Medicines optimisation teams need national support to maximise their contribution, say commissioners

A report from NHS England outlines the value of strategic medicines optimisation and the role of national organisations in supporting local initiatives.

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Support from NHS England and other national organisations is essential for local medicines optimisation teams and the pharmacists that lead them to carry on delivering for patients and the NHS, according to a publication by NHS Clinical Commissioners (NHSCC), the body which represents clinical commissioning groups (CCGs).

It includes five suggestions for how national organisations can support the delivery of local medicines optimisation now and in the future, including the development of a formal support network, backed by NHS England, to ensure effective communication and engagement with local medicines optimisation teams.

The report also suggests that NHS England and the other arm’s-length bodies must ensure that where national support is provided to improve local prescribing practice, for example NHS England funded clinical pharmacists in GP surgeries, they should use CCG medicines optimisation teams to co-ordinate, advise, and provide local leadership and support implementation.

“This publication highlights the outstanding work that local medicines optimisations teams are already doing across the country to ensure safety and best outcomes for patients as well as getting the best value for each NHS pound on behalf of the taxpayer,” said Julie Wood, chief executive of the NHSCC.

“We believe it is therefore essential that these teams are supported by NHS England and other national bodies to continue this important work and keep on delivering for patients, populations and the NHS.”

Sandra Gidley, chair of the Royal Pharmaceutical Society English Pharmacy Board, said that the report was useful in highlighting the significant role that CCG pharmacists are playing in ensuring that patients receive the right medicine and have improved outcomes.

“With a lack of clarity over the future of CCGs it is imperative that this vital role is not overlooked as we move to new NHS structures, as the role of pharmacists in medicines optimisation has never been more important.

“The bottom line savings are useful in making a business case but it is the added value, and improvement in everyday lives, that is of utmost importance.”

But she questioned whether the recommendations went fair enough.

“It seems to me that another piece of work needs to be completed. Medicines optimisation teams do not work in isolation and more needs to be done to join up medicines optimisation work with pharmacists in all care settings. By greater co-working with community and hospital pharmacists the profession can ensure that patients receive a continuity of message, leading to the very best in care.”

The publication features several case studies from CCGs across the country that demonstrate the value that local strategic medicines optimisation teams, and in particular pharmacists, bring for patients, populations and the wider NHS. However, Gidley was concerned that branded generics were given as one of the examples.

“This is not actually medicines optimisation but a pure cost-saving measure and the recent proliferation of branded generics has, in some cases, led to confusion in patients and frustration among community pharmacists who are left with an expensive array of dead stock when the CCG recommends a new, temporarily cheaper, product.

“This is why it is important that pharmacists, across the system, work together. So, as an addition to the much welcome national guidance I would like to see a focus on better intraprofessional communication and collaboration on these very important issues.”

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Citation
The Pharmaceutical Journal, Medicines optimisation teams need national support to maximise their contribution, say commissioners;Online:DOI:10.1211/PJ.2018.20205501

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