🔐 Medicines Optimisation and Safety: The Pharmacist’s Impact
Introduction: Why Medicines Optimisation Matters
Medicines are the most common intervention in the NHS — and also one of the riskiest. While they have the power to prevent, manage, and cure disease, they can also cause harm if not used optimally.
- Over 1.1 billion prescription items are issued annually in England.
- Around 10% of hospital admissions in older adults are related to medicines.
- Up to half of patients don’t take their medicines as intended.
Medicines optimisation is about ensuring the right medicine is prescribed for the right patient, at the right time, and used in the right way. And no one is better placed to lead on this than PCN pharmacists.
Defining Medicines Optimisation
Medicines optimisation goes beyond medicines management. It’s a proactive, patient-centred approach that aims to:
- Improve patient outcomes.
- Reduce medication-related harm.
- Ensure value for money.
- Promote shared decision-making.
- Minimise unnecessary prescribing.
This approach is a core NHS England priority and an essential element of safe, sustainable primary care.
The Pharmacist’s Role in Optimisation
PCN pharmacists are uniquely qualified to lead this work. Their responsibilities include:
- Clinical review: ensuring prescribing aligns with NICE and local guidance.
- Deprescribing: safely reducing or stopping unnecessary medicines.
- Monitoring: tracking outcomes, side effects, and adherence.
- Audit and governance: supporting practices to meet safety standards.
- Education: empowering patients to understand and manage their therapy.
Their medicines expertise allows them to spot patterns and risks that may otherwise be missed.
Why Safety Is at the Heart of Optimisation
Unsafe prescribing isn’t just a clinical issue — it’s a patient safety concern. Common problems include:
- Duplicate therapies
- Inappropriate polypharmacy
- Drug–drug interactions
- High-risk prescribing (e.g. NSAIDs, anticoagulants)
- Failure to monitor or review
Pharmacist intervention has been shown to significantly reduce medication errors and hospital admissions.
Supporting NHS Priorities Through Optimisation
Medicines optimisation aligns closely with national priorities such as:
- NHS England’s Medicines Safety Improvement Programme.
- IIF and QOF targets focused on safe prescribing.
- NICE guidance on polypharmacy, frailty, and deprescribing.
- ICB strategies for cost-effective use of resources.
By focusing on safety and effectiveness, pharmacists support both patient outcomes and system sustainability.
Deprescribing: Doing More by Prescribing Less
Deprescribing is a crucial — and often underused — part of optimisation. It involves:
- Identifying medicines with no clear ongoing indication.
- Discussing risks and benefits with patients.
- Reducing or stopping medicines safely.
- Monitoring outcomes closely.
Far from taking something away, deprescribing often improves patients’ quality of life, reduces side effects, and simplifies treatment plans.
Building a Culture of Shared Decision-Making
Optimisation is most effective when patients are partners in their care. Pharmacists build trust through:
- Clear, jargon-free communication.
- Respecting patient preferences.
- Addressing concerns about medicines.
- Encouraging self-management where appropriate.
This approach improves adherence and satisfaction while reinforcing safety.
Future Outlook: Intelligent, Data-Driven Optimisation
In the near future, pharmacists will use digital tools and population health analytics to:
- Identify at-risk patients proactively.
- Prioritise interventions more efficiently.
- Track the impact of optimisation programmes over time.
Independent prescribing will further empower pharmacists to implement changes swiftly, without waiting for GP sign-off.
How Prescribing Care Direct Supports Medicines Optimisation
At Prescribing Care Direct, we provide:
- Experienced PCN pharmacists with expertise in optimisation and safety.
- Programme support aligned with national and local priorities.
- Clinical governance frameworks to support safe practice.
- Data-informed approaches to population health and cost savings.
We help PCNs move from reactive to proactive safety strategies.
Conclusion: Safer Medicines, Better Outcomes
Medicines optimisation is not just a technical exercise — it’s about saving lives, improving care, and making the NHS sustainable.
Pharmacists are uniquely positioned to lead this work. Their combination of expertise, patient engagement, and clinical leadership allows practices and PCNs to deliver safer, more efficient care.
📞 Call to Action:
To strengthen medicines optimisation and safety in your PCN, partner with Prescribing Care Direct.
👉 Contact us today to explore tailored pharmacist support and leadership.