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Transition of care, when a patient moves from one setting of care to another, is a period of high vulnerability for patients and one of the six most common areas of risk with medicines across health and adult social care services.1–4 For example, after discharge from hospital, problems may arise when patients are not prescribed their usual medicines. Other known issues include transcribing errors, mistakes or omissions in discharge letters issued by hospitals to general practitioners (GPs), as well as delays in acting on the information provided in the discharge summary.3–5 This can result in patients moving between care settings without a full understanding of any new medicines or changes to their existing medicines.
In general, community pharmacists are not routinely sent information on discharge medication for patients who have been in hospital, or even informed that patients have been admitted or discharged. However, evidence is emerging that involving community pharmacists in …
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