Safe Transfer of Medicine Between Care Settings

Record a current list of medicine, including:

•    prescribed

•    over-the-counter

•    complementary medicines.

Compare this list with the medicines the patient is taking. This should include a conversation with the patient to check if they take their medicines as prescribed.

Any discrepancies should be recognised, resolved and changes should be documented.

The medicines reconciliation process will vary depending on the care setting that the person has moved into (or from). Always refer to your care providers Policies and Procedures.

Trained and competent staff should carry out the medicines reconciliation.
They should consult with a health professional. Ideally, this should be the person's GP, nurse or pharmacist.

These staff will need knowledge, skills and expertise including:

•    effective communication skills

•    technical knowledge of processes for managing medicines

•    therapeutic knowledge of medicines use.

Where appropriate, people, their family members and carers should be involved.

• contact details for relevant healthcare professionals

• known allergies and reactions to medicines or ingredients and the type of reaction

• current medicines, including:

  • name

  • strength

  • form

  • dose

  • timing and frequency

  • route

  • indication - what the medicine is for

• how and when the person prefers to or usually takes their medicine. This should include an assessment for self-administration

• changes to medicines and reason for change, including:

  • medicines started

  • stopped

  • dose changes

• date and time the last dose of any 'when required' medicine was taken -include specific instructions to support the administration of these

• information about any medicine given less often than once a day - weekly or monthly medicines

• information given to the person, family members or carers

• when the medicine should be reviewed or any monitoring

Record the information from medicines reconciliation in the medicines care plan.

Make sure to record:

• details of the person completing the medicines reconciliation (name, job title)

• the date of the medicines reconciliation

• source(s) of information about the reconciled medicines

Check the medicines administration record (MAR) to make sure it contains accurate information.

For more information please visit CQC Medicines: information for all adult social care services website and view the 'Medicines reconciliation (how to check you have the right medicines)' guide.