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The government, the NHS and health bodies should revise the indicators used to compare how different prescribers and organisations use medicines, says a report by the Welsh Audit Office.
‘Managing medicines in primary and secondary care’, published on 15 December 2016, calls on the Welsh government to develop national prescribing indicators — in partnership with GPs, health bodies and the All Wales Medicines Strategy Group, a health technology assessment body — to encourage health professionals to consider whether patients are receiving the right medicines and whether these medicines are improving outcomes.
Berwyn Owen, clinical director of pharmacy and medicines management for Betsi Cadwaladr University Health Board (BCUHB), believes the report’s recommendations are achievable.
“Prescribing indicators have traditionally been specific to a drug category — for example, hypnotics and anxiolytics,” he explains. “We are now utilising this data to inform a wider indicator in relation to falls prevention.”
The Welsh Audit Office’s report discusses the improvements made to the way medicines are managed in Wales but also makes recommendations on how further improvements can be made.
The report calls on the government to consider widening access to patients’ electronic records. Hospital pharmacists and pharmacy technicians would then be able to retrieve information on patients who are admitted for an elective procedure, as well as those admitted as emergencies.
Community pharmacies should also have access to records, the report says, so that “whenever it is clinically appropriate, patients can have their medicines managed in the community without accessing a GP or other NHS services”.
The document also recommends that each health body should develop a time-bound plan for improving storage and security of medicines on hospital wards and that chief pharmacists should be, or report directly to, an executive director.
In addition, the report advises the All Wales Chief Pharmacists’ Committee to lead a national audit on the safe and effective delivery of homecare services and encourages the Welsh government to work with pharmacy teams, clinical coding staff and clinicians to develop a programme that identifies and prevents medicines-related hospital admissions.
BCUHB are already progressing with many of the recommendations. Owen explained that, like other health boards in Wales, it is introducing ward automation to mitigate risks with medicines storage.
A total of 50 ward automation units are operational in Wales, he explained, and will be implemented across all wards within the next five years.
