1. Maximising your DMR Potential To build confidence in the DMR service we need all contractors to be involved. This will protect existing funding streams and build confidence in the pharmacy network for future commissioning.

2. Initial Thoughts Not everyone is starting from the same place. There is a huge variance in engagement, even between pharmacies in the same neighbourhood There are probably many different reasons for this, most are common, only a few are unique. If we spend some time thinking about the “barriers” to delivery and work together, we can distinguish between the “real” and the “perceived barriers” and move the service forward.

3. In Wales we have worked to understand why the DMR service works well in some of our pharmacies and not in others. We have had some successes (and disappointments)and gathered learnings along the way. I will try and share some tips with you that will hopefully help you to keep even more patients safe.

4. This is what I regularly hear pharmacists say I haven’t got time It’s too difficult It takes too long I can’t get DALs My GP surgery/hospital/care home doesn’t want to play. Patients don’t want the service I can’t get consent Patients don’t come back And there are plenty more !

5. I would question how much of this is really true? Some may be But I also know that there are pharmacists out in their community who find a way around these barriers and make the service work for them and their patients.

6. Enablers e-DMR and MTED is coming The new DMR forms should be easier to use. Welsh Government is firmly behind the service Awareness in secondary care is increasing.

7. Some practical tips Refresh your knowledge of the service, who is eligible and make sure you are up to date with the recent changes. Think about the local relationships you already have (or need to build) to help you maximise the service. The message is that we are trying to keep our patients safe. Get yourself organised to streamline the operational process.

8. Relationships Start internally with your own staff, they are your best advocates and your eyes and ears, they can do a lot of the set up for you. GP’s – do they know about and understand the value of the service? Hospital discharge teams – have they got your phone number & have you got theirs? What does the discharge process look like on your local wards? How many of the people who visit your pharmacy are carers or have a sick relative in hospital?

9. Who else? District Nurses? Community Resource Teams? Care agencies? Social services? Frailty teams? Care Homes? Sheltered housing? And finally the most important group - Patients themselves, how are you telling them about the service? Proactive recruitment? There are DMR “Top Tips” on the CPW Website

10. An easier process Set up a DMR folder to keep everything in one place and keep track of progress. Section 1: An Index and overview sheet with notes on how you operate the service in your pharmacy. Section2: Copies of all the paperwork you need e.g. DMR part 1 forms, MUR forms and consent forms. Section 3: A tracker to help you plan the interventions and make sure you don’t miss any of the stages or lose payments. Section 4: DMR paperwork for patients “In progress” Section 5: Completed and claimed DMRs

11. DMR FILE - Index In this file you will find everything you need to complete DMRs Section 1 Summary of the service Section 2 Forms – DMR part 1s, DMR part 2s, Consent forms - photocopy as needed Section 3 DMR progress form Section 4 DMRs in progress Section 5 Completed DMRs – filed together with consent form Please photocopy and keep a number of each of the relevant forms in the file ready for use.

12. DMR noNameInitial Sign UpDMR Part 1DMR Part 2Claimed on Necaf Consent form signed Put through till Form complete Put through till Form complete Put through till 2014/139J Henley 2014/140AP McCoyDue around 21 st April DMR Progress Form

13. Any Questions?