New research shows that patient prioritisation systems are beneficial for pharmacy teams working in acute mental health settings and could help alleviate the burden of overstretched workforces and underfunded resources by ensuring that pharmacists see patients in most need first.
Acute care pharmacists across the UK already use patient prioritisation tools, but little is known about the use of pharmaceutical patient prioritisation approaches in mental health settings. This study aimed to explore the tools used by UK inpatient mental health pharmacy teams to achieve this.
Between July 2022 and January 2023, a survey was distributed to chief and senior pharmacists across all UK mental health organisations to identify existing prioritisation tools and systems. Follow-up interviews were held with respondents who reported using such systems, and available prioritisation documents were analysed. A prioritisation system was defined as any process or tool that guides pharmacy teams in prioritising patients.
Out of 73 organisations providing inpatient mental health services, 75.3% (n=55) responded to the survey. A total of 21 organisations (38.2%) used a prioritisation system within their inpatient pharmacy services, with 14 of those located in England, six in Scotland and one in Northern Ireland.
The researchers interviewed 16 staff who reported using prioritisation systems, and 11 institutions provided prioritisation documents for analysis.
Optimising services with patient prioritisation tools
The findings revealed that prioritisation systems varied widely in both complexity and construction. Most of the systems were simple, having been built based on the team’s experience and knowledge, and lacked any formal evaluation of their effectiveness.
The interviews revealed that staff believed the existing systems were beneficial, enhancing patient safety and ensuring consistency of care. They also believed that the prioritisation tools helped to optimise clinical pharmacy services, allowing for prioritisation criteria for certain high-risk medicines such as lithium, issues related to mental health legislation and patient-related factors such as swallowing difficulties.
The researchers acknowledged that single interviews with one member of staff may not reflect the views of all team members. However, the analysis showed that patient prioritisation tools were widely seen as beneficial for pharmacy teams, helping them manage their workload and optimise the delivery of services despite the constraints of the work environment.
Efforts to optimise pharmacy services and medicines management support NHS recommendations to improve the quality of care in mental health, the researchers said.
Future research should focus on developing an evidence-based patient prioritisation system for pharmacists, they added.
Reference
Alshaikhmubarak F et al. Exploring current approaches towards patient prioritisation for clinical pharmacy services in UK mental health inpatient care. BMC Psychiatry 2025; 25: 617.
