The Discharge Medicines Service (DMS) is a service all community pharmacies provide to patients who would benefit from extra support related to their medicines.


Please note that this service does not include the pharmacies within your GP’s practice.

Gloucestershire Hospital NHS Foundation Trust can refer patients to their community pharmacy when discharged from hospital.

Who will benefit from the Discharge Medicines Service

  • Any patient who has had medication changes and/or new medication started during an inpatient stay.
  • Patients who have started certain medications. These include:
    • Inhalers
    • Medications for thyroid problems
    • Medications that thin your blood from a group of drugs called Direct Oral Anticoagulants
    • Medications to treat heart conditions, such as high blood pressure, high cholesterol
  • All patients who have their medication dispensed in a tablet organiser (also known as a dosette box, trays, compliance aids, blister packs).
  • Patients who might require some extra support or help with their medications.
  • Patients who might have difficulty understanding instructions given to them.
  • Patients with a newly diagnosed chronic condition requiring a number of new medications.
  • Patients who have been prescribed medications that need to be managed for problems such as dependence.
  • Patients who have been prescribed medications that need to be managed for problems such as withdrawal. These may include strong pain relief medications such as opioids, or medications to help with stopping smoking called Nicotine Replacement Therapy.
  • Those patients whose medications require regular dose changes.

Referral process

During your stay in hospital, the hospital pharmacy team will assess you and your medicines to check if you would benefit from the Discharge Medicines Service.

If the pharmacy team think that you are suitable, they will inform you and make a note of your nominated community pharmacy and start the Discharge Medicines Service referral process.

The referral will be sent securely, online, to your nominated community pharmacy when you are discharged from hospital.

About the community pharmacy

Using the information in the referral, the community pharmacy team will compare the medicines that you were sent home with, to those you were taking before you were admitted to hospital.

The community pharmacy team will request a new set of prescriptions based on any changes that have been made to your medication. Once they have this information, they will compare them to your discharge referral notes from the hospital.

The community pharmacy team will then arrange an appointment with you and/or your carer to discuss your medication. This will help you to understand which medicines you should now be taking.

Benefits of the Discharge Medicines Service

  • Your community pharmacy team will be given information about any changes made to your medication during your hospital stay.
  • Your community pharmacy team will provide you with ongoing support and information about your medicines. This will help to make sure that you are taking your medications safely and will improve your understanding of the medicines you are taking.

Contact information

If you need advice or information about the medicines you have been prescribed by the hospital, please contact the Medicines Helpline before you see the community pharmacist.

Medicines Helpline

Gloucestershire Royal Hospital

Tel: 0300 422 6837

Monday to Friday, 10:00am to 11:00am

Cheltenham General Hospital

Tel: 0300 422 2805

Monday to Friday, 3:00pm to 4:00pm

Printable version of this page

Discharge Medicines Service GHPI1823_11_23 Department: Pharmacy Review due: November 2026 PDF, 360.1 KB, 4 pages
Reference number GHPI1823_11_23
Department Pharmacy
Review due November 2026