1. Pharmacy LPN Chair (Merseyside) NHS England
Hassan Argomandkhah FRPharmS IPresc
Transfer of
Care to
Pharmacy

2. Transfer of Care to Pharmacy
Patient
admitted to &
discharged
from hospital

3. Key objectives
1. To create a fully Integrated system which enables
hospitals to transfer relevant clinical information
between care settings and improve medicines
optimisation.
2. To enhance communications between care settings
thus delivering timely, positive and measurable patient
outcomes and experiences.
Transfer of Care to Pharmacy

4. Key objectives
3. Link with with Cheshire & Merseyside Sustainability and Transformation
Plan (STP) objectives.
Reducing emergency bed days and length of stay*.
Reducing hospital re-admissions*.
Early identification and intervention.
Delivery of care in alternative settings.
Optimise direct patient care through forging links with community
pharmacy.
Improve the health of the C&M population through medicines
optimisation.
Reduced drug waste and impact on primary care medicines
spend*.
Improved patient satisfaction*
✴ These are the project objectives that would be measured as part of the academic evaluation.
Transfer of Care to Pharmacy

5. Project outline
The project aims will establish the following patient eTCP
pathways
• Hospital admission notification to community pharmacies.
• Hospital admission notification to GP practices.
• Hospital discharge notification to community pharmacies.
• Hospital discharge information to community pharmacies.
• Anonymised monitoring of messages via a secure ‘hub’
Transfer of Care to Pharmacy

6. ✦ Hospital pharmacy needs to deliver more services to increase patient safety.
✦ A transfer of care to pharmacy pathway can deliver the desired outcome.
✦ Seamless delivery requires a more efficient delivery platform
✦ electronic Transfer of Care to Pharmacy (eTCP) will provide the efficiency
✦ eTCP will deliver optimal use of medicines, technology and workforce.
✦ eTCP will create a fully automated transfer of admission and discharge information to
encourage collaboration between secondary and primary care and remove unnecessary
variation in services.
✦ This will deliver value for money for the taxpayer and good clinical outcomes for all
patients seven days a week.
Transfer of Care to Pharmacy
Reference
1. Keeping patients safe when they transfer between care providers – getting the medicines right, July 2011: http://www.rpharms.com/current-campaigns-pdfs/1303
Cheshire and Merseyside Overview

7. Key Features
• Hospital admission notification to
1. community pharmacies
2. GP Practices
• Hospital discharge notification & information
Providing pharmacies with a copy of the relevant
patient discharge information
• anonymised monitoring of eTCP messages through
a secure hub
Key System Objective
Fully Integrated system to
enable hospitals to transfer
relevant clinical information
between care settings to improve
medicines optimisation
NHS England Funding
To fully develop and implement
software solution in all
Cheshire and Merseyside
NHS Acute Hospital Trusts
Electronic Transfer of Care to Pharmacy (eTCP)

8. Electronic Transfer of Care to Pharmacy (eTCP)
On Patient Admission to Hospital
1. Hospital pharmacy team
assesses risk of meds changes
2. Automated notification
Community Pharmacy
Team
Practice
Admin Team
1. Suspend medication
supply
2. Add notes to PMR
3. Await discharge
information
Anonymised monitoring HUB [SAM]
Secure Allocation Management
1. Suspend Rx
2. Add notes to clinical
system
3. Await discharge
information
Monitors eTCP actions
Admission
notification Patient selection
✦ Non-elective
✦ 4 meds or more
✦ MDS (blister packs)
✦ CVD event

9. Electronic Transfer of Care to Pharmacy (eTCP)
On Patient Discharge from Hospital
Automated notification &
transfer of discharge
information
Community Pharmacy
Team
Monitors eTCP actions 1. Reviews discharge
information
2. Reviews any
outstanding Rx
3. Cancel unwanted Rx
& query new Rx
Anonymised monitoring HUB [SAM]
Secure Allocation Management
1. Adds note to clinical
system
2. Post discharge meds
reconciliation
3. Act on any new Rx
query
Discharge
information
Practice
Team
continues to
receive
discharge
information
through
existing
channels

10. Electronic Transfer of Care to Pharmacy (eTCP)
Patient
admitted to &
discharged
from hospital
Admission notification plus
Discharge notification &
information is sent to the
Community pharmacy
Secure Allocation Manager (SAM)
Anonymised monitoring of eTCP messages
Full pathway

11. Enhanced pt.
safety
• Reduced
medication
errors
• Support on
concordance
• Less likelihood
of re-admission
Patients
Electronic Transfer of Care to Pharmacy (eTCP)
Hospital
Increased
efficiency
• Smoother
discharge
• Reduced 30d
re-admission
• Better links to
primary care
benefits of eTCP - admission & discharge
notifications
Pharmacy
Safer for pts. &
reduces waste
• Access to
timely
information
• Better use of
clinical skills
• Less
medicines
dispensed and
wasted
GP Practice
Better pt. safety &
reduces waste
• Targets
“revolvingdoor”
pts.
• Identifies pt’s.
meds
adherence
issues
• Less
medicines
wasted
NHS/CCG/
Social Care
GPs / Commissioners would see a reduction in hospital admissions due to an improvement in medicines adherence.
Community pharmacists have the opportunity to be an integral part of a patient pathway which allows them to utilise
their inherent skills, and to build professional relationships with patients and fellow health professionals.
Key benefits to eTCP partner come from the benefits to their patients
More productivity
• Fewerre-
admissions
• Bettermeds
optimisation
• Lessmedwaste
• Better
managementof
resources

12. Electronic Transfer of Care to Pharmacy (eTCP)
P
o
t
e
n
t
i
a
l
S
a
v
i
n
g
s

13. 4
Liverpool Heart & Chest
Thomas Drive, Liverpool,
Merseyside, L14 3PE
1
Aintree University Hospital
Lower Lane,
Liverpool, Merseyside, L9 7AL
6
Royal Liverpool Hospital
Prescot Street , Liverpool,
Merseyside, L7 8XP
10
Arrowe Park Hospital
Upton, Wirral, Merseyside,
CH49 5PE
7
Southport and Ormskirk
Town Lane, Southport,
PR8 6PN
8
Whiston Hospital
Warrington Rd, Prescot
L35 5DR
3
Macclesfield General
East Cheshire NHS Trust
Macclesfield, SK10 3BL
2
Countess Of Chester
Health Park, Chester,
Cheshire, CH2 1UL
5
Leighton Hospital
Mid Cheshire NHS Foundation
Trust, Crewe, CW1 4QJ
9
Warrington Hospital
Lovely Lane , Warrington,
Cheshire, WA5 1QG
11
Bowmere Hospital MHT
Health Park, Liverpool Road,
Chester, CH2 1BQ
eTCP EOI - Hospital Trusts
12
Alder Hey Children's
Hospital
East Prescot Rd, West Derby,
Liverpool, L14 5AB

14. 1
2
3
4
5
6
7
8
9
10
11
eTCP EOI - Hospital Trusts
12

15. Electronic Transfer of Care to Pharmacy (eTCP)
Project implementation
• STP Board engagement
• Patient engagement
• Clinician engagement
• Innovation Agency
• CPPE
• Project Roll-out

16. Electronic Transfer of Care to Pharmacy (eTCP)
Hospital Trust system selection.
• We are supporting each hospital Trust to choose their preferred
system supplier which meets our joint project objectives based on
system compatibilities including any third party IT solutions
Partnership arrangements.
The following organisations have agreed to support NHS England /
PLPN to deliver elements of eTCP. These will be managed through
Service Level Agreements.
• The NHS Innovation Agency / Academic Health Sciences
Network (AHSN North West Coast).
• Centre for Post Graduate Pharmacy Education (CPPE).
Governance arrangements

17. Electronic Transfer of Care to Pharmacy (eTCP)
Governance arrangements
• Governance for the complete project falls under NHS
England (Cheshire and Merseyside) through pharmacy
Local Professional Network (Merseyside) - PLPN
• NHS England / PLPN Merseyside through a SLA with IA
(Innovation Agency / AHSN) will deliver eTCP in 12 C&M
Trusts
• Each site will establish a footprint steering group and use a
common reporting framework and will be accountable to
the PLPN steering group
• All eTCP meetings with project partners fall under the
same governance arrangements

18. Electronic Transfer of Care to Pharmacy (eTCP)
System provider selection
• Due to the unique nature of this project there are only two
system providers that can currently deliver this service
specification.
• The two are Webstar and Pinnacle Health.
• Each system provider shall enter into a SLA with the IA
with a commitment to meet the outline service as described
in this proposal within an agreed financial envelope.

19. Any Questions?
Hassan Argomandkhah FRPharmS IPresc
Chair of Pharmacy Local Professional Network
NHS England (Merseyside)
hassan.argomandkhah@nhs.net
Electronic Transfer of Care to Pharmacy (eTCP)