Service case study: Positive results in first six months for anticoagulant hospital referral service (March 2016)

Published on: 20th February 2017 | Updated on: 30th March 2022

Six months after the launch of Swindon and Wiltshire LPC’s New Medicine Service (NMS) anticoagulant referral service with Great Western Hospital, 138 patients have been referred into the service.

The idea to set up a referral service in Swindon came from a training session to provide GPs with an update on anticoagulants. Fiona Castle, Chief Officer of Swindon and Wiltshire LPC, delivered a presentation during the session to promote NMS and the role of community pharmacy teams in supporting patients who are prescribed anticoagulants.

After the presentation, the main concern was that many patients were being prescribed anticoagulants in hospital, but were not receiving NMS because they were not being referred by the hospital team for the service.

In Swindon, most of the anticoagulant prescribing and monitoring is done by the Great Western Hospital. Fiona approached the hospital team with the idea of setting up a referral service who were keen on the idea. The LPC worked closely with the team at the hospital and the NMS referral service for patients who were prescribed anticoagulants was created.

Fiona set up PharmOutcomes, for the hospital team to use to make referrals to the patient’s local community pharmacy and for the pharmacist to use to show the actions they’d taken following receiving the referral and details of any outcomes following an NMS.

No specific training was required to be able to provide the service but a meeting was set up between the hospital nurse, hospital pharmacist and community pharmacy contractors to provide an outline of how the service would work and address any concerns or questions that contractors had.

Other key results from the six month evaluation report include:

  • In seven cases, an issue related to the patient’s treatment was resolved;
  • in 15 cases, the pharmacist reported that the interaction with the patient had improved the patient’s knowledge, confidence or ability to continue taking their medicine;
  • all pharmacies, but one, have reported that the referral process has been useful; and
  • a number of pharmacists have commented that the patients they have contacted have welcomed this proactive approach.

Further details on this service and other discharge support services can be found on the Community Pharmacy England Services Database.

Fiona’s top tips to other LPCs who wish to implement a similar service are:

  • build relationships with local GPs and hospital teams, many don’t know about the services that community pharmacy teams can offer!
  • speak to other LPCs who have been involved in setting up a referral service;
  • make data entry on PharmOutcomes as simple as possible for contractors; and
  • communicate regularly with contractors, for example, through LPC newsletter articles to promote the service.

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