Hi all

I’m interested in the opinion of this group to help direct our approach to our Q project. https://q.health.org.uk/idea/2024/medicine-waste-in-care-homes-reducing-social-and-environmental-impact/

One of our aims is to:

Explore the infrastructure, organisational and cultural factors across care homes, general practice and community pharmacies which contribute to avoidable medicines waste.

Care home staff order medication monthly, GP practices churn out the prescriptions and community pharmacies dispense them. This is an enormously complex and time consuming process and also high risk as the patient population is usually frail elderly with multiple long term conditions on multiple medicines. There is a huge amount of waste. The evidence suggests that this is due to it being easier/quicker to reorder an entire set of medicines rather than work out what is left, what is not needed etc.

Personally, I think that the fact the prescribing budget is not held by either the care homes or the GP practices, means that there is no accountability for optimising the cost effectiveness of the monthly ordering process. Community pharmacies get paid a dispensing fee per item which is potentially a disincentive to reducing the monthly ordering. In addition, the physical separation of the three parties and impact of this on communication between the three against the background of very busy working environments is also likely to be an issue. 

We hope to explore this complex issue as one of our first steps in our project. I would really value thoughts from this group on how to approach this while aiming to build collaboration between the three parties. 

Many thanks

Nuala