Dear Members,

The discharge medicines service (DMS) becomes an essential service as part of the Community Pharmacy Contractual Framework from 15^th February 2021. 

NHS Trusts will be able to refer patients who would benefit from extra guidance around new prescribed medicines for provision of the DMS at their community pharmacy.

What you need to do:

1. Read the section on DMS within the NHSE&I guidance on the regulations; and
2. Read the DMS toolkit
3. Recommended to complete - CPPE NHS Discharge Medicines Service eLearning and assessment. 
4. DMS Declaration of Competence must be completed – Keep a copy of this in the pharmacy for each pharmacist / technician 
5. DMS briefing for pharmacy teams
6. Download the PharmaPlus SOP attached 
7. NHS Trusts will identify patients who will benefit from the DMS and, subject to the patient consenting to a referral, they will send a referral to the pharmacy via a secure electronic system, e.g. Refer to Pharmacy, PharmOutcomes or NHSmail
8. 3 stages to the service (see full guidance for further details):
   1. Stage 1: A discharge referral is received by the pharmacy – check for this and action within 72 hours
   2. Stage 2: First prescription received by the pharmacy – cross check with this the discharge referral 
   3. Stage 3: Check patients understanding of their medicines – offer other appropriate services at this stage e.g. new medicines service, disposal of unwanted medicines, etc.

Funding

• A set up fee of £400 – to cover the costs of preparing to provide the service including training and putting in place a SOP – THIS WILL BE PAID AUTOMATICALLY
• Full service fee is £35 
• Where only part of the service can be provided only a partial payment will be made (see below 
• for stages):
  • Stage 1: £12
  • Stage 2: £11
  • Stage 3: £12 
• Claims to be made monthly via MYS for completed DMS provisions
• Summary data on each DMS provided to support the evaluation of the impact of the service, contract monitoring and post-payment verification.

Stages of the Service:

• Stage 1: The community pharmacy receives a discharge referral.
  • A clinical review is undertaken by a community pharmacist following receipt of a patient referral. 
  • The community pharmacy team may contact the referring NHS trust contact or the PCN pharmacy team to discuss any concerns (eg an important medicine the patient usually takes is omitted on the discharge referral) and to seek clarification about the discharge referral. 
• Stage 2: The community pharmacy receives the first prescription following discharge. 
  • The pharmacist or pharmacy technician will ensure medicines prescribed post-discharge take account of the appropriate changes made during the hospital admission. 
  • If there are discrepancies, the pharmacy team will try to resolve them with the general practice, utilising existing communication channels. 
  • Alternatively, the community pharmacist may refer the patient to the PCN pharmacy team for a Structured Medication Review or other intervention. 
• Stage 3: The community pharmacy checks the patient’s understanding of their medicines regimen. 
  • The pharmacist or pharmacy technician will hold a discussion, adopting a shared decision-making approach, with the patient (or the carer if appropriate) to check their understanding of their post-discharge medicines’ regimen. 
  • The pharmacist or pharmacy technician will identify any adherence, clinical issues, outstanding questions or needs the patient may have regarding their medicines.