Before Christmas I had the pleasure of chatting to Dave Gerrard, who works for NHS England, regarding the STOMP initiative (stopping the over medication of people with a learning disability, autism or both). Dave and I spoke about the support ARC England as an organisation is giving to this critical awareness raising campaign and as a part of this I suggested we feature a blog from him to reach our to Real People e-magazine readers once again. I explained that we contributed to its design and gave valuable feedback at the beginning of the process and elaborated on how it is featured in our ‘Supporting medication in social care settings’ training and how Active Support as a service model can reduce the need for medication.
My name is Dave Gerrard and I work with the national STOMP team at NHS England. STOMP (Stopping over-medication of people with a learning disability, autism or both) is a national campaign to improve the lives of people with a learning disability and/or autism who take powerful medications to manage behaviour thought to be challenging.
The medications of concern include psychotropics such as antipsychotics, antidepressants, anti-epileptic drugs used to stabilise mood, anxiolytics or anti-anxiety drugs such as diazepam and hypnotics or sleeping tablets. Many of these medications are used to treat mental health conditions such as schizophrenia, bipolar disorder or depression. They are also used to manage behaviour thought to be challenging despite there being little evidence for using them in this way.
It is estimated that each day in England up to 35,000 people with a learning disability and/or autism take a psychotropic medication even though they do not have a mental illness. It is thought they are being used to manage behaviour. The STOMP programme aims to challenge medication being used in this way.
The National Institute of Health and Care Excellence (NICE) issued specific guidance in this field in 2015 which states that medication should only be used when other interventions have failed to manage the situation. If used, medication should be at the lowest possible dose for the shortest time and then removed. In the past this was not challenged allowing the 35,000 people to remain on medication often in the longer term.
I am also a pharmacist and find it difficult to give people medication for which there is poor evidence. I am also aware that the medications in question can cause serious side effects such as weight gain, shaky limbs, sedation and constipation to name but a few. All these side effects worsen a person’s quality of life and it makes perfect sense to me to challenge this medication with a view to improving the world in which they live.
The NHS England STOMP team have worked with all Social Care and Healthcare providers to sign up to a STOMP pledge. Within each pledge are a number of commitments to promote quality of life improvement for the people they care for. This involves a focus on alternatives to medication such as Positive Behavioural Support (PBS), a better understanding of psychotropic medication and their side effects and giving people the rights and confidence to challenge medication. These commitments require staff to receive specific training in all aspects of the STOMP agenda and this can be accessed through organisations such as the Association for Real Change (ARC).
I encourage you to access this training and to consider how your organisation can demonstrate their commitment to STOMP. You may consider signing the STOMP Social Care Pledge available via the VODG organisation STOMP Pledge sign up
or to raise awareness within your teams using the resources found on the NHS England STOMP page STOMP resources
STOMP can deliver meaningful change in a person’s life so commit to more training and I challenge you to pledge you support for STOMP.
Joint Pharmacist Lead