Community pharmacy will transform post-hospital care in 2021

One of the biggest loopholes in the NHS is discharge from hospital; too many patients go out with a plastic bag full of medicine, but have no idea what they are taking or what warning signs they need to watch out for before leaving.

The latest survey on hospitalized patients from the Care Quality Commission, published in July 2020, shows a “sustained decline” in the quality of care at discharge around medication. Some 10% of those surveyed said that a staff member did not explain the purpose of the drugs in a way they could understand, which is a significant increase of one percentage point from 2018.

When asked if they had received clear written or printed information about their medications, 65% of patients responded, “Yes, completely,” which represents a decrease of six percentage points from 2017. The results are most effective. more negatives were observed for “Does a staff member tell you about side effects of medications to watch out for when you get home?” “; almost half of the patients (44%) said “no”.

These numbers date back to 2019, but were likely to be even worse in 2020 during the COVID-19 pandemic, as many patients were quickly released to free capacity in the early stages. A recent HealthWatch survey of nearly 600 patients and caregivers found this process to have been chaotic, with patients being released without or enough medication, and “little or no information” on how it should be administered.

Of course, it was during a health emergency, but even before the pandemic emergency hospital admissions in England were on the rise. And this lack of drug information – or perhaps the withholding of that information by patients – could be a contributing factor in what is often a painful and expensive return to hospital.

Fortunately, there is a solution: and it comes in the form of the community pharmacist.

Research clearly shows that patients who are followed by community pharmacists after discharge from hospital are less likely to be readmitted within 30 days. A recent research article in Pharmaceutical journal shows that when they receive details of discharge medications, community pharmacists are able to offer education and information, and address patient concerns about medications, which is likely to contribute to better optimization and adherence to medications.

And from February 2021, a new essential service will be launched in all community pharmacies in England that could prove transformative. The Discharge Medicines Service in England will build on the success of the Medication Transfer of Care Service (TCAM), where many hospitals digitally transfer outgoing medicine information to community pharmacies.

It will be a contractual obligation for pharmacies to support patients referred to them digitally by hospitals after discharge. Using the information in the referral, their community pharmacy will receive a small fee to check the patient’s medications on discharge and compare them with the medications they were taking previously.

After that, community pharmacists will have a conversation with the patient and / or their caregiver to ensure they understand any changes to their medications and raise any issues identified with the NHS Trust or the patient’s general practice, depending on the case. They will also ensure that all old medications are disposed of properly and that any remaining repeat prescriptions in the system are up to date.

The potential of this new service is immense. It utilizes the unique pharmaceutical expertise of community pharmacists at a critical time for the patient, improving patient safety and outcomes. Depending on the number of referrals from the NHS trusts, this is also likely to have a profoundly positive effect on the pressure on the rest of the health service. Indeed, it is estimated that the TCAM service may have already saved the healthcare economy more than £ 50million, by reducing the number of hospital readmissions.

There may be a lot of gloom surrounding community pharmacy in England right now, but it’s a bit of light for 2021.

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