Discharge Medicines Service
Discharge Medicines 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.
Background to the service
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.
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.
The need and evidence base for the service
A recent audit of NHS hospital discharges showed that 79% of patients were prescribed at least one new medication after being discharged from hospital. New prescriptions can sometimes cause side effects, or interact with existing treatments, potentially leading to readmission.
Research by the National Institute for Health Research (NIHR) shows that people over 65 are less likely to be readmitted to hospital if they’re given help with their medication after discharge. Research on local schemes implemented around the country has also demonstrated that patients who see their community pharmacist after they’ve been in hospital are less likely to be readmitted and will experience a shorter stay if they are.
The new service will also help meet the World Health Organization’s (WHO) goal to reduce severe avoidable harm from medicines by 50% by 2022.
The detail on the service
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.
There will be specific funding related to provision of the service, but the detail of this has not yet been published.