Medication Waste Reduction in PCNs: Practical Steps That Work

• 8th May 2026

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• Key Strategies for Medication Waste Reduction in PCNs
• What causes medication waste in PCNs?
• What are the most effective strategies for reducing medication waste NHS-wide?
• How do clinical reviews reduce medicines waste?
• How should PCNs implement a medication waste reduction plan?

Medication waste reduction in PCNs starts with three key levers: stopping unnecessary repeat prescribing, deploying clinical pharmacy teams for structured reviews, and engaging patients effectively. Medication waste costs the NHS hundreds of millions each year, much of it avoidable through better prescription management and medication review processes. For Primary Care Network (PCN) managers, tackling this issue is a fast “quick win” within the broader goal of improving prescribing efficiency. It reduces clinical risk, frees up capacity, and delivers immediate cost savings.

Key Takeaways

• Repeat ordering drives waste: Up to £300m of medicines are wasted annually in England, with a significant portion linked to unnecessary repeat requests.
• Pharmacy-led reviews are the biggest lever: Comprehensive clinical reviews consistently reduce unnecessary medicines and improve patient safety.
• Behaviour change matters: “Only order what you need” campaigns reduce over-ordering quickly and at scale.

Key Strategies for Medication Waste Reduction in PCNs

• Pharmacy-led clinical reviews to reduce prescribing of unnecessary medicines
• Electronic repeat dispensing to prevent over-ordering
• Patient campaigns to change ordering behaviour
• Audits to identify patterns for repeat prescribing waste reduction
• Clinical pharmacy team integration for ongoing optimisation.

What causes medication waste in PCNs?

Medication waste in primary care is mainly caused by over-ordering, poor synchronisation of prescriptions, and a lack of regular clinical review. Automatic repeat ordering without patient need is a primary driver. Patients often stockpile medication “just in case,” leading to significant pharmaceutical waste.

A lack of deprescribing in long-term conditions also contributes heavily. Hospital discharge changes are sometimes not reflected in GP records, causing duplicate prescriptions. Poor adherence leads to unused medicines accumulating in patients’ homes. This aligns with NHS England guidance on medicines optimisation.

What are the most effective strategies for reducing medication waste NHS-wide?

The most effective strategies combine system-level changes with patient-facing interventions.

Strategy	Primary Benefit	Implementation Effort
Pharmacy-led Clinical Reviews	Identifies unnecessary or unsafe medicines	High (Requires Clinical Pharmacists)
Electronic Repeat Dispensing	Synchronises prescriptions, reduces manual requests	Medium
Patient Awareness Campaigns	Reduces over-ordering quickly	Low
Repeat Prescription Audits	Highlights specific areas of waste	Medium
Clinical Pharmacy Team Integration	Supports continuous medication optimisation	High

1. Pharmacy-led clinical reviews

Clinical reviews identify unnecessary, duplicate, or unsafe medicines. They are highly effective for polypharmacy patients and care home residents. As outlined by NHS England’s SMR guidance, structured medication reviews are a core component of effective prescribing management.

2. Electronic Repeat Dispensing (eRD)

Electronic repeat dispensing benefits PCNs by reducing over-ordering. It synchronises prescriptions and removes manual requests, leading to fewer unnecessary requests and reduced administrative workload.

3. “Only order what you need” campaigns

Simple patient messaging reduces demand quickly. Examples include SMS reminders before ordering and posters in practices. These campaigns deliver measurable impact.

4. Repeat prescription audits

A medicines waste audit in primary care highlights where waste is happening. Focus areas should include high-cost medicines, frequently returned items, and patients ordering excessively.

5. Clinical Pharmacy team integration

Clinical Pharmacists and Pharmacy Technicians play a central role in reducing waste. A dedicated clinical pharmacist support service supports safer prescribing, deprescribing, and patient education.

How do clinical reviews reduce medicines waste?

Thorough clinical reviews reduce waste by identifying medicines that are no longer clinically needed or not being taken as intended. They typically uncover duplicate therapies, medicines without current indication, and poor adherence.

This process improves patient safety first, with repeat prescribing waste reduction as a secondary benefit. Regular medication reviews provide opportunities for simplification, directly supporting the goal of reducing medication waste NHS-wide.

How should PCNs implement a medication waste reduction plan?

A practical Primary Care Network (PCN) approach combines quick wins with longer-term system changes. Start by running a repeat prescribing audit to identify high-risk cohorts.

Next, deploy your clinical pharmacy team for clinical reviews and optimise implementation of eRD. Launch a patient awareness campaign and track prescribing and waste metrics monthly. This keeps the focus on measurable outcomes.

Medication waste is rarely a single issue. The PCNs that see the biggest improvements are the ones that combine data, clinical pharmacy expertise, and patient engagement into a single joined-up approach.

Adeem Azhar, Co-Founder and Chief Executive Officer – Core Prescribing Solutions

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