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Medicines reconciliation

Hospitals failing to pass on information about patients’ new drugs on discharge

An inquiry by Healthwatch England raises concerns about what happens when vulnerable patients are discharged from hospital.

A third of hospital trusts admit that they fail to pass on information about new medicines to GPs or carers when patients are discharged, according to an inquiry. In the image, an elderly patient is being discharged from hospital by a doctor

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Healthwatch England undertook an inquiry into what happens when vulnerable patients, including older people, leave hospital or care settings and are discharged back into the community

A third of hospital trusts admit that they fail to pass on information about new medicines to GPs or carers when patients are discharged, according to an inquiry[1] by Healthwatch England.

The organisation, which describes itself as the national consumer champion in health and care, also found that a third of the 102 hospital trusts it questioned in England failed to make a proper record of new drugs prescribed to patients during their hospital stay.

The findings follow its year-long inquiry into what happens when vulnerable patients — older people, people who are homeless or people with mental health issues — leave hospital or care settings and are discharged back into the community. There were 3,000 pieces of evidence given to the inquiry.

Between 2012 and 2013, one million patients in England were readmitted to hospital within 30 days of being discharged, costing the NHS £2.4bn, the inquiry report says.

The report, entitled ‘Safely home: what happens when people leave hospital and care settings’, also highlights the challenges around medication and discharge from hospital.

It says that there was less than a 10% chance that someone admitted to hospital would be discharged with the same medicines they came in with. Around 60% of older people taking three or more medicines would have their medicines changed during their hospital stay and approximately 20% of patients suffered an adverse drug event after they were discharged, the report says.

“We know this is a big issue and there is no shortage of guidance and good practice identifying solutions,” says Anne Bradley, chair of Healthwatch England, in the report’s foreword. “Yet, in practice, too few hospitals make full use of the available knowledge and experience to ensure people have the basic support they need when they leave.”

Bradley adds that a “system-wide commitment” is needed to change people’s experiences of being transferred between care settings.

Heidi Wright, Royal Pharmaceutical Society (RPS) practice and policy lead for England, says disjointed communication between health professionals in different care settings means the transfer of medicines information is not as straightforward as it should be.

“Pharmacists are often at the sharp end, picking up the pieces and sorting out the medicines for patients,” she says. “There’s a real appetite for change though.”

Since RPS guidance about the safe transfer of medicines information when patients are discharged from hospital was produced in 2012, more than 30 organisations have taken part in a pilot to change practice at a local level, says Wright. The RPS has developed a toolkit to support hospital pharmacists in transferring medicines information to colleagues in community pharmacy.

“There’s a growing awareness that getting the medicines right for patients has huge benefits, not just for their health but in terms of cost benefits to the NHS because of reduced readmissions to hospital,” she adds.

The Healthwatch inquiry report has been released ahead of guidance from the National Institute for Health and Care Excellence about the transition between inpatient hospital settings and community or care home settings for adults with social care needs.

Draft guidance is out for consultation until 6 August 2015, with final guidance due to be published in November 2015.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20069032

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  • A third of hospital trusts admit that they fail to pass on information about new medicines to GPs or carers when patients are discharged, according to an inquiry. In the image, an elderly patient is being discharged from hospital by a doctor

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