1. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service The CPW Perspective Chris James Chair Community Pharmacy Wales Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales

2. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru March 2011: DH provides funding for New Medicines Service in England April 2011: Health Minister, Edwina Hart agrees consequential funding for new community pharmacy service in Wales May 2011: Elections for National Assembly for Wales September 2011: WG & CPW agree a new Discharge Medicines Service November 2011: Discharge Medicines Review (DMR) service introduced February 2014: CPW Commissioned Service Evaluation Completed and confirms provides strong patient benefit April 2014 – Health Minister agrees DMR service should continue Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales

3. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru  Introduction of DMR Service exposes significant differences in discharge arrangements across Wales  For example, in Carmarthen there are minimum of 3 separate patient experiences: Hospital M – envelope for community pharmacy Hospital G – verbal messages Hospital PP – different verbal messages Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales

4. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales  CPW welcomes Evaluation of DMR  Main findings: Unambiguously cost effective; Service generates 3:1 return on investment; Estimated £3 million released as result of reduced A& E and hospital admissions and drug wastage; Service has the capacity to save lives. Identified 28.7 medication error rate; Increased Patient Awareness of importance of medicines management Enhances role of the community pharmacy

5. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales Evaluation Report Recommendations  Consider Advice and guidance to Health Boards  Consider involvement of non- pharmacy hospital staff in DMR initiation Agree clearer WG advice to HBs would benefit service delivery Support use of non-pharmacy in DMR initiation based on clear lines of responsibility WG & CPW to agree appropriate advice which ensures service continuity

6. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales Evaluation Report Recommendations  Consideration to be given to patient consent and patient registration arrangements Support registration with a specific pharmacy for specific service WG/CPW to evaluate value of registration arrangements for CAS Support simplification of patient consent procedures

7. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales Evaluation Report Recommendations  Provide electronic access to improved quality discharge information agree that electronic access would greatly assist the smooth and effective operation of DMR encouraged by WG provision of £280,000 for two pathfinder sites

8. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Evaluation Report Recommendations  Streamline DMR paperwork Support strongly calls to streamline paperwork CPW has put initial proposals to WG and received positive responses Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales

9. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Evaluation Report Recommendations  Hospitals to agree lead responsibility for initiation of DMR agree that patients and community pharmacies likely to find the service more straightforward if there is clarity around DMR responsibility within hospitals accept no one size fits all arrangement Want to work with secondary care colleagues to take this forward Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales

10. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales Evaluation Report Recommendations  Disseminate details of benefits of DMR to HBs & Secondary Care Colleagues agree wider dissemination will assist engagement around delivery of the service The findings of the evaluation will assist dissemination process through provision of hard data about suspected benefits such a service would deliver

11. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales Evaluation Report Recommendations  Extensive communication programme needed on DMR to be aimed at HBs, hospitals, patients and carers agree that a thorough communication programme required to enable this innovative service to realise its full potential Suggest need to pool available resources WG and NHS Wales approved posters and leaflets continue to be available via CPW to support such a programme aimed at patients leaving hospital and those caring for those who have recently returned home

12. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales Evaluation Report Recommendations  Extensive communication programme needed on DMR to be addressed by HBs, hospitals, patients and carers CPW arranging autumn workshops targeting o Community Pharmacy Contractors o Other Healthcare Professionals, Carers & Third Sector Organisations who support hospital discharge services

13. The Face & Voice of Community Pharmacies in Wales Wyneb a llais o fferyllfeydd cymunedol yng Nghymru Discharge Medicines Review Service Workshop : 17 July 2014 Chris James, Chair Community Pharmacy Wales Conclusion Proud to have been involved in the development of this innovative and important service Appreciates the insights brought by the academics through the Evaluation Thanks all those involved in making this Symposium today happen – an innovation in itself looks forward to working with partners in the NHS to make greater use of the DMR service to deliver significant advances in prudent patient care to the people of Wales.