Case Study: Transfer of care around medicines (TCAM) to care homes

What is TCAM to Care Homes?

Approximately 50% of acute trusts across England support patients when they are discharged from hospital, by referring them to Community Pharmacists for follow up appointments. This evidence-based pathway is now nationally commissioned and termed the Discharge Medicines Service (DMS).

The TCAM to Care Homes project extends the DMS, referring patients being discharged to care homes to teams which provide a clinical pharmacy service to those homes.

What were the aims of TCAM to Care Homes?

• To highlight resident discharges to primary care pharmacists contemporaneously
• Develop a referral pathway to support medicines optimisation for patients being discharged from hospital to care homes

What did we do?

We have implemented the direct referral of discharged residents to pharmacy teams which provide services to care homes. At our pilot site, this was to a team of pharmacists in the Clinical Commissioning Group (CCG), but in other systems, the referral may be to GP practice pharmacists, Primary Care Network (PCN), or medicine optimisation in care homes (MOCH) pharmacists.

The team worked with Pinnacle Health, the provider of PharmOutcomes, an e-platform used to refer patients through the DMS pathway, to develop a new platform which would make referrals to the appropriate team.

What were the outcomes?

As a result of the COVID-19 pandemic, pharmacy teams who usually provide home-based medicines optimisation services were unable to provide the support that patients needed.

In response, two Trusts in the West Midlands adopted our pathway, sending 167 referrals which were all actioned. This resulted in direct support for care home residents, enabling them to receive accurate and timely administration of medicines after discharge from hospital.

A further seven Trusts are now adopting the pathway and will go live in 2021.