Transfer of Care around Medicines (TCAM)

Community pharmacist support for patients leaving hospital

When some patients leave hospital, they can need extra support taking their prescribed medicines. This may be because their medicines have changed, or they need a bit of help taking their medicines safely and effectively. The transfer of care process between care settings is also associated with an increased risk of harm, with 30-70% of patients experiencing unintentional changes to their treatment, or an error being made because of a miscommunication. These are some of the challenges that the Transfer of Care Around Medicines Programme aims to address.

When patients are discharged from hospital, they may be referred through a safe and secure digital platform for advice from their local community pharmacist on how to manage their medicines with confidence. Improving the transfer of information about a patient’s medicines should also help to ensure that they continue to take the right medication on leaving hospital. Both aspects can reduce the incidence of avoidable harm.

Evidence has clearly shown that patients who saw their community pharmacist after their discharge from hospital were much less likely to be readmitted and, if they were, that they experienced a reduced length of stay. Further details on service evaluation can be found below.

The TCAM pathway also brings benefits to Community Pharmacy through improved workflow and operational processes, better informed dispensing and a reduction in waste medicine.

We are working with partners across Kent, Surrey and Sussex, including trusts, Local Pharmaceutical Committees and CCGs, to implement the pathway. Where possible we set up secure electronic interfaces between the hospital IT systems and community pharmacy systems in order to provide patient medicines information quickly and seamlessly between care settings.

This pathway is now live in East Sussex Healthcare NHS Trust, Ashford and St. Peter’s Hospitals NHS Foundation Trust, Surrey & Borders Partnership NHS Foundation Trust, Royal Surrey NHS Foundation Trust, Medway NHS Foundation Trust, University Hospitals Sussex Trust and Darren Valley Hospital Trust.

There is a PharmOutcomes Instruction Video for completion of TCAM referrals and follow up form.

Discharge Medicine Service (DMS)

From 15th February 2021, the Discharge Medicines Service (DMS) became a new Essential service within the Community Pharmacy Contractual Framework (CPCF). This enables NHS Trusts to refer patients who would benefit from extra guidance around new prescribed medicines for provision of the DMS at their community pharmacy. The service has been identified by NHS England and NHS Improvement’s (NHSE&I) Medicines Safety Improvement Programme to be a significant contributor to the safety of patients at transitions of care, by reducing readmissions to hospital.

This service builds on the work that the Health Innovation Network undertook with Trusts and LPCs over recent years, as part of the Transfer of Care Around Medicines (TCAM) programme.

TCAM round table event 

Health Innovation Wessex hosted a TCAM round table event in June 2021 to capture lessons learned from the national roll out.

A report from the event is available here, and you can see a recording of the meeting here.

Find out more about TCAM on the National Health Innovation Network website.