The context


Across the UK there has been significant concern over prescription waste and spending - both in terms of unused prescriptions and the use of branded drugs as opposed to cheaper generic ones. Practice Medicine Managers or Coordinators have been recruited into some PCT's GP practices in order to help them review prescribing and monitoring practices and bring down costs.

These jobs are filled by a wide variety of people, for example people with nursing and pharmaceutical backgrounds, receptionists and administrators. The GP practices are also supported by a team of Practice Support Pharmacists who bring in-depth drug expertise to the surgeries.

The need

GP practices are small businesses. They are owned and run by busy GPs who often "rule the roost". Challenging and influencing how drugs are prescribed and monitored can be a difficult job particularly for non medical or pharmaceutical staff.

The need was identified to increase the confidence, influencing skills and behavioural understanding of the Practice Medicine Managers so that they can drive change in practice. There was also a need to create a strong vision for what effective Medicine Management could achieve across the PCT.

The solution

DevelopChange has worked with all the Practice Medicine Managers and Practice Support Pharmacists from across the PCT to strengthen the support network by:

  • exploring in depth the group dynamics in team workshops
  • sharing issues, concerns and best practice between practice medicine managers
  • building a strong sense of team work focused around a common vision
  • increasing understanding of how they and others "tick" using psychometric tools such as MBTI
  • developing strategies for influencing and working with GP's and practice managers

Outcomes so far

Confident and focused Practice Medicine Managers and Practice Support Pharmacists who are now making a significant contribution to reducing unnecessary or inappropriate prescription spend.

They work to specific metrics of Quality, Satisfaction, Safety and Waste and all of these metrics show significant improvement.

  • From a financial perspective, the initiative over the last three years has reduced the weighted per capita prescribing costs in the PCT from circa £42 down to £32.92.
  • This year's prescribing budget for the PCT is c£85 million so the savings are dramatic. The exciting thing about these metrics is that the process generates year on year, rather than one off, savings.

The next step is that DevelopChange has been asked to join a PCT taskforce as the Change agent partner. The target is to reduce the prescribing spend by another £10 million per annum without affecting the quality of care available.