Consensus for patient groups considered most at risk and medication groups considered to pose the greatest risk to patients during transitions from hospital to primary care in rounds 2 and 3
| Category | Groups | Consensus round 2,% | Consensus round 3, % |
|---|---|---|---|
| Age | Children | 2.78 | — |
| People who are older and frail | 97.22 | — | |
| Medical factors | Cancer | 2.78 | 3.33 |
| Complex patients on >5 medications | 58.33 | 80.00 | |
| Diabetes, including those newly started on insulin | 0 | — | |
| Drug addiction or those with alcohol dependency | 0 | — | |
| Heart failure | 0 | — | |
| Immunosuppression | 0 | — | |
| Learning disabilities and cognitive disorders (including dementia) | 16.67 | 6.67 | |
| Orthopaedic | 0 | — | |
| Palliative care | 0 | — | |
| Patients on anticoagulants | 2.78 | 0 | |
| Patients requiring services such as physiotherapy following surgery | 0 | — | |
| Patients who are frequently admitted to hospital | 5.56 | 3.33 | |
| Patients who have had a recent change to their medication | 5.56 | 3.33 | |
| Chronic kidney disease | 0 | — | |
| Poor vision or hearing | 2.78 | 3.33 | |
| Pregnancy | 2.78 | 0 | |
| Psychiatric illness | 0 | — | |
| Stroke | 2.78 | 0 | |
| Social factors | Illiteracy | 5.56 | 3.33 |
| Low socioeconomic status | 0 | — | |
| Patients who are non-English speakers, ethnic minorities, and refugees | 33.33 | 43.33 | |
| Out-of-area discharges | 0 | — | |
| Patients being partly managed by private health services | 0 | — | |
| Patients who are new to the practice or unsure about the NHS health system | 0 | — | |
| Patients who live on boundaries of CCG catchment areas | 0 | — | |
| Patients with no fixed abode | 8.33 | 10.00 | |
| Patients with poor mobility | 0 | — | |
| Patients with poor understanding of their health conditions | 8.33 | 6.67 | |
| Patients who are socially isolated (including housebound) | 19.44 | 20.00 | |
| Vulnerable adults requiring social care support and safeguarding cases | 25.00 | 16.67 | |
| Medications or groups of medications | Antibiotics | 0 | — |
| Anticoagulants (including warfarin, clopidogrel, rivaroxaban and other NOACs, DOACs) | 44.44 | 76.67 | |
| Anti-epileptic medications | 2.78 | 0 | |
| Antihypertensive medications (including ACEi, ARB) | 5.56 | 0 | |
| Antipsychotics | 2.78 | 3.33 | |
| DMARDs | 8.33 | 3.33 | |
| Eye drops | 0 | — | |
| Hormone tablets initiated by sex reassignment clinics | 2.78 | 0 | |
| Hypoglycaemics and insulin | 0 | — | |
| Immunosuppressants | 2.78 | 0 | |
| Injectables | 5.56 | 3.33 | |
| Melatonin | 0 | — | |
| Pain medications (including opioids) | 11.11 | 3.33 | |
| Sedatives (including benzodiazepines) | 2.78 | 6.67 | |
| Statins | 0 | — | |
| Steroids (oral and topical) | 0 | — | |
| Unlicensed medications of various specialties | 11.11 | 3.33 | |
ACEi = angiotensin-converting enzyme inhibitor. ARB = angiotensin receptor blockers. CCG = clinical commissioning group. DMARDs = disease modifying anti-rheumatic drugs. DOACs = direct oral anticoagulant. NOACs = non-vitamin K antagonist oral anticoagulants.