Patients who stay in hospital can often feel frightened, stressed and vulnerable, so hearing the words “we will discharge you today” can be so comforting. We need to make sure that these patients receive the best possible treatment after they have been discharged.
In the hospital, pharmacists are largely responsible for ensuring that an accurate, up-to-date medical history is recorded for each patient. In practice, we must use a minimum of two reliable sources to ensure that all the information is accurate. This guarantees that patients still consistently receive their medications in hospital, and avoids interactions. Obtaining one of these sources will involve contacting the patient’s community pharmacy to provide their current medical history; this helps to achieve an optimal clinical plan during their stay.
But community pharmacies need to work alongside GPs and hospitals after discharge too, to ensure that the patient is taking the correct medications to avoid readmission. To help with this, it is important for the community pharmacy to receive the discharge letter. With miscommunication often inevitable from both sides, the letter can improve medicines optimisation drastically.
For example, pharmacies may have prescriptions ready for collection for patients who are on a monitored dosage system (MDS), often with no knowledge that the patient has been in hospital. Miscommunication can lead to the patient receiving their MDS without knowing the changes to their prescription that could lead to readmission. Essentially, community pharmacists are often more likely than the GP to see the patient after their discharge, so pharmacists can provide advice on patients’ new medications or request amendments to prescriptions, which will help to reduce pressure on GPs.
I believe community pharmacy should receive the discharge letter the same way as GPs. I am aware that this idea is being implemented in certain places, but it should become universal.
Ayah Abbass, locum pharmacist, Sheffield