Taking stock: the experience of medicines optimisation in ICSs
Findings and recommendations from an ICS Network stocktake to better understand how medicines optimisation is developing in a system environment.
Download the report $Taking Stock Experience Of Medicines Optimisation In Icss (1) 791.0 kBKey points
- Delivering on ICSs’ four core purposes. Medicines are the most common healthcare intervention, the most common cause of avoidable harm to patients and the second highest area of NHS spending after staffing. Optimising medicines usage plays a significant role across all four of the ICS priorities: improving population health and healthcare; tackling unequal outcomes and access; enhancing productivity and value for money; and helping the NHS to support broader social and economic development. A strategic role for medicines optimisation in systems – looking across patient pathways from prevention to diagnosis and social prescribing – could unlock significant opportunities to go further and faster in achieving these core aims.
- Governance. Since 1 July 2022, statutory ICBs and wider ICSs have been building new governance arrangements to achieve this vision, albeit they are at different stages. Many have recruited directors of medicines optimisation or chief pharmacists and established new medicines boards tying together medicines leadership in different sectors. While building new governance arrangements to adapt to the new statutory structures is crucial to enabling change, it is not an end itself and inevitably this transitional work has consumed time and effort.
- Building one team. Building one medicines team – beyond pharmacy teams – requires all parts of the system to work together at a local level, including across the NHS, private providers, social care and the voluntary sector. However, substantial workforce vacancies, exacerbated by competition within systems for the same staff, and a lack of development opportunities to retain, inspire and develop the medicines workforce of tomorrow, are a significant challenge.
- Digitising medicines. ICBs are uniquely placed to build a system view of how medicines are prescribed and used and their impact on patient outcomes. There are exciting opportunities for improved digital technology, data sharing and common access to enhance understanding population health, where inequalities in use and access exist, and how to address them.
- Progress made, but much more to do. ICSs have made progress with the ‘systemisation’ of medicines optimisation. While this stocktake sets out examples where appropriate governance structures have been created, new pharmacy career pathways developed and new data tools deployed, much of the transformation opportunity still lies ahead. Progress could be accelerated by:
- using system leadership to ‘mainstream’ medicines optimisation in pathway redesign
- ensuring appropriate governance is in place and supports greater focus on transformation
- developing pharmacy workforce plans alongside building awareness of medicines optimisation in wider disciplines
- harnessing digital and data to share medicines records and establish a baseline for improvement
- sharing learning between systems to drive self-improvement.