Call for proof of 'chemical cosh' cuts in care homes

Evidence of progress on reducing the inappropriate use of antipsychotic medication in care homes has been demanded by the Older People's Commissioner for Wales.

In 2014, Sarah Rochira published the results of a major review of the experience of care home residents.

The use of antipsychotic drugs was a recurrent theme which she has branded a "national scandal".

Health boards and care homes have said changes are being made.

The commissioner is asking them to show significant improvements in practice.

"I know professionals don't like this phrase, but across Wales older people in care homes, through the inappropriate use of these drugs, are being 'chemically coshed'. That's the reality of it.

"It is a national scandal. I made that clear when I published my review. I was very clear I would come back and look for evidence of changes and I've now begun that process.

"I will publish the findings from the health boards later this year and I cannot be any clearer in my expectation that they understand how inappropriate the current situation is and that they can evidence real progress."

Health boards say

• Abertawe Bro Morgannwg University Health Board has introduced "care home interface nurses" to provide dementia care training in care homes, including those not specifically registered to provide dementia care

• Aneurin Bevan University Health Board said since the report was published it has been working closely with care homes and it would provide evidence to the commissioner by next month

• Betsi Cadwaladr University Health Board said an audit last November showed antipsychotic medication was prescribed to 8% of people with dementia which was "significantly" below the UK average. It also said a detailed action plan was set up to respond to the commissioner's recommendations

• Cardiff and Vale University Health Board said it has been working with two care homes to review the prescribing of antipsychotic medications. A spokesman said guidance has now been developed to support antipsychotic reviews by GPs and pharmacists working in the community

• Cwm Taf University Health Board said the development of roles for pharmacists working alongside GPs was resulting in a greater number of detailed medication reviews for patients in care homes

• Hywel Dda University Health Board also said pharmacists, GPs and community mental health colleagues were carrying out more detailed medication reviews for care homes patients which, it said, was having a "positive impact through reducing harm and waste"

• Powys Teaching Health Board has been asked to comment

Antipsychotic drugs are primarily used to treat conditions such as schizophrenia and bipolar disorder.

A survey last November by the Royal College of Psychiatrists found nearly one in five - 18% - of dementia patients were being prescribed antipsychotics.

The Royal Pharmaceutical Society in Wales published its own report into the use of medicines in care homes following the Ms Rochira's report.

The society's director in Wales, Mair Davies, told BBC Radio Wales' Eye on Wales programme that there were examples of expert practice.

"What we need is to make sure that happens in every care home in Wales," she said.

Steve Ford, the dementia care lead for Care Forum Wales, which represents more than 450 independent care homes in Wales, believes progress is being made.

"We need to look at the underlying reasons for unwanted behaviour that challenges, rather than picking up the phone to the GP and requesting those prescriptions," he said.

• Eye on Wales is on BBC Radio Wales on Sunday 19 February at 12:30 GMT