. Search for ‘Refer to Clinical Pharmacology / Polypharmacy‘
  4. The referring clinician does not need to do anything else. The patient will receive an appointment and information letter by post from the Polypharmacy team, for a telephone consultation on a Wednesday afternoon within two weeks

The Polypharmacy team will liaise with the patient and their GP about any advised medication changes. The outcome of the review is documented in iCLIP.

We encourage all internal referrals to go through iCLIP.  If you are having problems with this then you can send referrals to internal.referrals@stgeorges.nhs.uk.  Please ensure you are following information governance protocols.

External staff

We welcome referrals from any healthcare professional involved in medicines management (e.g. GPs, pharmacists, nurses) within South West London ICS.  Refer via NHS e-Referral Service (e-RS):

  1. Search for “General Medicine” in the Specialty filter
  2. Enter the name of the consultant clinical pharmacologist, either “Chris Threapleton” or “Daniel Burrage” in the Named Clinician box
  3. Select “Clinical Pharmacology & Polypharmacy Clinic @ St George’s University Hospital – RJ7″
  4. Please send a copy of the GP summary and a short summary of your concerns
  5. The referrer needs to ensure that they (or the patient) books an appointment in the clinic.  Please give us at least two weeks to allow time to review the patient’s notes before the appointment.

A step by step guide to referring to our service (with screenshots) is available for download here.

We encourage all external referrals to go through e-RS.  If you are having problems with this then you can send referrals, and any questions, to stgh-tr.referrals@nhs.net.  Please ensure you are following information governance protocols.

Advice and Guidance

Any clinician in South West London can contact us to ask questions or request advice.

How to get in touch

Refer via NHS e-Referral Service (e-RS):

  1. Search for “General Medicine” in the Specialty filter
  2. Enter the name of the consultant clinical pharmacologist, either “Chris Threapleton” or “Daniel Burrage” in the Named Clinician box
  3. Select “Clinical Pharmacology advice only @ St George’s University Hospital – RJ7″
  4. Please send a copy of the GP summary and a short summary of the main issues along with your question(s).

 

Polypharmacy multidisciplinary team meetings

Membership

Chair: Dr Chris Threapleton, Consultant in Clinical Pharmacology

Any healthcare professional in SW London caring for patients with multiple and complex medicines

Attendees include: GPs, PCN pharmacists, specialist pharmacists (e.g. cardiovascular medicine, mental health), and resident doctors in Clinical Pharmacology

Aim

The purpose of these meetings is to discuss patients you have seen where you felt uncertain about your decision making.  Our goal is to provide guidance and support to help with further management while strengthening your skills and confidence.

Examples of cases we discuss:

  • problematic or complex polypharmacy
  • adverse drug reactions/allergies that are problematic or limiting treatment options
  • drugs of dependence
  • high risk medicines

Agenda

  1. Case discussion – 3 cases/meeting.  Please aim to share brief details with the Chair in advance
  2. General questions/discussions – deprescribing a particular drug class, uncertainty in interpreting a particular test or difficulty in managing aspects of your consultations when discussing medicines
  3. Brief teaching sessions (if time allows) on specific areas of prescribing and considerations when making prescribing decisions

Data governance

If you have patient consent, you can provide patient details during the meeting (and please share these with the Chair in advance)

If you don’t have patient consent, cases can be discussed without identifying information

Log in to the meetings with nhs.net or nhs.uk email addresses

How to sign up

Fill in your contact details below to get the link to our meetings and keep up to date with training events.  Note, the meeting link can only be sent to an nhs.net or nhs.uk email address: