Medicines project delivers £11 million savings

A collaboration between hospitals and pharmacies in Cheshire and Merseyside has saved the NHS £11 million – and improved patient care.

Pharmacies in Cheshire and Merseyside are being notified by their local hospital when a patient is discharged who might need help understanding changes to their medicines following their stay.

The initiative, called Transfer of Care Around Medicines, is improving patient safety and quality of care by providing support for patients and their carers following a hospital discharge – and saved the NHS in Cheshire and Merseyside an estimated £11 million over the three years to summer 2019 through a reduction in hospital readmissions.

All 635 community pharmacies in Cheshire and Merseyside are participating, and this has been shown to help reduce the number of avoidable bed days in hospital in what is thought to be the most comprehensive rollout of the programme in the country.

Some patients leaving hospital need advice and support to help them take their medicines correctly and safely. Around 60 per cent of patients have three or more changes made to their medicines during their stay in hospital, and only 10 per cent of older patients are discharged with the same medication they were taking before they went into hospital.

In 2016 NHS England in Cheshire and Merseyside in partnership with the Innovation Agency, the Academic Health Science Network for the North West Coast, received funding to help introduce new systems enabling the transfer of care from hospitals to community pharmacies. A secure digital system allows a hospital’s pharmacy team, with the patient’s consent, to inform their local pharmacy of the patient’s medicines on discharge and the reasons for any changes so the pharmacist can follow up with advice and services.

As of May 2019, Transfer of Care Around Medicines in Cheshire and Merseyside has been implemented in 10 trusts, including 11 hospitals, two mental health trusts and all 635 community pharmacies – the fastest adoption and widest spread of the initiative in any region in England.

By March of this year there had been 17,686 referrals to community pharmacists resulting in an estimated reduction of 6,008 bed days to the NHS as well as improved patient safety and quality of care.

Una Harding, pharmacist at Day Lewis Pharmacy in Aintree, said: “We now get notifications on our system on a daily basis, it’s a platform we use every day. New discharges or referrals are the first thing you see when you log on. If we see a patient has recently been in hospital we can make a note to speak to them about their medication when they next come in.

“Patients now understand we can deliver more for them. There’s a culture now where people are realising that their GP doesn’t always have to be the first port of call. They know now that if they come into the pharmacy we can talk to them about the changes to their medication.

“It’s fabulous. Finally we’re getting more information so we can make more clinical decisions without having to hunt for information from different sources.”

Hassan Argomandkhah, Chair of Pharmacy Local Professional Network NHS England Cheshire and Merseyside, said: “This initiative started as an ambitious idea but we’ve managed to achieve it, and even if we’ve made just one small change in the quality of life of one patient in the past two years it’s been well worth it. None of this would have happened without the dedication of the pharmacists and their teams – whether in NHS England, in the community pharmacies, or in the hospital pharmacy teams – and all the other ancillary staff surrounding them. Without that support and encouragement we wouldn’t have achieved this.”

Dr Liz Mear, Chief Executive of the Innovation Agency, said: “The scale and speed of the adoption of Transfer of Care Around Medicines in Cheshire and Merseyside is an inspiring example of the region’s healthcare professionals collaborating to improve the quality of care for patients and the efficiency of our health services.

“The initiative demonstrates the value of community pharmacies as a key part of our healthcare infrastructure. Transfer of Care Around Medicines has been adopted by the AHSN Network nationally as one of our key innovation programmes and I hope that Cheshire and Merseyside will be an exemplar to other regions, supporting the spread of this invaluable collaboration.”

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