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Integrated care board (ICB) chief pharmacists across England have written to NHS England, calling for medicines leadership to be a “fundamental component” of an overhauled ICB system.
In a joint letter sent on 15 April 2025, four ICB chief pharmacists urged senior NHS England executives to work with pharmacists as strategic commissioning of NHS services in England is developed.
“It is imperative to ensure we strategically lead one of the most significant investments within the NHS: medicines,” the letter stressed.
It also noted that ICB pharmacists oversee an almost £20bn expenditure on medicines across England, with more than £0.5bn in savings made by ICB medicines teams in 2024/2025.
For 2025/2026, the letter said that there are plans to achieve the same level of savings.
“We also recognise that we need to continue to transform how the system and individual people use medicines effectively (including alternatives to prescribing).
“Prescribing is one of the most volatile expenditures in the NHS, and we are collectively keen to work with you to maintain grip on the management of this precious resource,” it added.
The letter comes weeks after the government announced that ICBs must halve their budgets from October 2025 and in advance of a new ten-year plan for the NHS, which is due to be published later in 2025.
However, in a statement published on 1 April 2025, Jim Mackey, interim chief executive of NHS England, admitted that “reducing costs of ICBs by 50% will be a challenge”.
Commenting on the letter, Tase Oputu, chair of the Royal Pharmaceutical Society English Pharmacy Board, told The Pharmaceutical Journal: “Pharmacy teams play a crucial role in enhancing NHS care and optimising budgets. By providing expert medicines optimisation, pharmacists help ensure patients receive the right treatments, reducing hospital admissions and improving health outcomes. This integrated approach to healthcare ultimately benefits both patients and the entire healthcare system.
“I understand how the uncertainty around potential cuts to ICBs will concern pharmacists and pharmacy teams who are working hard every day to enhance patient care. It’s vital that pharmacy system leaders continue to be supported to help develop new services, ensure best use of resources and deliver significant savings for the NHS.”
A spokesperson for NHS England said: “We welcome this letter and the initiative from ICB pharmacy colleagues to build on strengths in areas such as best value generic and biosimilar adoption to further embed a strategic, forward-looking approach to medicines optimisation across the NHS in England.
“We will continue to work with ICB leaders on this shared agenda, supporting local expertise and insights with national coordination, policy and commercial capabilities that take advantage of our single payer model.”
