The Role of Clinical Pharmacists in Medicines Optimisation: A Guide for PCNs

• 13th February 2026

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The role of clinical pharmacists in medicines optimisation is to ensure patients get the best possible outcomes from their medicines. For clinical pharmacists in primary care, this means delivering structured, evidence-based reviews that reduce risk and improve safety.

For Primary Care Networks (PCNs), deploying pharmacists to conduct Structured Medication Reviews (SMRs) for high-risk patients is the most impactful first step. This approach delivers measurable improvements in patient safety and system efficiency, while aligning with national medicines optimisation priorities set by NHS England and NICE.

Key Takeaways

• Operational priority: Focus clinical pharmacists on Structured Medication Reviews (SMRs) for high-risk cohorts as the first deployment priority.
• Biggest wins: Greatest impact comes from care home residents, patients with problematic polypharmacy (10+ medicines), and those on high-risk drugs.
• Evidence ROI: Demonstrate value through reduced high-risk prescribing, improved monitoring, and measurable GP time savings.

Where Should PCNs Deploy Clinical Pharmacists First?

PCNs should deploy clinical pharmacists to lead on Structured Medication Reviews (SMRs), as mandated by NHS England. The highest-risk, highest-reward cohorts for a structured medication reviews PCN programme should be prioritised to demonstrate immediate value.

These groups include:

• Patients in care homes
• Those with severe frailty
• Individuals taking ten or more medicines (problematic polypharmacy)

For many networks, a structured medication reviews PCN programme provides the fastest route to reducing medicines-related risk while building confidence in the clinical pharmacist role.

A PCN clinical pharmacist SMR service is a targeted intervention that allows pharmacists to focus on patients most likely to experience harm from medicines.

By prioritising these patients, pharmacists can address key safety risks such as falls, adverse drug events, and avoidable hospital admissions. This targeted approach provides a clear, evidence-based starting point for any PCN looking to maximise its medicines optimisation service. This approach clearly defines the role of clinical pharmacists in medicines optimisation within PCNs, focusing clinical effort where it delivers the greatest patient safety and system benefit.

How Can You Measure the Impact of Medicines Optimisation?

To measure the impact of medicines optimisation in primary care, PCNs must track a combination of safety, clinical, and efficiency metrics that demonstrate improvements in patient safety and prescribing quality. This shifts the focus from activity (number of reviews completed) to outcomes (improvements in patient care).

These measures help PCNs demonstrate value to practices, commissioners, and internal stakeholders, while supporting a stronger focus on patient safety and system resilience. A baseline should always be established before the service begins.

Key metrics to track include:

Safety

• Reduction in high-risk prescribing (for example, NSAIDs in heart failure)
• Improved monitoring completion for specific medicines (such as DOACs)

Clinical outcomes

• Improved blood pressure control or optimised inhaler technique
• Reduced medicine-related hospital admissions

Efficiency

• GP time saved from handling complex medication queries
• Reduction in medicines waste from stopping unnecessary repeat prescriptions

The pharmacists who thrive in PCNs are those who receive proper integration, supervision, and role clarity from day one. Where PCNs invest in their pharmacy workforce, patient outcomes and practice stability improve.

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

What Defines the Clinical pharmacist role PCN Service?

A good medicines optimisation service is proactive, data-driven, and fully integrated within the wider PCN team. The clinical pharmacist role PCN service should include protected time for conducting SMRs, access to full clinical records, and clear referral pathways from GPs and other healthcare professionals.

According to NICE medicines optimisation guidance, reliable systems and clear responsibilities are fundamental to safe medicines use. This means the pharmacist’s work must be supported by robust processes for medicines reconciliation, repeat prescribing, and clear communication across the network, ensuring the benefits of reviews are sustained over time.

FAQs