Getting the Prescription Right

Giving a medicine is the commonest healthcare intervention.  Over the last 50 years, medicines have saved many lives and improved the quality of life for millions of people.  These benefits, however, do come at a cost.  There is not an inconsiderable financial cost, £8,000 million in the UK last year.  If medicines are not used correctly, whether as a result of a prescribing, dispensing or administration error, or even a mistake by a patient, there can be a massive human cost.

Recent Audit Commission reports have commended pharmacists working in hospitals and primary care organisations, for achieving optimal value for money from medicines.  Managing risks associated with medicines and improving the quality of prescribing are other key roles of these pharmacists.

The Audit Commission also recognised that there is much more to be done on the quality agenda.  Manpower is a major constraint and the NHS has had a long history of problems with recruitment and retention of pharmacists.  It will be a major challenge to move this quality agenda forward in terms of improving patients’ treatment and reducing adverse events, coupled with implementing new initiatives such as pharmacist prescribing.

Computerised prescribing and automation of dispensing improve quality and reduce risk as well as releasing pharmacists to work in more patient-centred activities.  The technologies for these already exist, although lack of investment is a major barrier to further implementation.

Agenda for Change, the new pay system for NHS staff has the potential to be a powerful tool for addressing recruitment and retention problems.  However, if it fails to recognise, value or reward pharmacists’ unique contribution to safe and effective patient care with medicines, then it will be expensive for the NHS.  More worryingly, patients will be at increased risk of harm due to inefficient and inappropriate use of medicines.

The Guild of Healthcare Pharmacists represents over 3000 pharmacists working in hospitals and Primary Care Organisations throughout the UK.