The challenge
NECS is commissioned to provide an in-practice medicines optimisation service by Calderdale Place, part of the West Yorkshire Integrated Care Board (WYICB). The service is delivered by a small team of pharmacy technicians and pharmacists who work in practices using an agreed medicines optimisation action plan.
Our response
The NECS team worked closely with the WYICB Place team to develop an action plan which was tailored to meet the needs of the local population, as well as the national medicines optimisation priorities. Examples of projects included:
- Reviewing the appropriateness of gluten free prescribing in line with a commissioning policy.
- Ensuring inhalers prescribed for asthma were in line with guidelines.
- Ensuring blood glucose meters used were in line with the local formulary.
The team also undertook safety audits to assess whether the prescribing of certain medications was in line with current guidance and best practice. Examples of these included:
- Ensuring patients prescribed ACE inhibitors or angiotensin receptor blockers (ARBs) had appropriate monitoring undertaken.
- Identifying and reviewing patients prescribed long term fluoroquinolone antibiotics to ensure continued use was appropriate.
- Reviewing patients prescribed hydroxychloroquine to identify those who had not had annual retinal screening.
- Reviewing patients of childbearing potential prescribed either topiramate or sodium valproate to ensure use is in line with MHRA guidance.
All work was carried out by registered health care professionals who reviewed each patient individually, working within agreed standard operating procedures.
Outcomes
In 2024/25, the NECS team reviewed over 11,000 individual patients and made more than 5,800 interventions. A substantial financial saving within the prescribing budget was achieved for the NHS, allowing money to be reinvested into the local health system.