Blog: Patsy Cotton shares an update on time critical medications

Patsy Cotton is a Parkinson's Specialist Nurse at the NHS Greater Manchester Neurosciences Centre where she and her team are well known for their award-winning Parkinson's care. She is also the Excellence Network Clinical Lead for Innovation.

A word from Patsy...

Hello everyone!

I’m Patsy, Chair of the Time Critical Parkinson’s Medication Steering Group. Alongside Mary Ellmers (Service Improvement Manager in Scotland), Callum Hughes (Service Improvement Advisor in Wales) and Jean Almond (Programme Manager - Time Critical Medications) and the members of the Steering Group, we’ve led a busy collaborative programme of work this year. Read on to hear what we’ve done so far and what's coming next.

Campaigning news

Let me begin by sharing the extraordinary campaigning efforts of Dr Jonny Acheson, Clare Addison and a group of fellow NHS professionals who live with Parkinson’s. In 2022, this group, with the support of the Parkinson's UK Campaigns team, approached chief executives at every NHS organisation to ask them to sign the Time Critical Parkinson’s medication (‘Get It On Time’) pledge. Since the campaign launched, over 100 chief executives of acute healthcare trusts, regional ambulances service leaders, chief nursing officers and other NHS executives across all 4 nations have pledged their support.

Keen to capitalise upon this amazing engagement, the professionals group worked collaboratively with the Excellence Network on the next phase of their campaign. On World Parkinson’s Day 2023, the chief nursing officers in England, Scotland, Wales and Northern Ireland, cascaded a letter which set out 10 recommendations for hospitals which will enable NHS staff to support timely, safe and appropriate medicines management for people with Parkinson's. An accompanying video produced by the professionals brought the recommendations to life.  

The letter encourages chief nurses across the UK to benchmark their hospitals against these 10 recommendations and feedback so that we can see where we can help. We will be closely monitoring this and working with hospitals to support the delivery of the 10 recommendations over the coming months. This endorsement by the chief nursing officers is incredibly powerful and has enabled us to speak directly to nurses in hospitals about the need for change.

Nurses webinar a success

Then on 19 April we continued this conversation with our nursing colleagues at a time critical medications webinar for nurses. Clare Addison, Lead Nurse for Adult Safeguarding at Surrey and Sussex Healthcare NHS Trust, and a key member of the Steering Group, worked with NHS England, subject matter experts, clinicians and patient representatives to co-design the webinar. Over 300 nurses joined the webinar to learn about time critical medications and how to improve practice in this area, with a particular focus on medication for Parkinson’s and diabetes.

Nurses are key to cracking time critical medications and the webinar was an incredible opportunity to empower them and showcase the tools which are available to deliver medications on time.

So, what else have we been up to this year? 

Scottish Ambulance Service collaboration

In Scotland the Parkinson’s UK team have been working closely with the Scottish Ambulance Service to improve care for patients with Parkinson’s. A wonderful fact sheet has been developed which explains what to do if a patient has Parkinson’s. The resource was launched this month and is being tested in Scotland. We look forward to receiving feedback from colleagues in the Scottish Ambulance Service and then hope to develop similar documents for England, Wales and Northern Ireland. 

Refreshed webpage for professionals

Another highlight has been launching an updated webpage for professionals dedicated to time critical medications. The page will act as a one stop shop for all of the information and resources professionals need and I am delighted to say that the feedback has been incredibly positive. View the webpage here.

2022 UK Parkinson’s Audit

Last but not least, like so many of you, my colleagues and I were eagerly awaiting the 2022 UK Parkinson’s Audit report in March. The audit provides a key measure for the time critical medication programme. It was no surprise to read that getting medication on time as an inpatient was a concern for many people with Parkinson’s who took part in the 2022 audit. Of the 21% of respondents who went to hospital, only 42% always got their medication on time. Unfortunately this has deteriorated since 2019, when the figure was 47%. That’s why we are working collaboratively to drive change and why we need your help to make it happen.

New guides for professionals coming soon

One of the key ways that we can make this change happen is by sharing the tools that health professionals need to deliver time critical medications on time, every time. This spring, work has progressed to develop 4 guides:

  1. A guide aimed specifically at NHS staff: The guide will be a hands-on resource highlighting the importance of time critical medication for people with Parkinson’s and signposting them to relevant Excellence Network materials that will support them to ensure medication is delivered on time.
  2. A guide aimed specifically at hospital pharmacists: Pharmacists are often underutilised in the hospital setting in relation to Parkinson’s care. This guide will support hospital-based pharmacists to make the right decisions, engage more effectively with appropriate clinical colleagues on this issue and ensure people with Parkinson’s get their medication on time.
  3. A swallowing guide aimed at senior charge nurses: This guide emphasises the key role that speech and language therapists play in assessing the swallowing ability of patients. It also outlines changes which nurses can implement in their ward area to help ensure swallowing problems are considered during each hospital admission.
  4. An ‘advocacy toolkit’ for people with Parkinson’s: We know that some people with Parkinson’s find it difficult to advocate for themselves when they go into hospital, particularly when they’re stressed and anxious about what will happen to them if they don’t get their medication on time. That’s why we’re working closely with our people with Parkinson’s group to develop this new resource which they can take into hospital when they’re admitted.

We think these new guides will make a real contribution to improving on the results from the 2022 audit. Keep an eye out for news on their release in the coming months.

That's it for my round up of the highlights from the time critical medication team so far this year. Mary, Callum, Jean and I are really pleased with what we’ve achieved so far. Despite the challenges faced by our colleagues in healthcare, there is a real sense of change and momentum on this important issue. But we can’t do this without your support! We want to make sure we’re bringing everyone on board. So if you have any thoughts, ideas or comments about how we can develop this work further, please get in touch. Email [email protected]

Wishing you well as we head into spring.

Best wishes,


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