Overprescribing is a complex issue

Developing a national policy for reducing overprescribing was the focus of the recent National Overprescribing Review Opening Symposium. Patient representative Graham Prestwich was there

Graham Prestwich

Four themes stood out for me at the symposium, which was organised by NHS England/ NHS Improvement.

Firstly, the language used, ‘deprescribing’, is not the best and not always helpful. Everyone I spoke to recognised this and, as a wide variety of people are involved, the most appropriate words may vary.

Clearer descriptions will and must emerge as this work progresses. What was agreed is that this is about improving health and wellbeing, about making sure that people for whom medicines are no longer beneficial are no longer prescribed them. Good quality care invariably costs less for everyone involved, and most of all for patients themselves. The healthier we feel, the better – and the less likely we are to require health services.

Secondly, there was the transparency in the way this work is being progressed. The workshop sessions enabled everyone to contribute and see how their views and wishes were being considered.

Competing issues

My third learning point concerned the conversations about the complexity and competing issues associated with making good progress in the interest of patient health and wellbeing.

Lots of people in different organisations are involved in the choice and use of ongoing treatments for long-term conditions, which account for 70-80 per cent of all prescriptions in primary care.

Tackling overprescribing involves deciding when, who and how best to organise current health and care systems in order to safely review and revise, as appropriate, treatments that may have been initiated over many years for many good reasons by many different and competent clinicians.

This brings a challenge for primary care in particular, and we see the emphasis and priority being targeted at the introduction of additional expertise through skilled and trained pharmacists and pharmacy technicians working in closer association with primary care service providers.

This also raises questions about how patients are going to be authentically involved in these decisions. Specifically, how people with the greatest and more complex health and social care needs are going to be supported, helped and guided through this process so they retain their confidence and belief that their treatments are effective and safe.

Quality of life

Finally, it was felt by many that the agenda will have failed if it is reduced to how much has been saved by stopping treatment. A more important measure is how much quality of life has been improved and enhanced.

It is here where patients and their families and carers have the greatest opportunity to contribute through a variety of local, area, regional and national contributions. Those who are keen and interested should be encouraged to make reasonable efforts to share their views.

• More information is available here.

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