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Case study: Targeted medicines support reduces readmissions

‘This service will make an enormous difference to our ability to help patients after discharge from hospital’

Khal Khaliq, community pharmacist, Lansdale Pharmacy, High Wycombe


Lead AHSN and joint partners

Oxford AHSN, six NHS trusts, 400 community pharmacists and PharmOutcomes, a web-based pharmacy information service.

Key points at a glance

Patients are being offered targeted support from community pharmacies after leaving hospital to help them make the most of their medicines and avoid readmission to hospital. When fully operational it could benefit hundreds of patients every month.

Background summary

On discharge from hospital, patients can find it difficult to manage their medication effectively. If their needs are not picked up, they can stop taking their medicines as prescribed and end up back in hospital. This negative cycle can be stopped through better communication, support and monitoring when care is transferred between service providers.

Challenge identified and actions taken

Patients who would benefit from extra help are referred by a hospital pharmacist for a consultation with a community pharmacist within a month of leaving hospital. At these enhanced post-discharge Medication Use Reviews (MUR) they can get expert advice about their medication, side effects and any extra support they may need – as well as being signposted to other services where necessary. The aim in the first year is to increase MUR uptake by ten per cent and reduce hospital readmissions by 50%. Each readmission prevented represents a saving of £3,500. It is hoped an indirect benefit of the service will be an improvement in patient satisfaction and adherence to their medication regimes, which in turn will reduce wasted medicines.


Six hospital Trusts in the Oxford AHSN region have signed up to the project which was launched in July 2015 along with approximately 400 community pharmacies in Berkshire, Buckinghamshire and Oxfordshire. Partnering organisations have received training from Oxford AHSN Medicines Optimisation clinical network on the service and are operating a bespoke interface reflecting local and national needs. The project has been tailored to the specific governance needs of each Trust to ensure that all patient data is transferred securely and patient confidentiality is maintained. Three Trusts have gone live with the remainder due to do so shortly. The acute and community service providers are already more integrated and work together more effectively. Continuity of care has been strengthened and detailed data will become available through monitoring, evaluation and patient feedback.

Plans for the future

We are sharing our experiences and best practice with other AHSNs and with the Royal Pharmaceutical Society. Further monitoring, evaluation and patient feedback.

Further information

Dr Lindsey Roberts, Medicines Optimisation Network Manager, Oxford Academic Health Science Network, Magdalen Centre North, Robert Robinson Avenue
Oxford Science Park, OX4 4GA

AHSN Core Objectives

A – Promote health equality and best practice

B – Speed up adoption of innovation into practice to improve clinical outcomes

C – Build a culture of partnership and collaboration

Clinical priority or enabling theme/s

2 – Enhancing quality of life for people with long term conditions

3 – Helping people recover from episodes of ill-health or following injury

4 – Positive experience of treatment and care

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