What is the role of Medicines Optimisation?
Approximately 11% of the funding the Integrated Care Board (ICB) receives to commission the best quality health care for our population is spent on medicines in primary care. Over the last twelve months (2021 – 2022) that equates to around £300m on more than 32m prescription items across Hampshire and the Isle of Wight.
The ICB has six medicines optimisation teams which advise on the prescribing and safe supply of medicines. The teams operate in North and Mid Hampshire, South West Hampshire, Southampton, South East Hampshire, Portsmouth and on the Isle of Wight.
The teams work collaboratively with GP practices and community pharmacists to help promote the safe and effective use of medicines and awareness campaigns about medicines – this can help prevent their misuse and unnecessary medicine wastage. They also review the latest evidence and guidelines, ensuring that everyone can gain from the best possible, safest outcomes from the medicines available.
Prescribing is a key component of medicines optimisation, and there are an increasing range of healthcare professionals who can prescribe medicines. These include doctors, some nurses, pharmacists and other accredited healthcare professionals.
Prescribers are expected to take into account the effectiveness, safety, quality and cost-effectiveness of the medicines they prescribe.
More about the Hampshire and Isle of Wight ICB Medicines Optimisation Teams
Your medicines optimisation teams at the ICB are a dedicated group of highly skilled pharmacists, pharmacy technicians, dieticians and specially trained nurses, such as those trained in diabetes. Highly valued administrative staff support the teams with their activities.
They share one common goal:
To continuously improve the use of medicines across Hampshire and the Isle of Wight so that individuals, communities and the population - including those from all backgrounds and ethnicities - can benefit as much as possible from taking the most cost-effective, appropriate medicines for them, within the resources available to us.
As well as working collaboratively across Hampshire, Southampton and the Isle of Wight, each team also works closely with its local GP practices, clusters of GP practices (known as primary care networks), and community pharmacies, to:
- Promote high quality, safe, and cost-effective prescribing of medicines to that they can prevent, as well as treat, disease
- Support patients that have long-term conditions, so that they can use their medicines effectively and keep themselves healthier for as long as possible
- Review new drugs that become available to the market. The team ensures drugs that have been appraised by the National Institute for Health and Care Excellence (NICE) are made available to those who may benefit most from them
- Raise awareness of, and help to address, the expensive issue of medicines waste. This is estimated to cost the NHS £300m each year. Across Hampshire, Southampton and the Isle of Wight the cost is around £10 million, of which up to 50% is potentially avoidable.
In addition to working with GP practices, primary care networks and community pharmacies, the team also works with hospitals, local authorities, care homes and voluntary service organisations to help patients make the best use of their medicines.
Each year it is estimated that £300m is wasted in England, on medicines.
If you have unused medicines, please take them to your local pharmacy which can dispose of them safely on your behalf. It is very important to point out that medicines should never be disposed in normal waste, or down toilets.
Registered pharmacists entering the profession now must have at least an accredited Master’s degree (MPHarm) in pharmacy.
All community pharmacies must be under the personal control of a registered pharmacist.
All community pharmacies should dispense medicines and medical appliances, dispose of unwanted or spare medicine and provide advice on self-care, healthy living and medicines support for you if you have been discharged from hospital.
Read more about community pharmacy in this 2020 King’s Fund report.
Over the counter (OTC) medicines
Your GP, nurse or pharmacist will not generally give you a prescription for certain medicines that are available to buy in a pharmacy or supermarket, even if you qualify for free prescriptions. Please use this link for further information.
Items less suitable for prescribing
- Bath and shower emollients
Resistance to taking antibiotics is a huge issue. To find out more, and become an Antibiotic Guardian, see this video by Dr Christian van Tullekan
Medicines – some advice and guidance for you
Structured Medication Review Brief for Patients
A structured medication review (SMR) is a comprehensive review of all your medicines, taking into account your circumstances, values and wishes. You can find out more about the process.
Help with Health Costs provides information about prescription charges, exemptions and costs.
See the NHS Medicines Information web pages for more information about medicine. This includes the difference between medicines, branded and unbranded medicines and how medicines become available.
Medicines Formularies in Hampshire and the Isle of Wight
A medicines formulary is a list of medicines approved for use in adults. A formulary is used alongside other resources to ensure the safe and appropriate prescribing of medicines for patients.
Currently there are a number of medicines formularies in place across Hampshire, Southampton and the Isle of Wight:
The Southampton Joint Formulary includes medications available for routine prescribing within the University Hospital Southampton Trust (UHS) and primary care in the Southampton area. It is managed by the UHS Drugs Committee, following recommendations and guidance from the Basingstoke, Southampton and Winchester District Prescribing Committee (DPC).
South West, North and Mid Hampshire
The South West and North and Mid Hampshire areas are also part of the DPC and maintain a primary care medicines formulary.
Portsmouth and South East Hampshire
The Portsmouth and South East Hampshire Area Formulary is overseen by the Portsmouth and South East Hampshire Area Prescribing Committee (APC) based on consideration of clinical evidence, cost-effectiveness and safety. The APC has representation from primary care in the Portsmouth and South East Hampshire areas, Portsmouth Hospitals University NHS Trust, Southern Health NHS Foundation Trust and Solent NHS Trust.
The Isle of Wight Joint Formulary has been developed to provide both primary and secondary care clinicians and prescribers of all levels access to an approved list of medications. The formulary has been built and designed with the collaboration of the former IOW CCG Medicines Optimisation Team (MOT) and IOW NHS Trust Pharmacy Team. The appropriate options have been used to update the GP system A-Z medication list – SystmOne formulary, and options provided through OptimizeRx. Mutually agreed processes for the request of new items and the coding use throughout the formulary has been agreed between both organisations. New drug requests will be weighed against existing available treatments along with cost, safety and efficacy. The impact on primary and secondary care resources will also be evaluated.
There is a plan to create a single Hampshire and Isle of Wight Prescribing Committee that will lead to the harmonisation of the existing formularies.