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Pharmacy referral model to be priority project for RPS Innovators Forum

Development of a referral system to improve medicines safety for patients being transferred between care sectors is the first project announced by the Innovators Forum. The aim is to support relationships between secondary and primary care to improve patient care.

The Innovators Forum was created by the Royal Pharmaceutical Society in response to last year’s “Now or never” report which the RPS commissioned to look at the future of pharmacy.

“We need to improve communication between secondary care and primary care,” said Rhian Holland, a formulary and medicines management pharmacist at University College London Hospitals NHS Trust, who will co-ordinate activity implementing the report’s recommendations.

As part of the search for an ideal referral system between secondary care and primary care, Holland is assessing a model, known as ‘Refer to pharmacy’, which is due to be launched in East Lancashire, where a hospital’s discharge system is directly linked to community pharmacies.

“When a patient is discharged from hospital they are referred to a named community pharmacy, which is usually their regular pharmacy or, if they do not have one, the patient is recommended to another local pharmacy.” The aim of this model is to encourage pharmacists to offer the new medicine service or a medicines use review following discharge from hospital, she said.

According to a research article published in 2013, UK researchers found that community pharmacists received post-discharge information rarely and mainly for patients where the hospital perceived the patient’s medication issues as ‘complex’ (International Journal of Clinical Pharmacy 2013;35:813). The researchers said: “These findings suggest that the potential of community pharmacists to improve patient safety after discharge from hospital is not being utilised.”

Although Holland describes the ‘Refer to pharmacy’ model as a “fantastic innovation”, she says the Innovators Forum wants to know about other similar projects to “ensure that we tease out the key elements of the system, overcome barriers and develop the most appropriate tools and resources to aid commissioning”.

“We need to hear about any innovations, projects, concepts around improving the transition of care between care sectors that you know about – whether it’s yours, a friend or a colleague.”

Rachel Urban, research and evaluation manager at Community Pharmacy West Yorkshire, who is working with Holland on the project, said that lack of communication to community pharmacy at discharge can lead to error and hinders continuity of medication supply. “There is need for consistent and timely communication of hospital discharge summaries to community pharmacies to improve seamless care.”

Asked if the Innovators Forum would like to see a national system in place should the project become a success, Holland said: “We need to be realistic that not every hospital will take up this scheme, but ultimately we would like it to be nationally adopted.”

The forum decided to focus on developing a model referral system because the project spans community, primary and secondary care. The forum also believes that other healthcare professionals and the wider NHS will “buy into it”, said Holland.

Pharmacists interested in sharing information about a relevant project with the Innovators Forum can send an overview and contact details to Holland by 6 June 2014 (email or via Twitter @RhiHoll).

The Innovators Forum has held two meetings to date (in February and April), with the next one due to be held on 2 July 2014.

Holland says that members of the forum are enthused about making innovative practice a vision for the profession, and helping to spread good practice across health and social care.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11138366

Readers' comments (1)

  • Please could the forum consider addressing uptodate access to patient's bloods. I am deeply concerned about oral chemotherapy being given out in community pharmacies without the pharmacist seeing the blood results. Would this be possible for the forum to address?

    There will be more and more pharmacies in the future giving out chemotherapy tablets such as Capecitabine as the hospitals buy into privatising the outpatient (and often the inpatient ward supply) pharmacy service. This will result in the patient not having to wait for their prescription and being able to collect it at their local community pharmacy. When a patient has numerous cycles it may become the case it goes directly to the community pharmacy. If I were a community pharmacist I would be much happier seeing the patients blood results for myself before handing out this type of prescription.

     Having access to patients bloods would be extremely useful for other non-chemo drugs, being aware of the patient's renal function or hepatic function would mean that the community pharmacist is not just checking the dose is correct,  but that it is correct for the patient as they are that day (or from their latest blood result).It would make the clinical check more comprehensive and then if the patient wanted to buy for example ibuprofen the pharmacist could check their renal function. This could possibly prevent more readmissions.

     If the community pharmacist had access to the patient's notes, it would be much easier if they could annotate for the hospital pharmacist a drug history?


    I think its a great idea on the whole Rhian.


    Emer Sheridan

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