UPDATE MEDICINES MANAGEMENT


Medicines management is old news. The phrase of the day is ‘medicines optimisation’. But what does this change of wording mean for CCGs and how they incorporate prescribing into their plans? JULIA DENNISON finds out


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he phrase ‘medicines management’ is one many general practitioners and their commissioning partners will have heard, but what does it actually mean? NHS Local puts it simply as ‘enabling people


to make the best possible use of their medicines’, while the National Prescribing Centre describes it slightly more opaquely as ‘a system of processes and behaviours that determines how medicines are used’. Whichever definition you prefer, the main crux of the philosophy is ensuring the population gets the best outcomes from the medications it’s prescribed for the lowest cost. With the Nicholson Challenge hanging like the sword of Damocles over commissioners’ boardroom tables, cost-saving of any kind is very much top of the agenda. When prescribing and the management of drugs accounts for 12% of the overall NHS budget, the King’s Fund is right to highlight the area for potential efficiencies. Without excessive bureaucracy holding them back, CCGs have the power to implement these quickly. Medicines management is about more than just medicines. Shailen Rao, MD of medicines management firm Soar Beyond, believes that many areas that CCGs will be trying to tackle – such as long-term conditions and hospital admissions – can


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be directly impacted by medicines. “They’re a very integral part of the pathway,” he says. “If you look at pathway and service redesign, you have to consider the medicines aspect.” Historically, medicines have sometimes sat in a different budget category to that of, say, long-term conditions, and Rao hopes with the umbrella of commissioning there will be the opportunity to bring them together.


EDUCATING THE MASSES Two major areas to address first on the path to better value medicines is prescribing errors and patient adherence. It is estimated that £100m a year could be saved from patients taking medicine correctly, while £40m could be retained by reducing errors in prescriptions. Throughout the country PCTs have been working hard to reduce excessive prescribing costs, and this will now fall onto the lap of the CCG boards. As part of its recent focus on medicines management, NHS West Midlands made a list of priorities. It included reducing the number of people being admitted to hospital due to problems with their medicines; improving medication safety by reducing the number of medication errors and, lastly, echoing the National Prescribing Centre’s definition of medicines management, supporting people to make


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