1. NMS / MUR referral from Hull and East Yorkshire Hospitals at discharge
Transfer of Care
##th Feb 2016

2. National Strategic Direction
NHS 5 year plan
RPS hospital pharmacy standards
NICE guidelines
1/3 patients are non-adherent after 10 days
Improving patient outcomes
Medicines Optimisation

3. Local Background 97% of pharmacies offer MUR service
88% of pharmacies offer NMS
NMS uptake particularly low
Significant number of eligible treatments for NMS are started in hospital
Hull and East Yorkshire Hosptials want to work with community pharmacy to improve adherence on discharge

4. PharmOutcomes (Pinnacle)
Simple web-based application (1 minute!)
Secure method of data transfer
No cost to hospitals as licence owned by LPC
Already used by community pharmacies in the Community Pharmacy Humber area
Cardiology will start making referrals in February 2016

5. RiO Scoring
A scale used to determine the likelihood of readmission prevention based on the RiO healthcare management system
RiO 1 – no likelihood of re-admission e.g. compliance device to aid administration
RiO 2 – possible re-admission e.g. correct administration of inhalers
RiO 3 – likely readmission e.g. insulin dose changed to prevent ‘hypos’

6. Outcome Measures In other areas 93% were scored as RiO1
e.g. Patient had stop taking metformin due to side-effects until intervention
Other interventions made include lifestyle advice, smoking cessation service, medicine supply problems

7. - 7% were scored as RiO2
Child missing doses of a ‘special’, new supply process instigated
Newly diagnosed diabetic having frequent ‘hypos’ given dietary advice
Seretide inhaler being used once a day, also poor inhaler technique
New warfarin patient , had started missing doses, risk / benefits re-explained, also advice on OTC medicines
Patient forgetting to use inhalers, also poor inhaler technique

8. Questions?