Issue - meetings

Stuart Lakin, Head of Medicines Management, Rotherham Clinical Commissioning Group, presented a report on the work taking place in Rotherham to reduce pharmaceutical and medical waste as identified in the Select Commission’s 2013-14 work programme.

The report highlighted that in Rotherham:-

Summary of Savings

-          Nationally 10.7% (£831,292,864.99 per annum) of prescribing expenditure was on appliances (continence/stoma), nutritional supplements and wound care products – Rotherham had managed to significantly decrease the cost whilst improving the patient experience

-          Estimating that if Rotherham’s nutritional expenditure had increased in line with national cost growth trends since the service redesign – then spending would have been 89% higher, a potential saving of £468,125 per annum

-          Continence prescribing costs had decreased in Rotherham by -8.99%

-          Management of gluten free products through prescribing by the dietician had resulted in a -19.61% decrease

-          Stoma prescribing costs had decreased from £964,687 in 2011/12 to £748,159 in 2012/13 (-22.45%)

-          The above savings had been achieved by the improved management of prescriptions and regaining prescribing of appliances from the Direct Appliance Contractors – estimated savings of £1,094,753 against Rotherham’s 2012/13 prescribing costs

Reducing Waste

-          Patients understood that excess medicines was a waste of NHS resources

-          Approximately 300 patient questionnaire had been sent directly to patients in 2012 but had not revealed waste as an extensive problem nor identify any causes of waste

-          Continence and stoma patients reported receipt of unrequired products or surplus quantities – requests to practices to change the prescription/appliance companies went unheeded.  Similar issues with medication from pharmacists

-          Patients were genuinely resistant to tell their doctor that they were not taking a particular medication

-          Only intervention demonstrated to reduce medicine waste was the adoption of a 28 day prescription policy – 34 of Rotherham’s 36 GP practices had this in place

-          Pharmacies were paid for everything they dispensed under the current contract

Discussion ensued on the report with the following issues raised/clarified:-

·           Care homes tended to throw medication away at the end of the month unnecessarily and order new – no specific figures for care homes but overall waste is estimated at £1.5m in Rotherham

·           A pharmacy technician was to be seconded to work with the CCG for a year to look at the pathways of the hospital and wastage

·           Consideration was being given to having a pharmacy technician work with care homes.  If that resulted in a reduction of waste and saved more than it cost, it may be rolled out across Rotherham

·           Need to ensure that patients had a variety of ways to order their prescriptions e.g. out of hours, on line

·           Branded versus generic medication

·           Consideration given to certain drugs for certain conditions – quality criteria monitoring

·           Data was collected by searching the 2 IT systems

·           Due to European Legislation, medicines could not be re-issued once they had left the control supply chain even if they had not been opened

·           There were very few independent pharmacies in Rotherham – pharmacies were used  ...  view the full minutes text for item 74