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Medicines Optimisation QIPP savings for over the counter prescribing

Challenge

The NHS each year spends:
- £22.8 million on constipation – enough to fund around 900 community nurses
- £3 million on athlete’s foot and other fungal infections – enough to fund 810 hip ops
- £2.8 million on diarrhoea – enough to fund 2912 cataract operations

Some products can be purchased over the counter at a lower cost than that which would be incurred by the NHS – for example, a pack of 12 anti-sickness tablets can be purchased for £2.18 from a pharmacy whereas the cost to the NHS is over £3 after including dispensing fees, and over £35 when you include GP consultation and other administration costs. Similarly some common tablets are on average four times more expensive when provided on prescription by the NHS.

Working across the NHS system in the North East and North Cumbria, the NECS Communications and Engagement Team were tasked with developing and delivering an at scale approach to support efficiencies around QIPP schemes as agreed by the North East and North Cumbria CCG Prescribing Forum.

These schemes included raising awareness with patients and the public around the costs of prescribing medicines that are routinely available for the patient to buy from pharmacies and other outlets, such as paracetamol and hay fever medication. The overall aim was to save money on prescribing costs for items that patients can easily buy to treat self-limiting minor ailments, which allows the savings to be used elsewhere in the healthcare system.

The communications team needed to work across the region to create an innovative and memorable campaign. The team also needed to plan wider communications and stakeholder handling around the scheme in order to manage the reputation of the CCGs.

A suite of materials needed to be produced to promote these messages in a co-ordinated manner to ensure that all messages were consistent across the region.

The team would need to work effectively with internal colleagues and those within the wider NHS across the region. Medicines Optimisation QIPP savings for over the counter prescribing

Tasks

Following research with practices, a suite of communications materials was produced and distributed to GP practices, walk –in centres, A&E departments and pharmacies for prescribers who wanted to use it to help the discussion during interaction with patients to promote self-care. The research showed that when clinicians explain that conditions can be managed without the need for a prescription, patients choose self-care in the future for minor ailments.

This approach was supported by proactive communications through the media, information on CCG websites and social media. Media statements were produced and sent to all media outlets across the health and care system, FAQs, responding to FOIs, media handling as well as responding to social media in real time.

Audiences and stakeholders included local medical and pharmaceutical committees, GPs and practices, pharmacists,
prescribers, healthcare workers, MPs and Healthwatch organisations.

Key messages included:

  • The NHS is under increasing financial pressure and we need to look at ways in which we can save money
  • The amount of money prescribing paracetamol and other medicines costs the NHS each year
  • From 1st April, the NHS in the North East will be promoting self-care for minor conditions
  • Promoting the use of Pharmacies as a first port of call for self-limiting conditions

The materials used visual language such as illustrating the distance you would reach if you lined all the paracetamol tablets up that are prescribed annually in the North East and North Cumbria.

The creative used was powerful and aimed to get people thinking about taking more responsibility of self-care instead of the default position of making an appointment and getting a prescription from their GP, the overall aim was to encourage behavioural change in people to ultimately self-care and purchase medication from a pharmacy.

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The scheme running across the North East and North Cumbria has already shown that savings can be made by not routinely prescribing for minor ailments that can be self-managed. When these kinds of savings are made across the whole country, the NHS will be able to invest more in those services that are most needed such as new cancer treatments and improvements to mental health services.

Dr Graham Syers

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Results

Campaign materials were successfully distributed to all pharmacies, walk–in centres, A&E departments and GP practices across the system in the North East and North Cumbria.

The social media campaign was well received, with several other regions requesting the campaign artwork to promote similar messages within their area. Within the first twelve month of the campaign it has already shown impressive savings. Over £1million has been saved on the prescribing of products for hay fever and simple pain relief alone in the North East and North Cumbria region.

Following success of the campaign, NECS’ Communications and Engagement team were tasked by the Regional Prescribing Forum to promote NHS England’s national consultation regarding over the counter prescribing on behalf of the region’s CCGs. The team has since communicated the outcome of the national consultation across the region.

The campaign includes messages around pain relief, hay fever, sun safety and self-care.