Clare Howard, NHS England’s Deputy Chief Pharmaceutical Officer, explains why the launch of the Medicines Optimisation Dashboard is so vital:
Prescribing a medicine or medicines to a patient remains the most common intervention made by the NHS.
Medicines play a crucial role in maintaining health, preventing illness, managing chronic conditions and treating disease. But despite the opportunities that medicines can offer us, we know their use can often be described as “sub optimal”. Patients aren’t always supported to take their medicines as intended.
A recent NHS England workshop with patients highlighted their desire for greater support – Workshop report: making medicines – taking a better experience.
Where medicines aren’t used well, patients can end up either not getting the required benefit or at worst, suffering adverse effects and in some cases being hospitalised.
As a pharmacist, I’ve seen first-hand how patient care could have been so much improved had patient had the support they needed from the beginning of their journey with a new medicine. I’ve also seen the significant impact on unplanned admissions and patient quality of life where programmes to help people get the support they need from their medicines are implemented and all sectors of the NHS come together.
As well as a cost to the patients, there is also a cost to the NHS and to society in general from this sub optimal use of medicines. In the NHS in England, we spent £13.8 billion on medicines last year. In an era of significant economic, demographic and technological challenge it is crucial that patients, the NHS and the taxpayer get the best quality outcomes from the medicines we prescribe to our patients.
The vast majority of medicines are prescribed by general practice and dispensed from a community pharmacy. For this reason, it is important that CCGs are working locally to make sure their patients have the support they need to get the most from their medicines. CCGs should also be aware of how well services are co-ordinated for patients receiving in-hospital care.
Today we launched the Medicines Optimisation Dashboard. This first “prototype” version is intended to bring together a range of data which is much broader than data which focuses on drug costs and volume. We hope that it will help CCGs to think carefully about how well their local population is supported in its use of medicines both in the community and during a stay in hospital and upon transfer back into the community setting.
CCGs have access to expert pharmaceutical support. Historically, in some areas, this support has concentrated on driving down drug spend. Now, leading CCGs are recognising that there are greater efficiencies in using their pharmacists to lead medicines optimisation.
These longer term programmes are aimed at delivering far greater savings than simple drug switches and, more importantly, giving patients more of what they need to derive the greatest benefit from the medicines prescribed to them.
Ultimately medicines optimisation can help encourage patients to take ownership of their treatment.
In 1996, she was recruited to the IMPACT project in the West Midlands, which at that time was an innovative project using Community Pharmacists to work with GPs to review and change their prescribing practice.
The following year Clare joined Berkshire Health Authority as a Pharmaceutical Adviser and Nursing Home Inspector. During this time she worked with the team that developed the “4 Way Agreement” (one of the first projects in England to enable community pharmacists to supervise methadone consumption.)
Clare then moved to Newbury PCT as the Pharmaceutical Adviser with responsibility for primary care prescribing and community hospital services. In 2002, she was seconded to work for the National Prescribing Centre (NPC) as the regional trainer for Thames Valley, Bedfordshire and Hertfordshire.
Following seven years working with the GPs in Newbury, Clare made the move to Reading PCT to head up a bigger medicines management team and a work with a broader patient demographic.
In 2007, Clare worked as a freelance Pharmaceutical Adviser for a year before taking up the post of Pharmaceutical Adviser with South Central Strategic Health Authority. In this role, she led the South Central Medicines use and Procurement QIPP project.
Working across primary and secondary care, Clare led the project team and the senior pharmacists to deliver efficiencies of over £40 million over two years. The work she successfully led on medication waste in NHS South Central won a gold NHS Innovation Challenge award in 2012.
In January 2012, Clare was seconded into the Department of Health to lead the National Medicines Use and Procurement QIPP work stream.
As part of the NHS reforms, Clare was appointed as Deputy Chief Pharmaceutical Officer, NHS England in January 2013. She is currently leading the work on Medicines Optimisation programme for NHS England.
When not at work, Clare and her husband are kept busy with their two sons; eight year old Jacob and five year old Matthew.