“Positive steps being taken, but further scope to improve quality and costs”, says Auditor General
Health bodies in Wales are working together well to improve the way medicines are prescribed and managed, but it needs a higher profile. That’s the conclusion of a report, published today, by the Auditor General for Wales.
The report also found that while NHS Wales is taking steps to improve primary care prescribing, there is scope to further improve quality and costs. In hospital, pharmacy services are rated highly by NHS staff but there are problems with medicines storage, gaps in information about medicines, and the delay in implementing a national electronic prescribing system is frustrating efforts to improve safety and efficiency.
Prescribing medicines is the most common therapeutic intervention in the NHS and demand for medicines is growing – with a 46% increase in the number of items dispensed in Wales over the last 10 years.
Given the cost of medicines, the rising demand and the potential for harm to patients from inappropriate prescribing, it is important that the NHS optimises the use of medicines to ensure patients get good outcomes from their treatment and that maximum value is secured from this expenditure.
More action is needed to ensure medicines-related safety risks are managed when patients transfer between different care settings, and to properly understand the true extent of medicines related hospital admissions. There are opportunities for health professionals, particularly pharmacists, to work with patients to understand their experiences, ensure they are taking their medicines correctly and check that they are not taking unnecessary medicines. The benefits will be improved medicines safety, reduced wastage and better health outcomes for patients.
The report makes 10 recommendations for improvement, which include:To drive further improvements in prescribing, health bodies should ensure they have a targeted plan of action to achieve cost and quality improvements in prescribing in primary care and in secondary care, in line with prudent healthcare principles.
- A need to evolve the current National Prescribing Indicators so that they provide information on whether medicines are making a positive difference to patient outcomes
- The Welsh Government, NHS Wales Informatics Service and all health bodies should agree a detailed, time-bound plan for implementing electronic prescribing systems in secondary care, along with a clear process for monitoring the delivery of the plan.
- To raise the profile of prescribing and medicines management, health bodies should ensure their Chief Pharmacist is, or reports directly to, an executive director.
The Auditor General for Wales, Huw Vaughan Thomas, said today:
“With over £800m spent on medicines and over 79.5 million different medicines dispensed in the community per year, it is vitally important that the use of medicines is optimised so that patients receive the best possible outcomes.. It is encouraging to see NHS bodies collaborating well to improve medicines management. My recommendations are designed to strengthen current arrangements further.”