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Future of discharge medicines reviews secured in Wales

Practice Service shown to return £300,000 for every £100,000 invested and to have freed up resources worth £3 million, says CPW

Welsh pharmacies will be permanently contracted to deliver discharge medicines reviews (DMRs) after an evaluation showed the service was saving the NHS money.

The Home From Hospital service, which involves pharmacists providing medicine reviews to patients recently discharged from hospital, would be incorporated into the Welsh pharmacy contract after it was shown to return £300,000 for every £100,000 invested in it, Community Pharmacy Wales (CPW) reported yesterday (April 29).

The service also freed up resources worth £3 million, which helped reduce hospital admissions and drug wastage, according to an independent evaluation commissioned by CPW and carried out by the universities of Cardiff, Bradford and South Wales.

The government will look to build on the success of the DMR service, says Welsh health minister Mark Drakeford

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The reviews uncovered a medication error rate of 29 per cent, including some that were "potentially lethal", CPW said. More than a third of the DMRs carried out had the potential to reduce A&E visits, it said.

Last April the service was granted an extension until June despite pharmacists and GPs reporting teething problems getting discharge information from hospitals.

Welsh health minister Mark Drakeford said he was pleased the service would continue and looked to "build on its successes".

The Welsh government said it hoped to use £280,000 that the NHS Wales Informatics Service had secured from the government to support the DMR service by improving communication between community pharmacies and other parts of the NHS.

CPW chair Chris James said the success of the service was a "reflection of the hard work" of pharmacists.

"The results suggest that the service has been most successful where there is close co-operation between community pharmacies and hospitals. We look forward to working closely with these partners to develop key aspects of the service further now that its future is secured," he said.

The service has been funded from category M clawbacks since it was introduced in 2011, with up to £3.6m invested per year in 2011-12 and 2012-13. Pharmacies that initiated 10 DMR interventions in 2011-12 received an implementation payment of £1,400.

The two-part intervention service is designed to help improve the transfer of medicines information between secondary and primary care and improve medicines adherence. Consultations are carried out face-to-face or over the phone and relatives or carers can also hand over discharge letters to pharmacists on patients' behalf.

Do you think pharmacists in the rest of the UK should being contracted to provide discharge medicines reviews?
We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Harnek Chera, Community pharmacist

This needs tackling. It's never easy between the GP, Hospital and Pharmacy to have absolute clarity on what should been continued or stopped when patients are discharged, often leading to under/over prescribing and avoidable adverse effects.

Kevin Western, Community pharmacist

Well done on getting this service - it is amazing that one part of the NHS accepts this but another refuses to see the benefits. can we swap negotiators?

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