12 Health Innovation Networks (HINs) participated in phase one of the three-year national polypharmacy programme delivering a three-pillar implementation model. To read the evaluation reports, please visit the Health Innovation Network Polypharmacy page.
To support the NHS 10 Year Plan, the programme has been remodelled to include focus on frailty, community pharmacy, AI /digital and repeat prescribing. This second phase of the programme has a “Five Pillar Implementation” model and is offered to HINs to support ICBs, Primary Care Networks and other health care systems to deliver their 5-year prevention plans.
Why is this work important?
Addressing problematic polypharmacy is a national priority in the NHS Medium Term Planning Framework. Polypharmacy is intrinsically linked to frailty and is cited in NHS England frailty policy and the modern service framework for frailty and dementia. Addressing problematic polypharmacy is endorsed and supported by several Royal College’s, NICE and Voluntary Sector policies and guidance.
16.5% of unplanned hospital admissions are due to Adverse Drug Reactions (ADRs) with polypharmacy being a key driver. Extrapolated costs of these admissions in the NHS in England are £2.21 billion. The average length of stay of patients admitted with an adverse drug reaction is 6 days. Potentially inappropriate medication prescribed in older people could be up to 50%. Currently over 400,000 people aged 75 and over take 10 or more medicines (roughly 9%) . This is an anticipated increase to 13% of the population aged 75 and over by 2043.
The core principle of the Polypharmacy programme is to support local healthcare systems to address problematic polypharmacy through setting up local learning systems and adoption of the ‘five pillars’ approach underpinned by policy and guidance:
Pillar 1: Population Health Management
Using data (NHS BSA Polypharmacy Comparators) to understand the scale of polypharmacy locally. And to identify and prioritise patients who would benefit most from a Structured Medication Review.
Using the NHSBSA Oversupply Dashboard and the RCGP RPS Repeat Prescribing Toolkit to improve the safety and efficiency of local repeat prescribing processes.
Pillar 2: Education & Learning
Delivery of Polypharmacy Action Learning Sets (ALSs) and Polypharmacy Masterclasses to upskill the primary care workforce to be more confident about stopping unnecessary medicines. In Year 2, there will be a focus on educational offers to secondary care and community pharmacy.
We have already created the polypharmacy masterclass series to allow a deeper dive into particular therapeutic topics highlighted by clinicians attending the Polypharmacy Action Learning Sets . These Polypharmacy Masterclasses are open to all clinicians. Check out our events page for details of upcoming Polypharmacy Masterclasses.
To register your interest for future Polypharmacy Action Learning Set cohorts, sign up here.
Pillar 3: Changing Public Behaviour
Patients may not always understand the purpose of a Structured Medication Review. Our suite of resources, developed and tested with patients, has been shown to increase understanding of the Structured Medication Review process, increase engagement with Structured Medication Reviews and improve the quality of conversations between patients and their clinicians around their medicines.
See our dedicated Structured Mediation Review page for more information.
Pillar 4: Digital Innovation
We are planning to scope and identify digital, AI, and technological solutions that might help to tackle problematic polypharmacy.
Pillar 5: Learning Systems & Networks
We aim to develop a national learning ecosystem that strengthens shared learning around tackling problematic polypharmacy. Local networks will bring like-minded people together from ICB led learning systems. These will feed into our national Polypharmacy Shared Learning System to represent the work across England and to engage with global partners to help scale our work and generate new opportunities.
If you would like to join the 4,300 people already signed up to our Polypharmacy shared learning network, sign up here.
You can access more resources from the Polypharmacy toolkit (one-time registration required).
Click here to find out more and register.
Click here to find out more and register
