Discharge Medicines Review Service

Potted history of the Service April 2011: Health Minister agrees funding for new community pharmacy service in Wales November 2011: Discharge Medicines Review (DMR) service introduced in Wales February 2014: CPW commissioned service evaluation confirms strong patient benefit and NHS savings April 2014 – Health Minister announces DMR service is permanent service as part of Community pharmacist contractual agreement

Discharge Medicines Review Service - Early issues Introduction of the service exposed significant differences in procedure from different hospitals. Handwritten discharge Verbal information Confidential information

Evaluation “The continuation of the service... was dependent on the findings of the independent evaluation.... a high proportion of the interventions made by pharmacists... 39%, had the potential to prevent people needing to go to A&E departments “ “The report found a medication error rate of 28.7% (at the point of community reconciliation), some of which were serious and some even potentially lethal.“ “The service potentially saved NHS Wales £3million per annum”

Evaluation- Reduction in risk of Medication Errors Analysis of NECAF data ,649 DMRs accounted for 19,878 discrepancies Discrepancy rate was 1.3 per DMR; range % of discrepancies were for medicines either discontinued on 1 st prescription post- discharge or medicines which had stopped in one care setting and restarted after discharge Expert Panel review

Financial Potential savings to the NHS based on: – Avoided A&E attendance – Avoided hospital admissions – Avoided drug wastage = £3 million Potential benefit to each contractor = £5,180

Discharge Medicines Review Service Patient Stories Patients valued DMR as a safety improvement mechanism “I was down to take some of them (pills) twice. He sorted it out with the doctor for me” “You see I never got to see my doctor – he was on holiday – it was only a locum who didn’t know my history & I didn’t want to bother him” It must help the doctors too as the patients will make less mistakes and not take up appointment time”

ABUHBCVUHBHDHBBCUHBABMUHBPTHBCTHBWales Total DMR Feb DMR Feb Range Contractor s delivering service

Changes to DMR service – April 2015 Revisions to DMR paperwork Promotion of the DMR service for patients transferring to or between care homes Removal of need for written consent

Discharge Medicines Review Service Working in Partnership ‘Alone we can do so little, together we can do so much’ - Helen Keller ‘Coming together is a beginning. Keeping together is progress. Working together is success.’ –Henry Ford

Discharge Medicines Review Service Working in Partnership Emma Hinks – CTUHB Cwm Taf DMR.ppt

Discharge Medicines Review Service Working in Partnership Laurence James – Choose Pharmacy Project Choose Pharmacy.pptx

Contractor Top Tips Andy A Evans DMR top tips.ppt Ruth Maximising your DMR Potential.pptx

Discharge Medicines Review Service Workshop In your groups The reality of DMRs from both a hospital and community pharmacy perspective – Questions on each table Feedback

Discharge Medicines Review Service Next Steps There really is so much potential for this service Engagement with patients Engagement with tertiary care groups Engagement with secondary care Sharing what you have heard with others, become involved in the projects as they come to your locality, become an advocate and share DMR stories across sectors, share best practice with others What will you do?

Discharge Medicines Review Service Thankyou for listening