When a person comes into hospital,

taking medicines is not going to be
the most important thing on their mind.

We know from some recent work
that every patient admitted

is likely to have at least one issue
with medicines reconciliation,

which is matching up
the medicines they're taking

with the medicines
they've been prescribed

when they enter
the second care setting.

(new speaker)
This can be an important problem.

On many occasions, patients,
if we get the drugs slightly wrong,

it won't make much difference.

But possibly, in about 10% of cases,
there could be major ramifications.

The first step is that
when they're admitted to hospital,

we have to find out
what medicines they were taking.

Often, the person
won't be able to share that information

with the health professionals
admitting them.

In my experience, commonly,
there are major variations

between what's written
on the referral letter

and what the patient is actually taking.
In an ideal world,

we'd like to see the tablets themselves
and talk to the patients.

They're not always well enough
to do that.

They usually haven't brought
their medication with them.

(new speaker) When I had the accident
at home, I thought,

I must take my blood pressure tablets
with me if nothing else.

The rest, they'll sort out for me
when I get there,

not knowing that I was going
to stay in hospital.

(new speaker)
When patients come in hospital,

the problem with no knowing everything

is that it could lead to issues of the
patient getting the right therapy.

For example, a patient went to hospital.

They were on chemo medicine
which we needed to monitor them for

and other problems
and possibly give them some antibiotics,

but because we didn't have that
information, we didn't know what to do.

It's extremely useful that usually
within 24 hours of admission,

a pharmacist will investigate the drugs
that a patient is taking

and usually, the following day,
will receive information.

At the point of admission,

it's very, very useful to have
a pharmacist investigate the medication

and iron out any problems.

If you are a patient,
what I would say to you

is bring a list of medicines
into the hospital with you,

or whenever you're going to see
a health professional,

take your medicines with you and take
a list of your medicines with you.

Ask for the opportunity
to speak to a pharmacist

about your medicines
when you're in hospital.

Make sure that when you leave hospital,

the information is transferred with you
as well as with the health professionals

about what changes have been made

so you are aware of what you're taking
and why you're taking it

and you're able to pass that on
to the next health professional.

You must know what you're taking

and you must be able to get it
at the right time.

(Nina) If as a patient,
you want more information

about how you can help to support health
professionals looking after you,

go to www.ipharmacist.me

which will give you more information
about transfer of care with medicines.