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DMS goes live with ‘developing’ IT and ‘gradual’ referrals expected

PSNC: DMS can be carried out without IT support
PSNC: DMS can be carried out without IT support

The Discharge Medicines Service (DMS) has gone live as an essential service, but not all pharmacy IT systems allow teams to record DMS information just yet, PSNC has confirmed.

While all contractors are required to offer the DMS from today (February 15), some IT system suppliers are still developing a “functionality within their systems to support the provision” of the service, according to a Pharmaceutical Services Negotiating Committee (PSNC) update published today.

NHS England and NHS Improvement (NHSE&I) and NHS Digital are supporting the IT systems to ensure pharmacies can “transfer necessary data to the NHS Business Service Authority’s Manage Your Service (MYS) portal”, PSNC added.

A PSNC spokesperson told C+D today that it is aware that PharmOutcomes is still sorting its DMS features but added that the service can be completed without IT support.

Contractors can download and manually fill in a DMS worksheet where they cannot use their IT systems, PSNC added.

C+D approached PharmOutcomes for comment and was redirected to NHSE&I.

NHSE&I had not responded by the time of publication.

Number of referrals will vary

In a frequently asked questions page on its website, PSNC said that while the DMS launches today, “not all hospitals are yet ready to make referrals to the service, so some pharmacies will not start to receive referrals on a regular basis until local trusts have engaged with the service”.

The number of referrals pharmacies receive will “vary from pharmacy to pharmacy” and while PSNC said it cannot accurately estimate how many DMS referrals an average pharmacy will receive, its “best estimate is around 12 referrals per year”.

First mentioned as part of the five-year pharmacy contract in England announced in 2019, DMS will see hospitals digitally refer patients to community pharmacies for advice on newly prescribed medicines or changed prescriptions.

Under the service, pharmacies will be paid £35 for each full DMS completed and claimed for each month.

9 Comments
Question: 
Have you received any DMS referral yet?

Getting Shorter, Community pharmacist

To all the negative comments regarding this service overall... it's actaully pretty good, if you can only get that consent. You don't have to bother the patient at all in general for the first part, and surgeries have been really receptive to having their errors pointed out via the discharge summaries (wonders never cease???!).

 

But there have been rumours of issues (resolved? I'm not in a large multiple) around targets... there are reasons I don't work in a large multiple ;)

TC PA, Community pharmacist

Receipt of a referral from the hospital for a patient who regularly uses the pharmacy acts as implied consent according to PSNC. The patient would have agreed to the service and hopefully had it explained to them. That's the theory anyway. 

How High?, Community pharmacist

Just another target to get battered with by area managers and head offices.

"You've got 22,000 patients so statistically you should have 5 DMS per week and yet you've only done one. Please explain why this is the case and how you will make up this shortfall next week and get back on track."

Benie Locum, Locum pharmacist

Targets ? No way ! You must be mistaken.

Getting Shorter, Community pharmacist

We've had this in Wales for some time... hopefully, the English system will have avoided the biggest barrier we have here: the service can only be provided when  you have the written consent of the patient. And guess how many people just discharged from hospital are popping in with their own discharge letters...

So you end up doing the first review on the service anyway (as although you don't have the patient's permission to do it, I wouldn't like to stand in court/at the inquest and say "yes, we could see the surgery had written the wrong script, but we couldn't say anything as we didn't have a signature, so we had to let them die.") but not getting paid for it.

 

Why the consent to enter the service couldn't be officially given at the hospital while the patient is there in front of them, I have no clue. Even sillier with the electronic discharge notices, as the patient has to say where they would like them sent. 

Edward H Rowan, Locum pharmacist

We'll probably be expected by the patient to adjudicate between GP prescriptions and what's been told to them by hospital staff. We'll just be another opinion sent to confuse them. And no-one will know what we're talking about when we tell them at the GP's or the hospital when we say we're dealing with a DMS referral, cos they don't know what we're talking about now when we ring them about a CPCS. Hopefully it will develop slowly so we can get used to it gradually.

Correct, this is the monolith that is the poor communication between primary and secondary care lancing Community pharmacy for a scapegoat mechanism. Sad that hoping it develops slowly is probably the best outlook to take (short of committing to jumping ship), not even a cursory mention that this would be done much better with new sophisticated software (as opposed to an add on module somewhere) - I imagine this doesn't even register as a strategic change planning thought in the places where this tripe was cooked up.

This will not be an effective service and even with an IT solution (why isn't it developed already to be live at launch) it'll be an administrative challenge to deliver day to day.

Leon The Apothecary, Student

Healthcare provision is more and more about administration these days.

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