Implementing a Patient Helpline

This information is a guide to some of the many things you need to consider when establishing a medicine helpline for patients and their carers. These are recommendations or suggestions – you may decide that you wish to implement only some of them – but the advice here is based on the experience of those who run successful helplines. 

This guide should be read in conjunction with the national Patient Helpline Standards and example SOPs produced jointly by UKMi and The Thames Valley & Wessex Chief Pharmacists Network, and endorsed by the then Royal Pharmaceutical Society (now Royal College of Pharmacy). 

Introducing a Helpline 

Most Pharmacy departments are concerned that the potential workload generated by a patient helpline may be too much to bear. However, the extent to which the helpline is used is heavily determined by the methods used to promote it (see Promoting the Helpline below). It is also possible to introduce a helpline in a stepwise fashion to reduce any sudden impact. For example: 

1. Start with clinical areas with a fast patient turn-around (e.g. medical assessment wards, A&E). Patients may receive limited Pharmacy contact here and a helpline may show a Pharmacy contribution to urgent care targets.
2. Extend to other inpatient wards.
3. Extend to outpatients. 

This stepwise introduction, accompanied by a gradual escalation in promotional methods, may help to reassure Pharmacy staff that they will not be overwhelmed with calls. 

External to Pharmacy, it has proved valuable to involve matrons, medical directors, Trust publicity departments, and directorate-level managers in the early stages of roll-out to increase awareness. It is also helpful to be clear about the potential benefits that a helpline offers. 

Ownership and Management 

It is very important that Pharmacy as a whole recognises the importance of the helpline to patient care and contributes to its success. The service is a direct method of ensuring patients’ medicines are optimised in response to their own concerns, and so it should be viewed as having an equivalent importance to providing a clinical pharmacy service to a major ward.

The helpline should be a Pharmacy-wide service, linked to relevant host-Trust strategies, not one that emanates solely from one section of Pharmacy. If the helpline is only championed by a small group of people it will be less likely to succeed. In particular, a helpline needs support from these staff-members: 

1. Chief Pharmacist 

To uphold the benefits of the helpline to the Trust, to promote it at a high level, and help secure the resources needed to run it. Recognition, support and buy-in at senior Trust management level is crucial to ensuring patient benefit (e.g. Medical Director, Chief Nurse). 

2. Clinical Pharmacy and Patients Own Drugs (POD) Teams 

To alert patients to the existence of the helpline at discharge and to encourage ward staff to do the same. To advise helpline staff how to deal with specialist enquiries from patients or to take ownership of some calls and give specialist advice to the caller directly. 

3. Dispensary team 

To issue promotional materials (e.g. cards) to patients with discharge and outpatient medicines. 

4. Medicines Information/Advice (MI) team 

Often the location from which the helpline is run but if not, offering specialist advice, information resources and support for more complex patient calls. 

A senior manager in charge of a Pharmacy section should be responsible for ensuring that adequate and appropriate staff are available to take helpline calls every day for the complete duration of the advertised opening hours. This might be the Clinical Pharmacy Manager or Patient Services Manager for example. If the helpline is run by an MI Pharmacist then there must be cover when they are absent. 

Access for Patients 

1. Telephone Access 

If it will prove difficult to ensure that there is always a Pharmacist available to take helpline calls during the advertised hours of access, then consider these options: 

Run the helpline from a mobile phone, so that a pharmacist can carry the helpline around with them whilst performing other duties.

Many calls can be answered by a pharmacy technician so a helpline could be operated by technicians in the dispensary or a POD team. A pharmacist should be available if needed.
If the helpline will not be staffed during advertised opening hours, ensure that calls are diverted to another extension where a pharmacist is available. As a minimum, make provision for someone on another extension to take a message; the person taking a message need not be a pharmacist. 

Use of answer-phones is not encouraged during opening hours because patients do not like to leave messages. Out of hours, a short message must remind patients to leave contact details, and tell them when to expect a call back and what to do if their call is urgent. Do not instruct patients to “bleep” someone as they will not understand what this means. Some hospital switchboards operate ‘withheld numbers’ so that a person receiving a hospital call cannot determine who has rung them. Unfortunately, because withheld numbers are abused by ‘cold-calling’ companies, some domestic phones are set up to bar calls from organisations that utilise withheld numbers. Check with your organisation to see whether the number from which you operate the helpline is a withheld number, and investigate if this can be stopped. Otherwise, some callers may never know that you tried to ring them back, and you may need to routinely alert callers to ring the helpline back after a certain time if they have received no response.

2. Email Access 

Establish a generic email address for the service that everyone who operates the helpline can access. This might take the form of [email protected] A generic email address means that any enquiries by email can always be accessed by anyone in the helpline team, even if the manager of the service is absent. Make sure the email account is checked regularly. 

Recording Helpline Activity 

It is important to gather data on the activity generated by the helpline to help demonstrate its worth. In particular, you should gather data on the total number of calls, and the advice given and actions taken in response to serious calls. The easiest way to do this is to run the service from an MI centre where an enquiry recording system is already in place. If the helpline is not run from an MI centre then some other means of recording activity should be considered before initiating a helpline. 

For helpline services run from MI centres, it is impractical to record every single patient/carer by name in the database of enquirers within MiDatabank. It is recommended that you: 

• Create an individual with the surname “Helpline” and the first name “Medicines”; record their enquirer category as “member of the public” but leave the other details blank. 
• When calls are received, enter “helpline” in the surname box and select this option to identify the caller. Patient identity and contact details can be recorded in the relevant sections.
• Some callers wish to be anonymous, so you should also create an individual in the same way as above with the surname “Helpline” and the first name “Anonymous”. 

Promoting the Helpline 

It is helpful to have a promotion strategy for the helpline, to ensure that as many patients as possible are aware of it, but also so that it is promoted at a level where local resources can meet the demand. As already noted, promotional methods can be gradually escalated to increase awareness of the service. 

Involving your Trust’s PR department at an early stage is sensible – they may also require a standard appearance for any written promotional materials to match a Trust’s corporate identity. 

Promotional approaches

Credit Card-sized Adverts 

These are a popular method for promoting a helpline. It’s helpful to consider the following:

1. Make them bright and colourful so they show up in a white paper bag of medicines. 
2. Include examples of questions that patients can ask, so they understand what’s being offered.
3. Make sure you include days and hours of operation.
4. Include your direct dial-in telephone number, and an email address if you have one.
5. Indicate that the helpline is intended for hospital-initiated medicines.
6. Work with your dispensary team to design the cards and ask them if they are willing to distribute them. 

An example is attached below

Measuring Helpline Impact 

Consideration must be given to how the workload and benefits of the helpline can be measured. The following can be considered as initial, uncomplicated, metrics: 

Total number of enquiries received per month (It is helpful to set a target commensurate with the local resource available to answer calls).
Proportion of enquiries answered within the callers’ deadline (target >99%). 
It is also valuable to measure patient satisfaction with the service. This could be a continual measure in which every caller is invited to complete a survey, or an intermittent survey at set points. An example patient survey is attached. This can be posted to patients but it is recommended that it is converted to an online version to send by email.