DMS: Frequently Asked Questions (3)
DMS: Frequently Asked Questions (3)
February 21, 2021
The Discharge Medicines Service (DMS) commenced as a new Essential service which all pharmacies must provide earlier this month (15th February 2021).
Pharmacy contractors and their teams will find information on the service and links to guidance and resources to help them provide the service on our DMS webpage.
You will also find answers to frequently asked questions on the service on the DMS FAQs webpage and a selection of the questions posed to PSNC over the last few weeks are included below.
Q. Who should I contact at the referring Trust if I have questions about the referral?
The referral message should include contact details for the referring clinician or hospital department, which you can use where you have a query.
Q. What should I do if the first post-discharge prescription does not reflect the regimen at discharge, e.g. new medicines initiated in hospital have not been included?
In this circumstance, you should contact the patient’s general practice or the clinical pharmacy team within the Primary Care Network to highlight the discrepancy. Items may be missing from the new prescription for several reasons, including because the patient’s general practice record has not yet been updated following their discharge from hospital, or alternatively the patient’s medication may have been changed since discharge. A discussion with the general practice or clinical pharmacist can ensure the correct regimen is identified and then you can make sure the patient is also clear about the medicines they should be using.
Q. How can I identify the first post-discharge prescription for patients for whom a DMS referral has been received?
The patient’s PMR should be annotated with a note about the DMS referral, so that this is visible when viewing the patient’s record or dispensing prescriptions for them. PMR systems all have the ability to add alerts to patient records to allow for this.
Q. Can I undertake stage 3 of the DMS with another person, rather than the patient?
Stage 3 of the service should ideally be undertaken with the patient, but if they would like a carer involved in the consultation, that is also acceptable. If the patient is not able to participate in the discussion, it can just take place with the patient’s carer.
Q. What is the purpose of reporting on whether the hospital referral contained the minimum dataset?
DMS referrals from Trusts should contain the following information, as a minimum:
- The demographic and contact details of the person and their registered general practice (including their NHS number and their hospital Medical Record Number);
- The medicines being used by the patient at discharge (including prescribed, over‑the‑counter and specialist medicines, as there may be medicines interactions), including the name, strength, form, dose, timing, frequency and planned duration of treatment for all and the reason for prescribing;
- How the medicines are taken and what they are being taken for;
- Changes to medicines, including medicines started or stopped, or dosage changes, and reason for the change; and
- Contact details for the referring clinician or hospital department, to use where the pharmacy has a query.
Ideally, the referral should also contain the hospital’s Organisation Data Service (ODS) code.
Where this information is not provided in the referral, it may be necessary to contact the Trust to obtain any missing information which is essential to the provision of the service. The missing information should also be noted in the summary information which is reported to the NHSBSA as part of the contractor’s claim via the MYS portal. This reporting will provide data to help the NHS to address any frequent missing referral data issues at Trusts.
Q. Do the three stages of the service have to be provided in strict order?
No. The three stages of the service could occur in parallel, depending on the timing of the referral being received by the pharmacy and the patient’s individual circumstances. Normally stage 3 (the patient consultation) will occur when the first post-discharge prescription is received – this is usually one week to one month post-discharge, dependent on the quantity of medicines supplied by the hospital at discharge. However, if the patient contacts the pharmacy in advance of the first post-discharge prescription being received, it may be deemed appropriate to provide stage 3 at that time. In that circumstance, there may be a need for a further discussion with the patient when the first prescription is received if issues are spotted on that prescription, which need to be clarified with or communicated to the patient.
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