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How Medicines optimisation Can Reduce Health inequalities
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- A 5-Step Process for PCNs and GP Practices
- What do health inequalities look like in medicines use?
- How does Core20PLUS5 apply to medicines optimisation?
- What can PCN pharmacy teams do to reduce medicines-related inequalities?
Health inequalities affect how people access, understand and benefit from medicines. Medicines optimisation gives Primary Care Networks (PCNs) a practical way to identify patients at greater risk of medicines-related harm. It enables pharmacy teams to deliver targeted support before problems escalate. People living in the most deprived communities often develop multiple long-term conditions earlier in life. This increases their exposure to complex prescribing and medicines-related harm. The NHS Core20PLUS5 approach highlights the important role pharmacy teams play in identifying medicines-related risks. Targeting support where it can have the greatest impact is central to this preventative healthcare framework.
Key Takeaways
Medicines optimisation can help reduce health inequalities when pharmacy teams combine population health data with targeted clinical interventions. The following principles underpin an effective approach.
- Targeted risk: Patients in deprived areas are significantly more likely to experience polypharmacy and high-risk prescribing.
- National framework: The NHS Core20PLUS5 approach identifies the populations most at risk from medicines-related harm.
- Clinical leadership: Clinical Pharmacists and Pharmacy Technicians in primary care are uniquely positioned to close the gap through Structured Medication Reviews (SMRs).
- Systemic barriers: Digital exclusion and poor health literacy must be actively addressed alongside clinical interventions.
A 5-Step Process for PCNs and GP Practices
Reducing health inequalities through medicines optimisation requires a structured approach.
- Identify: Run population health searches to find underserved patients missing routine reviews.
- Analyse: Look for prescribing variation by deprivation, ethnicity, frailty, and long-term conditions.
- Prioritise: Direct Clinical Pharmacist services to the cohorts where clinical need is greatest.
- Intervene: Conduct SMRs, deprescribing, monitoring, and patient education.
- Measure: Track medication safety, review completion, prescribing variation and patient outcomes to assess whether inequalities are narrowing.
What do health inequalities look like in medicines use?
Inequality in medicines use is not just about access; it is about safety and appropriateness. Deprived populations often face higher rates of polypharmacy without the necessary monitoring. This leads to increased hospital admissions from adverse drug events. Furthermore, these same populations frequently have lower engagement with routine reducing inequalities in deprived populations initiatives and preventative care.
Addressing medicines-related health inequalities means proactively finding these patients rather than waiting for them to present in crisis. It involves checking whether language barriers affect adherence or if patients understand how to use their inhalers correctly.
| Challenge | Medicines optimisation Response |
| Polypharmacy | Structured Medication Reviews |
| Poor health literacy | Shared decision making and patient education |
| Digital exclusion | Alternative access routes and tailored communication |
| High-risk prescribing | Clinical Pharmacist review and recalls |
| Care transitions | Robust medicines reconciliation process |
| Population variation | Population health searches |
How does Core20PLUS5 apply to medicines optimisation?
The Core20PLUS5 framework directs NHS resources to the most deprived 20% of the population. For PCNs and Practices, this translates directly into medication safety priorities. Severe mental illness and chronic respiratory disease are key clinical areas within the framework. Both require complex prescribing and careful monitoring.
Aligning medicines optimisation support with Core20PLUS5 ensures clinical pharmacy teams focus on patients who benefit most. This aligns with NICE medicines optimisation guidance. It emphasises safe and effective medicines use to enable the best outcomes.
What can PCN pharmacy teams do to reduce medicines-related inequalities?
Clinical Pharmacists and Pharmacy Technicians help turn population health data into targeted clinical action. They have the expertise to conduct deep-dive SMRs. During these reviews, they practice shared decision making. This ensures patients truly understand their treatment plans.
Pharmacy Technicians can support this by tackling digital exclusion. They might help patients set up NHS App access. Clinical Pharmacists can then focus on complex deprescribing and medicines reconciliation.
Expert insight from Adeem Azhar, qualified Clinical Pharmacist and CEO
Reducing health inequalities isn’t simply about identifying patients at risk. It’s about ensuring the right pharmacy professionals have the time, data and clinical support to intervene early. Medicines optimisation is most effective when it reaches the patients who need it most at the earliest opportunity.
Adeem Azhar, MPharm, IPres
Co-Founder and Chief Executive Officer – Core Prescribing Solutions
Qualified Clinical Pharmacist
FAQs
Looking for support with your PCN pharmacy workforce?
If your PCN wants to strengthen proactive care through medicines optimisation, structured medication reviews and additional clinical pharmacy capacity, our Clinical Pharmacists and Pharmacy Technicians can integrate with your existing team to support risk-based care.
