Influencing Prescribing in a Primary Care Led NHS

The aim of the project was to evaluate the likely success of medicines management in a primary care led UK National Health Service (NHS). The methods used to achieve this objective included a postal survey and a review of the implementation literature. Medicines management is a broad process concerned with optimising patient outcomes, while achieving value for money. The improvement of the quality of prescribing is a central feature of medicines management. Although medicines management is a relatively new concept in the NHS, policies to improve the use of medicines in the NHS are not. The current organisational structure for primary care in the NHS takes the form of Primary Care Groups (PCGs) and Primary Care Trusts (PCTs), collectively known as Primary Care Organisations (PCOs). These organisations have a unified budget that incorporates primary care prescribing into the overall NHS cash limit. About 80% of NHS expenditure on drugs is accounted for by prescriptions dispensed in the community. The focus of this report is therefore on prescribing by doctors in primary care, although influences by secondary care are also considered.