As of Thursday, 1 October 2020, a PCN is required to:
“use appropriate tools to identify and prioritise the PCN’s patients who would benefit from a structured medication review (referred to in this Network Contract DES Specification as a “SMR”), which must include patients:
- in care homes
- with complex and problematic polypharmacy - specifically those on 10 or more medications
- on medicines commonly associated with medication errors
- using potentially addictive pain management medication
These patients should be offered a structured medication review.”
Highlighted by the NHS England guidance, the NHSBSA Polypharmacy Prescribing Comparators (the polypharmacy comparators) were developed by a group of GPs and pharmacists in Wessex working with NHSBSA analysts. Following their launch, they have been helping practices and PCNs to prioritise which of their patients may be at greatest risk of harm from problematic polypharmacy.
The polypharmacy comparators consist of measures which show practices and PCNs how many patients they have on 8 or more, 10 or more, 15 or more, and 20 or more, medicines.
The polypharmacy comparators also identify patients taking a combination of medicines known to increase risk of harm, such as multiple anticoagulants or medicines which, when taken together, can increase risk of cumulative anticholinergic cumulative side effects, increasing the risk of falls, confusion, constipation and other issues. View the medicines safety portal for more information.
In November 2019, this work was recognised nationally via the HSJ Patient Safety Award.
How do you access the polypharmacy comparators?
PCN pharmacists across England can access the polypharmacy comparators via ePACT2. Register or access ePACT2.
These case study shows how practices have used this data already to successfully identify patients at risk from harm and review their medicines usage:
The tool can then be used to access the NHS numbers of the patients identified.
Once PCNs have identified their priority areas, the NHSBSA can provide the NHS number of the patients who have been highlighted via the polypharmacy comparators.
New polypharmacy comparators
By the end of 2020, we will be adding new therapeutic comparators and additional functionality to enable searching by different age groups.