Change needed to address over-prescribing of medicines in Wales, says National Assembly committee
Not enough is being done to challenge the over-prescribing of medicines in Wales, according to a National Assembly committee.
The Public Accounts Committee heard that there has been a 46 per cent rise in the number of items dispensed by medics in the past ten years. Latest figures show the cost of prescribing medicines in Wales is around £800 million per year in primary care alone, or more than ten per cent of the total Welsh NHS budget.
The Committee was told that as many as half of all hospital admissions could be medication-related, where patients have either been prescribed the wrong drugs, or, more likely, had taken the wrong dosage.
But incidents of medication-related admissions are not recorded so there is no way of establishing the true size of the issue.
The Welsh Government is urging prudent prescribing and is providing support for greater use of pharmacists in primary care.
But the Committee found that, while 1,000 consultations a month were being undertaken by pharmacists, that only equated to 250 per week across the whole country.
The Committee also heard that cluster pharmacists are unable to plan strategically as funding is not allocated long term, and that there were tensions between GPs and pharmacists about the level of value that can be added by independent pharmacists.
Use of technology was also explored as a way of improving medicines management. The Committee has asked for an update on a trial of automated vending of medicines in hospital wards, which was due to be completed last year. Concerns were also raised about a new nationwide e-prescribing IT system which has been dogged by delays and has received mixed reviews in areas where it has been rolled out.
"The issue of medicines management is one which is relevant to everybody, from GPs, medical staff in hospitals and pharmacists to patients," said Nick Ramsay AM, Chair of the Public Accounts Committee.
"We all have a responsibility to ensure that medicines are not wasted or dispensed unnecessarily.
"Everyone on the Committee has had experiences of relatives, friends or constituents ending up with medicine cabinets full of medicines and the difficulties of getting items taken off repeat prescriptions.
"What we found during this inquiry was a system needing to change and a system not able to maximise its potential."
The Committee makes 17 recommendations in its report, including:
That the Welsh Government issue a national directive that all Health Boards need to develop campaigns to raise the profile of medicines management;
That the Welsh Government investigates ways of harnessing the academic expertise in Wales to understand the scale of Medicine Related Admissions and how to reduce them; and,
that as part of the Welsh Government's commissioning and roll out of an new e-prescribing system, it develops a supporting plan of action to help achieve the cultural shift that needs to accompany the introduction of a new system.
The Committee's findings will now be considered by the Welsh Government.
Read the full report:
Medicines Management (PDF, 888 KB)