28-05-2025
Pharmacy plan for Forth Valley takes aim at wasted prescriptions
Conversations with pharmacists can help patients and save the NHS money
Nearly 50,000 people across the NHS Forth Valley area are not taking their medication as prescribed, a report on local pharmacy services has estimated.
National research has shown that around half of all medicines are not taken as prescribed, particularly where people are taking more than four medicines.
In the Forth Valley area - Falkirk, Stirling and Clackmannanshire - nearly 97,000 people take five or more medicines, which leads pharmacy experts locally to conclude that more than 48,000 residents will not be taking them as instructed.
The figure astonished members of NHS Forth Valley's board, who were considering the Pharmaceutical Care Service Plan at their May meeting.
The report offered a picture of the range, nature and quality of pharmaceutical care provided with NHS Forth Valley, in a bid to identify any gaps or unmet needs.
The Falkirk area has 34 community pharmacies, serving a population that is estimated to grow by 3.7 per cent by 2029-30.
However, the report estimates that the 75+ year population is projected to increase by 98 per cent by 2037 in the Falkirk Health and Social Care Partnership area, which will have a significant impact on local services.
The board heard that pharmacies are increasingly playing a key role in delivering frontline healthcare at a time when services are increasingly stretched.
The Pharmacy First initiative - previously known as the Minor Ailments Service - promotes the value of local chemists to patients needing advice on common health complaints.
The Pharmacy First Plus service - now available in 26 chemists in Forth Valley - means some pharmacists can issue prescriptions for common ailments that would normally require a visit to GP, such as skin complaints and UTIs.
However, the national figures show that there is a huge issue around waste and the report highlights the role that pharmacy teams can play in reducing medicines being prescribed and then not used or taken incorrectly.
The report explains that many drugs in common use can cause problems, while adverse drug reactions (ADRs) are implicated in 5 - 17 per cent of all hospital admissions.
Patients on multiple medications are more likely to suffer drug side effects and those who are on medications deemed to be high risk are most at risk of a hospital admission.
Board members were keen to know what is happening locally to tackle the problem.
The director of pharmacy in Forth Valley, Laura Byrne, told members that work is ongoing to address waste in particular with a "robust polypharmacy plan".
"There are a number of projects going on across Forth Valley," she said, highlighting in particular the work of the team in Falkirk Community Hospital's pharmacy, which recently won a national award.
Their work over the last ten months has delivered around £140,000 worth of savings, which also had "all the added benefits around patient-centred care".
A polypharmacy pilot in various GP surgeries has also delivered benefits for patient care and safety as well as savings.
Pharmacy in acute services have struggled in the past with staff vacancies but in recent months they have managed to recruit and they are now working on specialists posts, supporting pharmacists to become advanced practitioners.
Ms Byrne told the board that their work, reviewing patients' prescriptions, had found a number of savings as treatments had been optimised.
"That wasn't the aim of it, but what we are looking to do is to scale that up across our specialities," she said.
Dr Andrew Murray, NHS Forth Valley's medical director, said it was important to remember that it is a long-standing and well-known fact that many patients deliberately do not take medicines as they have been prescribed and it is difficult to influence that.
He said: "We need to understand that approximately 50 per cent of all prescriptions are not adhered with throughout the developed world.
"At least half of those are deliberate - people deciding they are not going to comply."
"We can influence it to an extent, through realistic medicine, shared decision making and making sure people who are not actually ever going to take that medicine have that conversation up front so we can find ways for them to manage their symptoms."
The board also heard that a communication campaign had been running to try to reduce waste, with key messages such as asking people to only order what they need and to check their bags before leaving a community pharmacy.
There will be another campaign to get the messages across in the year ahead.
The plan highlights the numerous ways pharmacies are now involved in health care, from providing advice to care homes to supporting people dependent on opiates and other substances.
Ms Byrne said the pharmacy care plan was an important way to analyse what services are available and look at how any gaps can be addressed.
She said: "Through this analysis we are thinking 'what else do we need to be doing to try and bring care local to patients actually keep them away from out-of-hours and front door, and keep them well at home."
