Hospital Pharmacy Budget Cuts

Over the past twelve months hospital pharmacies have continued to feel the pressures of NHS cost saving incentives. Since the release of the Carter report there has been increased spending measures within hospital pharmacies and there are further plans to be introduced ahead of the deadline date in 2020. The three main incentives surround medicine optimisation, product variation and improved infrastructure.

Medicine optimisation is a prominent focus for the NHS.‘The overall NHS expenditure on medicines in 2015/16 was £16.8 billion, which is an increase of 8.0 per cent from £15.5 billion from 2014/15. Of the total £16.8 billion; £7.6 billion was spent on medicines used in hospitals (45.2 per cent).’1 Ann Jacklin, professional lead for pharmacy at the Department of Health’s NHS productivity and efficiency programme, spoke earlier this year about the forthcoming cuts. She has estimated that, ‘up to a billion pounds could be knocked off the NHS hospital drug budget of around £7 billion.’2 The Carter report has instructed the government to produce around £22 billion in efficiency savings across the NHS by 2020. The Royal Pharmaceutical Society England released a helpful guide to hospital pharmacies earlier this year which looks at the internal optimisation changes that can be made. The guide covers a plethora of ways hospital pharmacies are already showcasing medicine optimisation while also offering further suggestions to how things could be improved. The suggestions include:

  • Hospital pharmacy staff should be more involved in drug administration rounds and encourage patients to self administer their medicines on the wards which in turn helps with the patient assessment prior to discharge and ensures the patient does not become deskilled in relation to taking medicines during their admission.
  • Encourage patients and / or their carers to take a copy of their discharge letter to their usual community pharmacist or to seek help, advice or support from them.
  • Consider what data you already capture, what you could capture in the future and what value this may have in data provision for the wider NHS.

Variation and unwanted variation are often difficult topics to discuss and even harder issues to manage and improve. Former finance director at Chelsea and Westminster Hospital Foundation Trust Lorraine Bewes said “the first step in understanding is that people don’t know. In her own trust, introducing information systems which demonstrated variation had been a starting point, yet many trusts still did not have things like patient level costing systems 10 years later. An unintended consequence of the move towards foundation trusts had been fragmentation and the loss of systems and forums which helped trusts understand where they were on variation.’

The final budget cut incentive revolves around improving infrastructure. Similarly to variation, infrastructure proficiency is nation wide challenge and has already seen vast improvements. NHS England and CCGs have cut more than £250 million from running costs over the past three years and are looking to cut another £150 million by the end of 2019/20. 4 However NHS believe ‘our ways of working and cultures need to evolve and change’ further.

In conclusion, UL Medicines have witnessed hospital pharmacies make great steps in 2017 and are dedicated to the continuous improvement of the NHS and helping our customers through the challenges ahead. Our employees are heavily involved in industry debates and educational forums and are keen to stay at the forefront of change to ensure the best service and guidance to our customers. If you have any questions regarding the Carter report or would like to comment on the budget cuts your pharmacy is facing please get in touch by emailing info@ulmedicines.co.uk.

1 Telegraph. ‘UK pharma sector faces 'crisis' without early Brexit deal’ 2017’. Web. November 2017 http://www.telegraph.co.uk/business/2017/06/01/uk-pharma-sector-faces-crisis-without-early-brexit-deal/

2 Staines, Richard. Pharmaphorum. ‘Pharmacists under pressure as NHS looks for huge cost savings’. Web. November 2017 https://pharmaphorum.com/news/pharmacists-driving-nhs-cost-saving-efforts/#

3 Moore, Alison. HSJ. ‘Roundtable: How to tackle unwanted variation’. Web. November 2017 https://www.hsj.co.uk/quality-and-performance/roundtable-how-to-tackle-unwarranted-variation/7006187.article

4 NHS England. ‘Funding and efficiencies’ Web. November 2017 https://www.england.nhs.uk/five-year-forward-view/next-steps-on-the-nhs-five-year-forward-view/funding-and-efficiency