The DMS was launched as an essential service under the five-year Community Pharmacy Contractual Framework agreement one year ago today, on February 15, 2021.
The service lets hospitals digitally refer patients to community pharmacies for advice on newly prescribed medicines or changed prescriptions, following their discharge from hospital.
Pharmacies have three stages to complete once each referral comes through: they must complete a clinical review of the referral within 72 hours of receipt; check and resolve the first prescription issued on discharge; and make sure the patient understands their medicines regimen, according to the Pharmaceutical Services Negotiating Committee’s (PSNC) page on the service.
Pharmacies are paid £35 for each full DMS completed and claimed for each month.
According to data published by NHS Business Services Authority (NHS BSA) and analysed by C+D, contractors submitted claims worth £1,889,014 for both complete and incomplete consultations that they’ve carried out in the first nine months of the service.
But what do contractors make of the service? C+D has asked three pharmacists about their experience providing the service in the past year.
DMS allows pharmacies to reach patients in new ways
The DMS service has had “a good rollout” at Dalston Pharmacy in Dalston, Cumbria, owner and superintendent Mark Stakim tells C+D.
The pharmacy had been offering the DMS before it was launched across England as an essential service last year, as the service was already running locally in the north east, adds Mr Stakim, who is also chair of Community Pharmacy Cumbria.
“It was quite ready to go” in February 2021, Mr Stakim says. “It was just really changing the name [of the service] for us.”
Before DMS was established as a service, “it was a bit hit or miss whether you would get the information” about patients’ prescriptions from the hospital, he continues.
But “since we started on the DMS”, Mr Stakim says, “the information that's been coming out from the hospital for these patients has been much more prompt and much more thorough”.
Dalston Pharmacy started off receiving referrals for patients “on blister packs and compliancy”, as they tend to “slip through the cracks”.
“It also gives us the opportunity to refer them to other services, like the new medicines service” and make sure patients got their flu or COVID-19 jabs, Mr Stakim adds.
Dalston Pharmacy currently receives a “fairly consistent” stream of referrals, “half a dozen to a dozen a month”, Mr Stakim estimates, though “it probably could be more” than that.
Mr Stakim tells C+D he was “looking forward to the next phase” of the service “when we start introducing other patients” to it. "There are more patients that could benefit from it on top of people who get blister packs”, he says.
Inadequate communication from hospitals
According to the NHS BSA data, contractors lodged a total of 63,109 claims in the first nine months of the service – of which 16,791 were for incomplete claims.
For Eunice Waberuka, superintendent at Shefford Pharmacy in Shefford, Bedfordshire, the DMS referral process has been “OK”, but “there's still some glitches with the system where you don't get all the information that we need to do our stage one” in order to complete a clinical review of the referral.
The information sent over by hospitals is often incomplete or inadequate, she says, meaning that the pharmacy then “has to chase the hospital”.
The added time taken to do that often leaves Shefford Pharmacy unable to meet the 72-hour target to meet stage one of the service.
“Sometimes, it's been very annoying and we just give up on them for the discharge,” she says.
The pharmacy receives between three and four DMS referrals a month, Ms Waberuka said.
“Absolutely zero” referrals
When the DMS service launched last year, PSNC said that the number of referrals pharmacies would get would vary. Although it could not accurately estimate how many referrals pharmacies would get on average, it said its “best estimate is around 12 referrals per year”.
However, Farhat Ahmed, superintendent pharmacist at Washwood Heath Pharmacy in Birmingham, tells C+D that her pharmacy hasn’t received any DMS referrals yet, despite her pharmacy signing up to the service “immediately”.
She laments that the "useless" DMS has replaced medicines use reviews. "Somebody out there who put the services together needs their pay adjusted as far as I'm concerned,” Ms Ahmed says.
“[We've had] absolutely zero [referrals], we've yet to see one,” she concludes.
