Structured medication reviews increase in primary care despite end of financial incentive 

Exclusive: Analysis of NHS England data show there was a 15% increase in structured medication reviews in the 2023/2024 financial year up to February 2024, compared with the year before.
Man undertaking medication review with male physician

The number of structured medication reviews (SMRs) carried out in primary care across England has increased by 15% in 2023/2024, despite the removal of a financial incentive for primary care networks (PCNs) to prioritise them.

Analysis of NHS England data on appointments in general practice, published on 28 March 2024, shows that more than 2.9 million SMRs were undertaken in the financial year 2023/2024 up to and including February 2024, compared with 2.5 million SMRs in the entire previous financial year.

This is an increase of 15%, with one month’s data still to be recorded.

Primary care networks (PCNs) started offering SMRs in October 2020 to patients diagnosed with frailty or living in care homes; patients with complex polypharmacy (specifically taking ten or more medications); patients using potentially addictive pain management medication; and patients on medicines commonly associated with medication errors.

In March 2023, NHS England announced a reduction in the number of funding incentives offered to PCNs through the Impact and Investment Fund (IIF) for the 2023/2024 financial year, from 36 incentives down to 5, which no longer included SMRs as a target.

In 2022/2023, PCNs could claim a total of £223m through the IIF, with the amount of funding available for individual incentives dependent on each PCN’s patient demographics.

Commenting on the increase in SMRs, Graham Stretch, president of the Primary Care Pharmacy Association, said: “It looks like something like 3.2 million SMRs have been performed [from March 2023 to February 2024]. That’s an enormous number of half-hour sit downs.

“I completely welcome this, I think we’re doing a great job for patients having access to our expertise in all settings,” he added.

SMRs are primarily conducted by clinical pharmacists; however, they may also be carried out by suitably qualified advanced nurse practitioners, as well as GPs.

Brendon Jiang, a senior clinical pharmacist for North Oxfordshire Rural Alliance PCN, said the increased number of SMRs being carried out is welcome and is a service that should be prioritised.

“These target groups are patients who are most likely to benefit [from SMRs],” he said.

“If you think of what [PCN pharmacists] are doing in terms of having discussions with patients, having thorough reviews of their medication, making sure that they’re on the right things, making sure that they’re not on treatment with poor evidence, or really costly to the NHS, ensuring that their chances of going into hospital are minimised by making sure that you get in there early if something is going wrong.

“There needs to be more awareness around how important it is for pharmacy to be delivering and leading on this,” he added.

In March 2024, The Pharmaceutical Journal reported that the number of pharmacists working in primary care increased by almost a quarter in a year between 2022 and 2023.

Primary care workforce data for England, published by NHS Digital on 15 February 2024, showed that there were 6,874 full-time equivalent pharmacists working in general practices and PCNs in December 2023, an increase of 24.5% from 5,522 in December 2022.

Last updated
The Pharmaceutical Journal, PJ, April 2024, Vol 312, No 7984;312(7984)::DOI:10.1211/PJ.2024.1.308418

    Please leave a comment 

    You may also be interested in