Discharge Medicines Service to become Essential Service in February
The NHS Discharge Medicines Service (DMS) will become a new essential service for pharmacy contractors in England from 15 February 2021.
Regulations guidance has been published to support pharmacy contractors in providing the service. The DMS is covered in chapter 8 and recommends that all pharmacists and pharmacy technicians delivering the service complete the CPPE’s NHS Discharge Medicines Service training course.
Pharmacists and pharmacy technicians providing the DMS must also demonstrate that they have the necessary knowledge and skills by completing the NHS DMS Declaration of Competence. An SOP for provision of the NHS DMS must also be in place.
NHS trusts will determine when a patient needs the DMS and will then instigate a referral. This may be when a patient is discharged from hospital or when they are being transferred to another provider of NHS services. The DMS has three stages and the first stage must be actioned within 72 hours of a referral.
For each NHS DMS provision, contractors will be required to report a standard dataset through the NHSBSA MYS portal. Pharmacy contractors will be required to submit data monthly for payment, service evaluation and monitoring purposes.
A cross-sector DMS Toolkit will be published in January 2021 to support pharmacy teams across primary and secondary care to provide the service. It will set out the shared responsibility and roles of community pharmacies, NHS trusts and primary care networks.
The DMS aims to ensure better communication of changes to a patient’s medication when they leave hospital. An audit of NHS hospital discharges showed that 79 per cent of patients were prescribed at least one new medication after being discharged from hospital.
Research by the National Institute for Health Research (NIHR) shows that people over 65 are less likely to be readmitted to hospital if they’re given help with their medication after discharge.
Previous local schemes around the country have demonstrated that patients who see their community pharmacist after they’ve been in hospital are less likely to be readmitted and will experience a shorter stay if they are.
NICE Guideline NG5 on medicines optimisation recommends:
- Medicines-related communication systems should be in place when patients move from one care setting to another
- Medicines reconciliation processes should be in place for all persons discharged from a hospital or another care setting back into primary care and the act of reconciling the medicines should happen within a week of the patient being discharged.
The new service, part of the 5-year Community Pharmacy Contract agreement, was originally announced in February with a July start date. This was pushed back due to Covid-19 pressures and delays in the publication of the NHSE&I regulations and guidance, first to 1 January and then 15 February 2021.