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NHS England has said that patients in hospital should have all their time-critical medicines identified and prescribed, including a plan for pharmacy review, within 24 hours of admission.
The guidance was outlined as part of ‘The model acute pathway: standards for care of acutely unwell patients in their first 72 hours in hospital’, which was published on 9 February 2026 in collaboration with the Royal College of Physicians, the Society for Acute Medicine (SAM) and the British Geriatrics Society.
The standards, which apply from the moment a patient arrives at hospital, set out ways to reduce the time patients spend in emergency departments and the length of their following stay in hospital.
They are aimed to focus on what happens after the emergency department has completed its care and to “ensure greater clarity, ownership and oversight of care”, the guidance says.
Alongside rapid identification of time-critical medicines, the standards advise that the prescription of these should come with a plan for a pharmacy review.
“To ensure equity of provision of care and maximise discharge opportunities, all support services, including therapies, pharmacy and social services, should be available to acute receiving areas during extended-day working hours (for example, 8:00 to 20:00), seven days a week,” it adds.
In a statement from SAM, Vicky Price and Nick Murch, current and former president, respectively, said: “Improving outcomes for patients depends on whole-hospital and whole-system ownership of flow across the first 72 hours, with adequate staffing, diagnostics and community support seven days a week.”
Commenting on the standards, Tase Oputu, chair of the Royal Pharmaceutical Society English Pharmacy Board, said: “Hospital pharmacy teams have an important role in supporting safe and effective medicines use during the early stages of hospital admission. In many hospitals, pharmacists and pharmacy technicians are already embedded in medical admissions units and emergency departments, helping to ensure medicines-related issues are identified and managed promptly as part of multidisciplinary clinical decision-making.
“The model acute pathway provides an opportunity to strengthen consistency in how pharmacy services are integrated across acute receiving settings, including outside traditional working hours. Aligning pharmacy input more closely with the acute pathway can support continuity of care and reduce delays in medicines review and treatment planning.
“Any move towards extended or seven-day pharmacy services must be underpinned by sustainable workforce planning and investment. Hospital pharmacy teams are managing significant workload pressures, and expectations around service expansion need to reflect current capacity.”
The Royal College of Emergency Medicine has advised that all patients taking time-critical medicines should be identified within 30 minutes of arrival at an emergency department, and that all time-critical medicines should be administered within 30 minutes of the expected time.
In April 2025, a joint advisory statement from the Royal College of Emergency Medicine (RCEM), UK Clinical Pharmacy Association (UKCPA) and Association of Ambulance Chief Executives said that patients in emergency departments who are able to self-administer time-critical medicines should be supported to do so.
Many patients who attend emergency departments across the UK “are not given their time-critical medicines when they need them with doses being delayed or being missed completely”, the statement added.
In March 2025, an investigation by The Pharmaceutical Journal revealed that just 15% of NHS trusts met recommendations for pharmacist and pharmacy technician support laid down by the RCEM and the UKCPA.
- This story was amended on 16 February 2026 to clarify the details for time critical medicines in relation to ‘The model acute pathway: standards for care of acutely unwell patients in their first 72 hours in hospital’
