Discharge Medicines Service

Introduction to the Service

The Discharge Medicines Service (DMS) will be added to the Community Pharmacy Contractual Framework (CPCF) from 1st January 2021. This new Essential service, which all pharmacy contractors will have to provide, was originally trailed in the 5-year CPCF agreement, with a formal announcement regarding the service made by the Secretary of State for Health and Social Care in February 2020.

From January 2021, hospitals will be able to refer patients who would benefit from extra guidance around new prescribed medicines for provision of the DMS at their community pharmacy.

Service Details

On 20th October 2020 new NHS regulations were laid to introduce changes to the Terms of Service for pharmacy contractors and these included the contractual requirements for the DMS. Further information and guidance on the service will be published by NHS England and NHS Improvement (NHSE&I) in guidance on the regulations and a DMS Toolkit. It is expected that these documents will be published in November 2020.

Patients will be digitally referred to their pharmacy after discharge from hospital, using IT systems such as PharmOutcomes and Refer to Pharmacy or NHSmail. Using the information in the referral, pharmacists will be able to compare the patient’s medicines at discharge to those they were taking before admission to hospital. A check will also be made when the first new prescription for the patient is issued in primary care and a conversation with the patient and/or their carer will help to ensure that they understand which medicines the patient should now be using.

More information is available here

New Medicines Discharge Service – to be launched on 15th February  2020

This service builds on the work that the Academic Health Science Networks (AHSN) have undertaken with LPCs and pharmacy contractors over recent years, as part of the Transfer of Care Around Medicines (TCAM) programme.

The Greater Manchester  TCAM programme information led by Health Innovation Manchester has been rolled out to a number of trusts. Further information training and supporting resources are available here

We would encourage all contractors to ensure that they have;

  • completed the short 15 minute training session
  • read the supporting documents
  • ensure pharmacy teams are aware of the service.
  • Action any referrals completed on Pharmoutcomes.

Within this programme, the AHSNs have worked with NHS hospitals to put in place processes and IT infrastructure to allow hospital clinicians to identify patients admitted to hospital that might benefit from being referred to their community pharmacy at discharge. Around half of English hospitals have already participated in the programme and consequently many community pharmacies are already receiving information on their patients’ medicines regimen at discharge from hospital.

What do you need to do to prepare for the Launch of the New Medicines Discharge Advanced  Service?

Contractors need to undertake the following actions in preparation for the start of the service which is launching on 15th February 2021:

  • Read the NHSE&I regulations guidance and the NHSE&I DMS toolkit, so that you understand the service requirements;
  • Ensure any pharmacists or pharmacy technicians (including locums) that will be undertaking the service also read both those documents. Encourage them to also undertake the CPPE DMS e-learning and assessment;
  • Find out which Trusts in your area are already making referrals to community pharmacies following patients’ discharge and which will be starting this in due course. Your LPC or regional NHSE&I team will be able to provide this information to you. If it is likely that referrals will not start to be received soon after the service commences, contractors may need to refresh the knowledge of staff regarding the service once referrals do commence;
  • Consider the practicalities of providing the service, including the conversation with the patient and /or their carer in stage 3 and how you will be able to undertake that remotely, where the patient cannot visit the pharmacy. Also think about your referral networks to general practices and how clinical pharmacists within your Primary Care Network may be able to assist with issues you have identified with a patient’s medicines regimen;
  • Develop a Standard Operating Procedure (SOP) for the service. Make sure this includes the process by which referrals from Trusts will be received, how staff can access these referrals and the regularity of checking for new referrals;
  • Ensure all staff that will undertake parts of the service are briefed on the service and their role, and they are familiar with relevant sections of the SOP;
  • Once pharmacists and pharmacy technicians have undertaken the activity in point 2 and they are confident that they fully understand the service requirements and how it will operate in the pharmacy, they should complete the DMS Declaration of Competence and provide a copy of the completed document to the contractor.

Further information is available here

Toolkit and E-Learning Modules

NHSE&I have today (15th January 2021), published the NHS Discharge Medicines Service (DMS) Toolkit, which aims to assist and support cross-sector implementation of the DMS as an Essential service in all NHS community pharmacies in England from 15th February.

Further information can be found here, including a checklist to help with guidance on required actions.

The NHS MDS E-learning and assessment modules are also now live on the CPPE website. Access the modules here.

CPPE – Learning programmes and assessments

NHS Discharge Medicines Service: improving outcomes for patients transferring care – Click here