FOI220300: NHS Discharge Medicine Service (DMS) – patient eligibility criteria

Released 16 August 2022

Request:

Under the freedom of information act 2000, I am requesting the following information on the NHS discharge medicine service (DMS), which became a nationally commissioned service on 15 February 2021.

1. When did your trust begin referring patients through the NHS DMS?
2. How many patients has your trust referred to community pharmacies through the DMS between 15 February 2021 and 14 July 2022?
   • a. How many patients has your trust discharged in total within this timeframe?
3. According to national guidance for operating the DMS, trusts are responsible for developing their own eligibility criteria for patients referred through the service that meet “local population needs” (see page 13).

Please could you supply a copy of your trust’s eligibility criteria for referring patients through the DMS?

Information disclosed:

Please note University Hospitals Sussex NHS Foundation Trust was formed on 1 April 2021, with the merger of Brighton and Sussex University Hospitals NHS Trust and Western Sussex Hospitals NHS Foundation Trust. Whilst we are in the process of aligning services under the merged Trust, our Pharmacy Services within the legacy Trusts continue to operate separately to ensure there is no disruption to these services.

We have therefore provided our information broken down by the relevant hospitals where appropriate. Further information about the Trust’s hospitals can be found on our website.

Our response relative to Royal Sussex County Hospital, Brighton; Princess Royal Hospital, Haywards Heath; Royal Alexandra Children’s Hospital, Brighton and Sussex Eye Hospital, Brighton is provided below:

1. November 2021
2. 1,061 patients
   • a. 176,923 discharges were recorded across all sites, specialities and points of delivery during this period.
3. Please see below for the eligibility criteria:

Referral criteria:

Any major changes to a patients medication 

• Patients being discharged with new inhalers or respiratory medication 
• Any medicine that requires titration up or down, or blood monitoring 
• Patients being discharged with newly started high-risk medicines 
• Patients using blister packs 
• Patients prescribed medication that has the potential to cause dependence 
• Polypharmacy (>5 medicines where the risk of harmful effects and DIs is increased) 
• Newly started medications in the hospital 
• Patients who appear confused about their medicines on admission, and already needed additional support from HCP 
• Patients who have a learning disability 

Our response relative to St Richard’s Hospital, Chichester; Worthing Hospital, Worthing; Southlands Hospital, Shoreham-by-Sea is provided below:

1. February 2021
2. 3,842 patients
   • a. 182,921 discharges were recorded across all sites, specialities and points of delivery during this period.
3. Please see below for the eligibility criteria:

1.1 Patient selection

During ward visits, pharmacists and MMTs will identify patients who would benefit from referral to community pharmacy. Pharmacists and technicians should use their professional judgement as to which patients to refer.  Some example groups include:

1. Changed medication whilst in-patient.
2. New medications prescribed whilst in-patient.
3. Post-operative meds (surgical) – around opioids, gabapentin, etc.
4. High risk  medicines.
5. Polypharmacy – 5 or more medications prescribed.
6. A vulnerability and may require support with medicines