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DH: Pharmacies to accept hospital referrals for medicine advice

PSNC: Pharmacies will be paid a fee for each completed referral
PSNC: Pharmacies will be paid a fee for each completed referral

From July, community pharmacies will be expected to offer advice on newly prescribed medicines to patients discharged from hospital, in a bid to reduce hospital readmissions.

Hospitals will be able to digitally refer patients to their pharmacy if they believe they need support with their newly prescribed medicines or changed prescriptions, the Department of Health and Social Care (DH) and the Pharmaceutical Services Negotiating Committee (PSNC) announced in an update to the five-year Community Pharmacy Contractual Framework (CPCF) yesterday (February 23).

The digital referral will be sent as a notification “to let the pharmacy team know that there is a patient they need to get in touch with and provide support to after being discharged”, the DH said.

Under the new NHS Discharge Medicines Service – which is being introduced as an essential service – pharmacies will be asked to complete a one-off consultation with the patient and/or carer, a PSNC spokesperson told C+D yesterday (February 23).

Service details

Hospitals will make referrals to pharmacies electronically, using IT systems such as PharmOutcomes, Refer to Pharmacy or NHSmail, the spokesperson added.

It is not yet clear how much pharmacies will be remunerated for providing the service, but they will “receive a fee” for every referral they complete. PSNC is negotiating the amount with the DH, along with the details of how the service will work, according to the spokesperson.

The number of referrals to individual pharmacies under this new service is expected to vary depending on their “patient cohort and the activity of local secondary care providers”, the negotiator said in a frequently asked questions (FAQs) document.

“There is still further work to be undertaken by the NHS to get all hospitals ready to send post-discharge information to community pharmacies”, the document also said. 

National rollout

Similar local schemes have been running in different parts of England since 2014, through the transfer of care around medicines programme.

These schemes showed that “patients who see their community pharmacist after they’ve been in hospital are less likely to be readmitted and, if they are, will experience a shorter stay”, the DH said.

The service will be rolled out nationally to help pharmacists advise their patients on the use of new medicines and identify their concerns as soon as possible, the DH added.

Health secretary Matt Hancock said: “I want all patients to get the right care close to home, and to avoid any unnecessary visits to hospital. To help do that I’ve begun the Pharmacy First programme, asking pharmacies to do more to support people in the community, as they do in other countries like France.”

Services: a “challenge”

In addition to the NHS Discharge Medicines Service, a number of new services will be rolled out this year as part of the CPCF, PSNC said.

These include extensions to the Community Pharmacist Consultation Service (CPCS) – under which GP practices will refer patients to community pharmacy and launching referrals for urgent medicine supply from NHS 111 online.

The new services also comprise a hepatitis C testing service and, depending on negotiations with NHS England, four NHS travel vaccines that are currently provided by some GP practices. These are: polio, typhoid, hepatitis A and cholera.

“This year will be a crucial one for our sector. It will be a significant challenge to deliver all that Government wants from community pharmacy within a flat funding envelope,” PSNC CEO Simon Dukes said.

PSNC will work closely with other pharmacy bodies to seek additional investment for the sector, he added.

13 Comments
Question: 
What do you make of the new NHS Discharge Medicines Service?

A LOCUM, Community pharmacist

Is this not the job of the 'clinical', 'i'm exceptionally well qualified' HOSPITAL PHARMACIST ?

Benie I, Locum pharmacist

I wonder if the pharmacist will receive any remuneration or if the pharmacy/contractor keeps it all ?

Leon The Apothecary, Student

I think direct pharmacist remuneration would solve a lot of issues surrounding contractor pushing services for the sake of KPIs.

Joan Richardson, Locum pharmacist

What would be really useful would be a discharge notice for the patients using a dosette box - there have been many times when there have been medication changes but the pharmacy has not been informed and has continued to supply the previous medication.  We are not psychic!  Maybe this scheme will indirectly solve the problem

Gillian Draycott, Pharmacy technician

Our hospital trust not only calls the patients pharmacy notifying them of any dosette changes but sends a copy of the discharge summary. I guess it depends on the hospital concerned. Please don't assume all hospitals have no regard for patient safety and care. 

Farmer Cyst, Community pharmacist

Joan, this is covered by the TCAMs system being introduced in some areas (through PharmOutcomes or similar).

Joan Richardson, Locum pharmacist

There was a local system when I worked in Walsall and information was sent to the pharmacy on discharge of a patient with a dosette box but nothing in place where I am now.  One surgery told us that we could not see a copy of the discharge information as it was confidential.

Benie I, Locum pharmacist

Sounds like more work, same or less money. A very attractive proposition. 

chris langtry-lynas, Community pharmacist

The PSNC will craftily'negotiate' a piss poor fee because when we prove our worth  the DH will pay us more next time. Hmmmm have we been here before?

Peed Off Superintendent, Superintendent Pharmacist

DH says......'Pharmacies to accept'......'will be expected to'.....no negotiation there then...so PSNC why bother begging for a decent fee when we are expected to do another service for a pittance or for free.

A Hussain, Senior Management

I look forward to seeing my local surgery referring directly into their own pharmacy.

Kevin Western, Community pharmacist

I think you will find, for many hospitals, the reluctance to  trust Pharmacy will be a bigger stumbling block, and the process for surgeries will be too onerous, they will simply verbally send patients to their local p'cy with no referral and remuneration involved.

Leon The Apothecary, Student

I anticipate three major points of discussion:

1) Remuneration
2) Administration 
3) Time Management

Job of the week

Pharmacist / Manager
Doncaster, South Yorkshire
To be negotiated + benefits