Primary care network (PCN) pharmacists should be enabled to prioritise structured medication reviews (SMRs) in the highest risk patients, the Royal Pharmaceutical Society (RPS) has said in a policy statement today.

This follows concerns that PCNs and practices are deprioritising SMRs and directing pharmacists towards other work.

RPS England vice-chair Brendon Jiang suggested that the move was caused by workload and financial pressures within overstretched GP practices.

'With continued pressures across the health service, our members have warned that pharmacists are being re-directed from delivering structured medication reviews and tasked with other activities,' he said.

Changes to the PCN contract have also reduced incentivisation for the reviews, while inconsistent reporting means it is hard to identify whether the highest-risk patients are being assessed, the RPS suggested.

It cited a recent analysis of medication reviews using data from primary care records, which identified nine individual clinical codes being used for medication reviews.

'We are concerned that changes to the PCN contract mean that structured medication reviews are being deprioritised by practices that are working flat out,' said Mr Jiang.

And he highlighted the importance of SMRs in supporting patients taking multiple medications.

'Polypharmacy can potentially cause significant harm and it is vital that pharmacists can maximise their role in helping patients to get the most from their medicines and reducing avoidable hospital admissions,' he said.

In a policy statement released today, the RPS recommended that:

  • PCNs must recognise that medicines optimisation and SMRs remain part of the core contract and PCNs are accountable for their delivery
  • PCN pharmacy teams should be enabled to prioritise SMR activity in the highest risk patients
  • SMR uptake and delivery should be monitored and reviewed regularly at ICS and PCN level
  • Efforts should be made to improve the quality and accuracy of the coding and structure of SMRs to support benchmarking and evaluation
  • Further patient outcome orientated research should be funded to measure and evaluate the value of SMRs in England.

The policy update follows discussion at a recent RPS board meeting on the issue.