Ward-based pharmacists are beneficial and cost-effective

The National Institute for Health and Care Excellence (NICE) guideline NG94, published in March 2018, focused on organising and delivering emergency and acute medical care for people aged over 16 years in the community and in hospital[1]
. The main aims of the guideline were to reduce the need for unplanned hospital admissions, promote good-quality care in hospital and facilitate joined-up working between health and social care.

The efficiency of ward pharmacy services was examined in this guideline, in which a review was undertaken that aimed to assess whether ward-based pharmacists improve outcomes and are cost effective. This systematic review and accompanying meta-analysis demonstrated the potential benefits for patient safety of regular involvement of ward-based pharmacists in care provision. It also showed that this input on regular basis, through a dedicated ward-based pharmacist, is cost-effective. Based on the findings, a strong recommendation was made in the guideline to “include ward-based pharmacists in the multidisciplinary care of people admitted to hospital with a medical emergency”[1]

It is no surprise that the paper reporting the findings of this review has attracted considerable interest and support from within and outside the pharmacy profession since it was published online on 19 October 2018 in Research in Social and Administrative Pharmacy
. This level of evidence provides exactly the kind of support that hospital chief pharmacists can use for business cases to promote patient-facing pharmacists who are involved in medicines optimisation from admission to discharge.  Investment in a patient-facing, ward-based pharmacy workforce will contribute to implementation of the recommendations of Lord Carter’s review, which support hospitals in addressing unwarranted variations in care[3]

The authors of this letter encourage hospital pharmacists to make use of this up-to-date and comprehensive review to make the case for more direct involvement from pharmacists at ward level to provide medicines optimisation, governance and safety for patients, as recommended by Lord Carter[3]


Dalia Dawoud, lecturer, Clinical and Pharmaceutical Sciences Department, University of Hertfordshire

Nina Barnett, consultant pharmacist, care of older people, London North West University Healthcare NHS Trust and NHS Specialist Pharmacy Service


[1] National Institute for Health and Care Excellence. Emergency and acute medical care in over 16s: service delivery and organisation (NG94). March 2018. Available at: https://www.nice.org.uk/guidance/ng94 (accessed October 2018)

[2] Dawoud D, Smyth M, Ashe J et al. Effectiveness and cost effectiveness of pharmacist input at the ward level: a systematic review and meta-analysis. Res Social Adm Pharm 2018 (In press). doi: 10.1016/j.sapharm.2018.10.006

[3] Lord Carter of Coles, Department of Health. Operational productivity and performance in English NHS acute hospitals: Unwarranted variations. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/499229/Operational_productivity_A.pdf (accessed October 2018)

Last updated
The Pharmaceutical Journal, PJ, November 2018, Vol 301, No 7919;301(7919):DOI:10.1211/PJ.2018.20205653

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