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A guide aimed at helping primary care providers and integrated care boards (ICBs) to tackle “problematic polypharmacy” has been published by NHS England’s Health Innovation Network (HIN).
‘The mechanics of tackling overprescribing and problematic polypharmacy’, published on 3 March 2025 and launched as part of the HIN’s polypharmacy programme, “provides practical, evidence-based strategies to help organisations and healthcare professionals help to reduce overprescribing and improve patient outcomes”, the HIN said.
“The new guide offers simple yet impactful solutions to optimise prescribing practices, supporting ICBs, primary care networks [PCNs] and GP practices in organising their teams and improving the quality of structured medication reviews,” it added.
The HIN said the guide was developed “in response to a clear need identified by primary care and prescribing colleagues”, along with the government’s and NHS’s plans to prioritise prevention by moving care from hospitals to communities.
The guide includes a systematic approach to identifying and addressing overprescribing; strategies for conducting structured medication reviews (SMRs); tools for measuring success, including dashboards for tracking prescribing trends and patient outcomes; and case studies showcasing successful interventions.
According to the HIN, more than 1 million people in England take ten or more medicines for their long-term conditions. The HIN added that from 2008 to 2015, 16.5% of unplanned hospital admissions in adults are owing to adverse drug reactions, “with polypharmacy being a major driver”.
“One study estimates the annual cost of this to the NHS in England as £2.21bn,” the HIN said.
The HIN comprises 15 health innovation networks across England, which were established in 2013 to help the NHS adopt and grow innovative practices to improve health outcomes and generate economic growth.
Commenting on the guide, Tony Avery, national clinical director for prescribing for NHS England, said: “Tackling this complex topic can sometimes feel overwhelming, and this guide offers healthcare professionals structured approaches to ensure that medicines are being used effectively and safely, aligning with patient goals and reducing unnecessary prescriptions.”
He added that the guide features contributions “from leading experts, including clinical pharmacists, general practitioners and patient representatives, ensuring the guidance is both practical and informed by real-world experience”.
Lelly Oboh, clinical care and professional lead for overprescribing at NHS South East London, said: “This resource is a game-changer for clinicians tackling problematic polypharmacy or overprescribing, offering a practical and accessible guide to structured medication reviews.
“With practical tools, insightful tips, relatable metaphors and real-world case examples, it is designed to make patient-centred care straightforward and achievable in the process.”
Neil Hardy, chief pharmacist for NHS Hampshire and Isle of Wight, said: “The HIN’s problematic polypharmacy manual brings together all the evidence, why it is so important to patients, and how to address this vital topic in one, easy-to-use document. I think this is an essential resource for all clinicians working in primary care, as well as commissioners of those services.”
In October 2024, the HIN announced it would be providing funding for 25 PCNs in areas of high deprivation to offer patient information materials for structured medication reviews, aimed to tackle problematic polypharmacy.
All PCNs were due to have access to the materials by the end of November 2024 and their use will be evaluated in March 2025, the HIN said.
