Pharmacy staff providing the essential service must “have the necessary knowledge and competence to undertake it safely” and sign a declaration of competence ahead of its start next month, the Pharmaceutical Services Negotiating Committee (PSNC) said when the toolkit for the service was published on Friday (January 15).

Contractors are also reminded to have a standard operating procedure in place and to find out which hospital trusts in the area are already making referrals to community pharmacies following patients’ discharge, PSNC added in its checklist for pharmacy owners.

NHS England and NHS Improvement (NHSE&I) said its toolkit “sets out the shared responsibility and roles of pharmacy teams in community pharmacy, NHS trusts and primary care networks in ensuring patient safety, better patient outcomes and medicines reconciliation on discharge”.

Service details and funding

The Discharge Medicines Service (DMS) – first mentioned as part of the five-year pharmacy contract in England announced in 2019 – will see hospitals digitally refer patients to community pharmacies for advice on newly prescribed medicines or changed prescriptions.

It was initially due to launch in July 2020, but was delayed due to the pandemic.

From February 15, a referral may be made to a community pharmacy, at which point, contractors are expected to complete a three-staged process: undertake a clinical review within 72 hours of receipt of the referral; check and resolve (if necessary) the first prescription issued on discharge; and check the patient’s understanding of their medicines regimen, either in the pharmacy or remotely, via telephone or video consultation.

Pharmacies will automatically receive a £400 setup fee in the April payment and will be paid £35 for each full DMS completed and claimed for each month, PSNC outlined.

Partial payments of £12, £11 and £12 for each stage respectively will be made if only part of the service is completed, the negotiator added.  

NHSE&I stressed in its toolkit that as an essential service, “community pharmacy contractors cannot choose whether they provide the service”.

“However, where a referral is received for a patient who has not accessed services at the pharmacy before, the pharmacist or pharmacy technician may wish to contact the patient directly to ensure they intended for the referral to be sent to that pharmacy,” it added.

“By referring patients to the community pharmacy with good information about changes made to medicines in hospital, community pharmacy contractors can work effectively with their pharmacy colleagues in general practice to support patients on discharge to improve outcomes, prevent harm and reduce readmissions,” NHSE&I said.

“Community pharmacist[s] may also be able to provide further support via other commissioned services, such as the New Medicines Service, where this would be clinically appropriate and where the patient meets the eligibility criteria,” it added.