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Could people leaving hospital get their prescriptions from a community pharmacy instead of waiting for hospital pharmacy?

My idea is whether people prescriptions could be rethought for people leaving hospital. Waiting for medicines is a common reason for discharge being delayed and people leaving hospital later in the day. Could people be given a prescription to get their medicines at their local community pharmacy?

It has the potential to help people leave hospital earlier in the day.

This may be only appropriate for certain medicines or for certain conditions, perhaps for people who are otherwise well and perhaps in hospital because of a straightforward elective procedure.

There would be a cost implication of this for people who usually pay for their prescriptions, as medicines dispensed in hospital are free of charge. People who are usually exempt from prescription charges would not be impacted.

An experience I once had in outpatients made me wonder if we could think differently about hospital pharmacy, and help people be heading #Home4Noon.

The outpatients experience was that I was given a prescription, which I took to my community pharmacist to dispense. The community pharmacist explained that as it was a hospital-issued prescription, they were unable to dispense it and I would have to return to the hospital pharmacy, which I duly did. The doctor didn't make clear that I had to use the hospital pharmacy, and in any case it made sense to go to my community pharmacy.

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Kyle_NHS Aug 24, 2022

I have thought of this previously, however I believe their is too much risk in assuming that community pharmacy is accessible, will be accessed and even if they are will the pharmacy have adequate stock to supply?

Instead, I would love to see a Hospital courier service that can deliver to patients discharged destination - most major high street pharmacies offer this as business as usual already, why can't one of the worlds largest employers? Much better from a governance and safety aspect.

Outpatient TTA, I don't see a need for a courier service but more down to communication that it can only be issued via Hospital pharmacy.

Community prescription pads are held under lock and key and extremely hard to warrant use with every trust I have ever worked at.

In saying that, the actual KPIs of pharmacy fulfilling TTAs is less an hour on my site and the delay is getting clinicians to see as a priority.

Leigh Kendall Aug 25, 2022

Hi Kyle, it's interesting you mention a courier service - Christina Harrison has posted an idea about her trust using taxis for TTAs - would be interested to hear your thoughts!

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Kate Pound Aug 25, 2022

Most of this comes down to commissioning and community service not being able to process hospital prescripts, however doesn't mean we can't try. Running small prototyping tests will help us to understand the benefits.

Leigh Kendall Aug 25, 2022

Hi Kate, definitely as I found to my inconvenience - community pharmacists dispense FP10s whereas hospitals have a different sort of form. (It was a different colour, perhaps it should have been a clue! ;-)) Absolutely, it doesn't mean we can't try though and I'd be fascinated to discover what benefits prototyping tests uncover. Have you seen Christina Harrison's idea about the trust she works for using taxis to convey TTAs?

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Beverley Matthews Aug 25, 2022

Thanks for sharing Leigh. Following my admission a couple of years ago to Birmingham Midland Eye Centre i was given a community prescription on discharge - I was impressed! One of the drops is not widely routinely in stock in many chemist pharmacies so I was given clear instructions of a handful to go to where they were more likely to be in stock as well as given a couple of single use drops too.

This worked really well for me

GChan Dec 11, 2022

Hi it's an interesting idea. My concern would be

1) If there's a problem with the hospital handwritten prescription, eg illegible handwriting, out of stock items. What would the patient do? How easy is it for the patient to get in contact with the hospital doctor to ask for a fresh, legible prescription, or for alternative medications?

2) What do patients do in the event of lost prescriptions?

3) What about some patients eg elderly or vulnerable ones who have no one to bring them to a attend a community pharmacy, for them to hand in their prescription and be told the pharmacist is on lunch break and to come back later this afternoon? Wouldn't it be preferable for them to have the prescription on discharge?

A suggestion. In the community, the vast majority of GP practices use electronic prescriptions. Perhaps a solution might be for hospital to use electronic prescriptions, it saves a lot of time on illegible prescriptions. The hospital electronic prescription can either be issued by the hospital pharmacy if the patient is happy to wait. If not, the hospital should contact the community pharmacy and confirm that the medications are available, and then send the electronic prescription onwards to that particular pharmacy so that it can be prepared in advanced for when the patient comes round. Hope this helps.

Leigh Kendall Dec 14, 2022

Hi, thank you for taking the time to share your thoughts. The handwriting issue is a good point - it's making me wonder whether if hospitals could do electronic prescriptions the prescriptions could then be emailed to a community pharmacy, similar to how many GP practices operate.

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