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Medicines optimisation teams ‘lack capacity’ to drive transformation, says NHS Confed

Many medicines optimisation teams lack the capacity to build relationships across integrated care systems (ICSs) and drive transformation for this ‘golden thread of healthcare while also focusing on operational work, the NHS Confederation has warned.

These teams should be involved in projects and service redesigns from the start, the NHS Confederation recommended in its recent ‘Taking Stock: the experience of medicines optimisation in ICSs’ report.

It also said that integrated care boards (ICBs) should build awareness of medicines optimisation in wider disciplines, including in social care, seeking to create one united medicines optimisation team across the system.

‘Even though medicines optimisation cuts across all aspects of care in all settings, it is sometimes not well understood and is often seen as separate, technical and transactional,’ the report said. This makes it difficult for medicines optimisation teams to participate in system-wide discussions when services were being designed, and were often involved too late in the process, it added.

It also said that in some areas, teams were starting to implement a system prescribing approach, but that progress was slow in other areas.

The organisation added that medicines optimisation teams were currently taking on additional responsibility and workload without any additional funding or capacity.

Medicines optimisation challenges

In addition, NHS Confederation warned that competition within systems for pharmacy staff had presented a challenge to building medicines teams, recommending that pharmacy workforce plans should be developed that include ‘innovative and rotational roles’.

But it said that ‘in spite of these challenges, the pharmacy workforce has great potential to further contribute to the future sustainability of the NHS’, citing the Royal Pharmaceutical Society’s Vision for Pharmacy Professional Practice in England.

Another operational challenge outlined by the NHS Confederation report was the lack of interoperability between systems, such as a lack of linked patient records across different settings.

It said that misaligned incentives between different parts of the system prevented patient-first solutions from taking place.

For example, it suggested that when secondary care has access to the electronic prescribing system, the dispensing of drugs currently dispensed by NHS trusts – including high-tech medicines such as oral chemotherapy or immunotherapy drugs and monoclonal antibody therapies – could be moved to community pharmacy.

But this could only be made financially viable if community pharmacies were given the same discounts on these drugs that NHS trusts do, and therefore a three-way agreement between hospital, community pharmacy and pharmaceutical companies would need to be in place.

This story was originally published by our sister publication The Pharmacist.

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