Medicines Management

Background

Excellent management of medicines by health professionals and well targeted prescribing for patients and users delivers health improvement. This is true for both acute and chronic disease, and underpins many of the current initiatives to improve the quality of patient care.

Medicines management is also important because, in common with all other treatments, medicines incur a direct financial cost to purchase and administer, and potentially wider economic costs due to adverse events or wastage.
It is important, therefore, that the potential health gains from medicines are realised and that taxpayer’s investment in medicines is spent wisely.


Policy Context

The All Wales Medicines Strategy Group document Getting the Best Outcomes from Medicines for Wales proposes a vision for the future of prescribing and medicines management in Wales.

The focus of the strategy Remedies for Success is on the pharmaceutical needs of the individual and how these can be met over the next ten years.
The strategy aims to ensure that Wales offers an attractive and challenging environment to enable the profession to fulfil its potential and deliver high quality pharmaceutical services to the population of Wales.


A new contractual framework was introduced for community pharmacy in April 2005. Drawing on the assets of skills, expertise and experience of pharmacists and their staff and its presence in the community with a tradition of ready access to all - Community pharmacies now provide a greater range of services and are rewarded for the range and quality of those services. 

The Pharmaceutical Public Health Team of Public Health Wales covers a number of key areas including Medicines Management which focuses on the clinical effectiveness, cost effectiveness and safe use of medicines.

The Welsh Pharmaceutical Committee advises the Assembly on professional pharmaceutical issues in Wales.

The Chief Pharmaceutical Adviser:

  • Provides independent advice on all aspects of medicines including the regulation of medicines
  • Ensures that pharmaceutical services develop to meet specific healthcare needs
  • Leads the modernisation of pharmaceutical services and continuing professional development of pharmacists and support staff and
  • Works with other UK government departments to co-ordinate pharmaceutical advice and information.


Initiatives

A Medicines Management Pilot led by NHS Wales Informatics Service (NWIS) formerly Informing Healthcare is redesigning medicines management processes to eliminate delays, and to deliver patient medicines earlier resulting in quality delivery with efficiency savings of over £1million per annum. The project has received funding under the second round of the Assembly's Invest-to-Save fund, which provides interest free loans to public service providers to help them make their services more efficient. 

You can find out more via the link below:
Improving medication safety is a key element of the 1000 Lives Plus programme, more details are available at:

Medicines management in care homes and the prescribing of nutritional products in the Nealth Port Talbot area were highlighted as areas for potential improvement in a report to the Local Health Board.More information is available below:


The Medicines and Healthcare products Regulatory Agency (MHRA) is the government agency which is responsible for ensuring that medicines and medical devices work, and are acceptably safe. The MHRA is an executive agency of the Department of Health.

The National Prescribing Centre (NPC) facilitates the promotion of high quality, cost-effective prescribing and medicines management; It provides information on medicines and their use.

The National Patient Safety Agency (NPSA) leads and contributes to improved, safe patient care by informing, supporting and influencing organisations and people working in the health sector.

The All Wales Medicines Strategy Group (AWMSG) brings together NHS clinicians, pharmacists, healthcare professionals, academics, health economists, industry representatives and patient advocates to provide advice on strategic medicines management and prescribing to the Minister for Health & Social Services.

The Welsh Medicines Resource Centre (WeMeReC) is a source of independent information on prescribing for healthcare professionals working in Wales including general practitioners, community pharmacists, medical and pharmaceutical advisers. WeMeReC promotes effective, safe, appropriate and economical prescribing of medicines. The Centre liaises with many organisations across Wales to address national and local prescribing issues and to extend the learning opportunities it offers to all relevant audiences. 

The managed introduction of new medicines in Wales, of which the medicines appraisal process is a part, aims to ensure that valuable NHS resources are used responsibly to benefit patients. Medicines appraisal is the process by which the NHS decides whether the benefit to patients of a particular medicine justifies any additional cost for its purchase.

Yellow Card Centre Wales (formerly named CSM Wales) is one of five regional adverse drug reaction monitoring centres, acting on behalf of the Medicines and Healthcare products Regulatory Agency.


Publications

In August 2008, the Minister for Health and Social Services asked Professor Philip Routledge, Chair of the All Wales Medicines Strategy Group (AWMSG), to look at the broader issues of improving the availability of medicines and the use of so called heroic drugs to prolong life.
The final report below from the Expert Review Group was published in March 2009.

An Implementation Group, chaired by Professor Roger Walker, Consultant in Pharmaceutical Public Health for Public Health Wales, was set up to take forward the recommendations of the expert group and published their own report in March 2010.

The Medicines Management Collaborative Programme Wales led by the National Leadership and Innovation Agency for Healthcare (NLIAH) with a goal to optimise prescribing; improve health outcomes and patients experiences when medicines are involved.

The NHS Wales Governance e-Manual is designed to assist NHS organisations in Wales develop robust governance and assurance arrangements. A lot of the information on Medicines Management has been taken from ‘The Safe and Secure Handling of Medicines a Team Approach’ (Duthie 2005) which is linked to from the page below.

Antibiotic resistance has increased in the past years to the point where it is now a major threat to the future effectiveness of antibiotics. The increase in drug-resistant bacteria now constitutes a serious risk to public health. The Chief Medical Officer for Wales letter on Antibiotic Awareness encourages health professionals to continue to prescribe antibiotics appropriately.
The Welsh Assembly Government Get better without using antibiotics leaflet explains the need to get the right treatment for common illnesses such as colds and coughs without encouraging antibiotic resistance 

The Welsh Assembly Government report Free Prescriptions Three Years On marks the third anniversary of the introduction of free prescriptions. It shows how free prescriptions are helping to improve the health of the people of Wales.


The latest statistics on prescriptions dispensed in the community in Wales produced by the Welsh Assembly Government were released on 30 March 2010 according to the arrangements approved by the UK Statistics Authority.

The latest National Statistics on GP prescribing produced by the Welsh Assembly Government were released on 25 August 2010 according to the arrangements approved by the UK Statistics Authority


1000 Lives Plus - Medicines Management Videos