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Medicines optimisation is about ensuring that the right patients get the right choice of medicine, at the right time. By focusing on patients and their experiences, the goal is to help patients to:
  • Improve their outcomes
  • Take their medicines correctly
  • Avoid taking unnecessary medicines
  • Reduce wastage of medicines
  • Improve medicines safety
Ultimately medicines optimisation can help encourage patients to take ownership of their treatment.

In May 2013, the Royal Pharmaceutical Society published guidance on medicines optimisation, which included four principles, supported by the Association of the British Pharmaceutical Industry (ABPI) and NHS England, through Sir Bruce Keogh (Medical Director), Jane Cummings (Chief Nurse) and Keith Ridge (Chief Pharmaceutical Officer).

The principles are aimed at supporting patients and the public, and the professionals who care for them and with the full support of Government, a joint programme of action to encourage implementation of the principles of medicines optimisation has been established by NHS England, the AHSN Network and the ABPI. Its aspirations are complementary to and aligned with the work of NHS England’s recent reports: ‘Innovation, Health and Wealth’ and the 5 Year Forward View.

The 4 medicines optimisation principles:

Principle 1. Aim to understand the patient’s experience

  • To ensure the best possible outcomes from medicines, there is an ongoing, open dialogue with the patient and/or their carer about the patient’s experience of using medicines to manage their condition; recognising that the patient’s experience may change over time even if the medicines do not.
Projects that meet this principle: PINCER


Principle 2. Ensure medicines use is as safe as possible
  • The safe use of medicines is the responsibility of all professionals, healthcare organisations and patients and should be discussed with patients and/or their carers. Safety covers all aspects of medicines usage, including unwanted effects, interactions, safe processes and systems, and effective communication between professionals.
Projects that meet this principle: Truthful, PINCER, EPIFFany, Optimed


Principle 3. Use medicines that are (clinically and cost) effective
  • Clinically and cost effective medicines are chosen (informed by the best available evidence base) that can meet the needs of the patient.
Projects that meet this principle: Optimed, EPIFFany


Principle 4. Make medicines optimisation part of routine practice
  • Health professionals routinely discuss with each other and with patients and/or their carers how to get the best outcomes from medicines throughout the patients care.
Projects that meet this principle: Truthful, PINCER, Optimed, EPIFFany


To support this work EMAHSN has hosted a regional Medicines Optimisation Roadshow which brought together clinical, financial and operational leaders, providing a platform to share best practice on medicines optimisation and to consider further opportunities to maximise value from the use of medicines.

Objectives:
  • Communicate and clarify the national context for the initiative on medicines optimisation
  • Communicate the focus on improvement in patient care through optimum use of medication along with current levels of suboptimal use
  • Communicate and explain priorities attached to implementation of Pharmaceutical Price Regulation Scheme and implications for local budgets and national expenditure
  • Communicate and confirm priorities attached to implementation of the NICE Technology Appraisals recommendations on medicines
  • Understand local perspective and initiatives
  • Establish a common agenda on these issues with relevant leaders in the local health system
  • Ensure a multidisciplinary approach to developing a local medicines optimisation action plan

Medicines Optimisation Roadshow Event
On 30 April 2015 we held an East Midlands Medicines Optimisation Roadshow Event organised by ABPI, NHS England and EMAHSN. This event was focused on ensuring the right patients, get the right choice of medicine at the right time.  You can read the report from the event here.

NHS England also produced a pdfcombined national report which includes a summary of all the roadshows that took place.

EMAHSN will ensure that the principles of Medicines Optimisation are aligned to the East Midlands Patient Safety Collaborative and other areas of our work.