What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

Patients are not always honest about how, or even if, they take their medicines, or how they dispose of unwanted medicines.  Current pressures can prevent adequate time being made available for GPs to carry out a comprehensive Structured Medication Review, where patient education and shared decision-making is at the centre and where trust between patients and GPs enables honesty about their feelings towards their medicines.

The Health Innovation Network (HIN), The Greener Practice Network and Deb Gompertz, innovator of the evidence-based Show me your meds, please? approach will build upon our separate programmes of work to collaborate on a project to widen the conversation about medicines.  We will utilise community teams, primary care pharmacy technicians and social prescribers longer appointment times to initiate conversations with patients about their medicines adherence/ side effects and disposal, and share concerns with GPs to follow up if problematic medicines and non-adherence concerns are identified.

What does your project aim to achieve?

Patients: By providing an opportunity to discuss how they feel about their medicines with a trained health professional who works with their GP, we can improve patient  experience, reduce harm through identification of  potential risks associated with their  medication load and reduce unwanted side effects.

Clinical Teams:  Upskilling a wider range of health professionals in the awareness of problematic polypharmacy and the environmental impact of medicines can support clinical teams to provide better patient care, meet the policy requirement that patients on 10+ medicines should have access to an SMR and support GP practices to deliver a NetZero health service.

The environment:  Stopping unnecessary/unused medicines reduces the environmental impact of medicine prescribing/disposal.  Increasing #GP practices/clinical teams adopting Greener/environmental policies/practices through participation in this project and wider shared learning opportunities.

Health Inequalities: older people from lower socio-economic/certain population groups have significantly higher odds of polypharmacy will be included in this project.

How will the project be delivered?

The HIN has successfully designed, delivered and evaluated innovative change projects/programmes at pace in the NHS since 2013, including several QLab/QExchange funded projects.  The  Polypharmacy Programme launched in 2022 and the project will sit within this  portfolio, with access to  the programme’s clinical education expertise, patient facing materials and independent evaluation partner.  Adept at working with restricted funding/budget constraints, the HIN utilises its networks to drive change by identifying collaboration opportunities and innovative use of resources to make adjustments to business-as-usual work practices to test new ideas.

Our proposed collaboration with Show Me Your Meds Please? provides a structured approach  for wider testing of this proven innovation, combined with partnership working with the Greener Practices Group to bring the environmental expertise and access to their resources for this work.  The delivery team are based across three regional geographies (Somerset/Yorkshire/WestMidlands) and able to recruit across a mix of healthcare sectors/settings and  professional roles.

How is your project going to share learning?

The HIN has 15 regional offices working across a wide range of sectors interested in health improvement and change.  The Polypharmacy Programme has over 2000 stakeholders, including a network of Communities of Practice across England where we share learning to address problematic polypharmacy.    The Polypharmacy Programme works closely with NHS England medicines optimisation networks, the national overprescribing review advisory network and NHS medicines communications  team and is able to share learning  across England via the NHSE Primary Care and Community Care bulletins.

The Polypharmacy Programme also has links with colleagues in Ireland, Scotland, New Zealand and Australia who are interested in our work with a view to adopt  resources/tool into practice in their localities.

Our collaborating colleagues  are connected to the British Geriatric Society, Royal College of General Practitioners, Royal Pharmaceutical Society and  The Greener Practice Group has extensive networks and connections driving the Green Agenda across England.