Medicines Management
Issue no 2, p1
March/April 2002

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PCTs see growing role for medicines management

Prescribing advisers in primary care trusts say that they hope to begin using medicines management more widely in the battle to contain rising pressures on prescribing budgets.

With the widespread decommissioning of health authorities on 31 March, community pharmacists will be increasingly represented on PCTs. PCT prescribing advisers believe this will lead to better integration of community pharmacists with primary care teams, enabling medicines management schemes to take off across organisations.

Chris Lawson, prescribing adviser for Mansfield PCT, said her PCT would now be looking to use medicines management as part of its efforts to maintain quality prescribing and cost-effective medicines use.

"We are already seeing a fast pace, and a lot of the work is being driven by the medicines management collaborative pilots, because they have set a lot more targets for organisations around community pharmacy development."

But Ms Lawson said that continuing pressures on prescribing budgets from implementing national guidance from NSFs and NICE were making it more difficult to invest in the staff needed to drive forward quality prescribing and medicines management. "There is a lot less room for manoeuvre within the budget," she said.

Dr Brian Curwain, chief pharmacist for New Forest PCT, said NSF drug costs were also driving prescribing spending up in his area, and that PCTs would increasingly be looking to medicines management to help curb prescribing costs.

"Some PCTs are millions of pounds overspent. We are extremely short of money, and a number of PCTs will inherit deficits from health authorities," said Dr Curwain.

He added: "If you're looking for savings in prescribing now, in most parts of the country the easy hits with generic prescribing have been made. It will be down to individual therapeutic review centred on patients, including medication reviews. But that process is very labour intensive."

Louise Jackson, primary care pharmacist for Wakefield PCT, said that community pharmacists were increasingly being represented on its medicines management committee, being established to take forward the PCT's strategy.

"We've changed our prescribing section in our strategy document to medicines management, because we recognise that it is not just one GP making decisions about which medicine is right."

She added that the PCT hoped to use expertise from a range of primary care professionals to influence its medicines management policy, from health visitors seeing problems with patients' medicines right through to community pharmacists.

Richard Seal, from the National Prescribing Centre, Liverpool, said baseline data from the first-wave medicines management collaborative pilots confirmed that PCTs were looking at cost issues around medicines use.

“The areas that people are looking at are not surprising, and we have a number of sites looking at gastrointestinal prescribing, around acid suppression and proton pump inhibitors." Mr Seal added that NSAID use, osteoporosis and the appropriate prescribing of statins were also being looked at by pilot sites.