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New contract to see pharmacists giving post-discharge medicines advice

By Isabel Shaw

23 Feb 2020

Community pharmacists will be expected to support patients with medication when they are discharged from hospital, as part of a new digital referral service announced under the new pharmacy contract.

This essential service, called the discharge medicines service (DMS), will come into force in July. It was announced yesterday (23 February) as part of a raft of changes to the community pharmacy contractual framework.

These changes include a new hepatitis C testing service, a short-term increase in transitional payments, an extension to the phasing out of establishment payments, and the introduction of referrals from GP practices and NHS 111 online into the community pharmacist consultation service.

Under the discharge scheme, when a patient is released from hospital with new medications, the hospital will send a notification – or digital referral – to the patient’s local pharmacy to inform them of the discharge.

A pharmacist will then have to contact the patient to provide information and advice about their new medication and any changes to their prescriptions.

There will be a fee attached to providing the compulsory service, but a PSNC briefing released alongside details of the contract changes stated that the fee is ‘still to be negotiated’.

The scheme forms part of Health Secretary Matt Hancock’s Pharmacy First campaign. Specifically, it is aimed at supporting people to better understand their medication, reducing the likelihood of side effects or complications, and helping to avoid hospital readmissions.

Mr Hancock said: ‘I want all patients to get the right care close to home, and to avoid any unnecessary visits to hospital.

‘These new services will help strengthen what community pharmacists can do, helping interrelation with general practice and hospitals, and help them deliver safer, more efficient patient care right across the NHS.

‘This new contract bolsters the enhanced role highly-skilled pharmacists are playing in preventing ill health and helping us to stay well in our communities.’

According to the Department for Health and Social Care, 79% of patients have at least one new medication on discharge from hospital.

Often, patients are unsure about what to take when or confused about changes to their prescription. In addition, new drugs could be contraindicated or cause unexpected side effects.

Readmission as a result is a particular risk for the over-65s.

But recent research by the National Institute for Health Research (NIHR) found that this patient cohort is less likely to need to go back into hospital if they get help with medicines when they are first discharged.

Simon Dukes, CEO of the Pharmaceutical Services Negotiating Committee, said: ‘We know that lots of people get confused by changes made to their medicines while in hospital and this new NHS Discharge Medicines Service from community pharmacies will help people to understand which medicines they should be taking and why.

‘Pharmacists will also be able to offer people advice on how to get the most benefit from their medicines.

‘The service is a welcome development – people will be able to get advice about medicines close to their homes, reducing the likelihood of them being readmitted to hospital at a later date, thus saving the NHS millions of pounds each year. The service also links community pharmacies into the care of patients at a stressful time in their lives.’

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