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Medicines management project not worth £30m

I refer to the National Prescribing Centre report (News, January 13) in which project leader Richard Seal was quoted as saying 'this is something you can do that has real benefits' ­ although I note these benefits cost a mere £30 million.

As the lead GP in one of the very active first-wave practices I think it important to point out how these improvements were made.

The average number of items given to patients 65 and over. This is not a real improvement but merely reflects the fact that items no longer being taken by a patient were removed from their repeat list.

Percentage of repeat prescription requests failing to include all items reduced from 55 to 37 per cent. A significant improvement but very time-consuming. What we do not know as yet is whether or not these patients stay synchronised. These decay rates are still under study within my own practice.

The vast improvement in dosage instruction (23 per cent to 7.5 per cent). This was a true success, but was the easiest target to tackle.

The large fall in patients experiencing a problem may be true but I suspect in my own case this reflects the fact that patients were asked repeatedly to let us know if there was a problem and over time they become bored of doing this and so the figures fall.

The true findings in Southampton were that to deliver medicines management services properly patients on repeat medication require a regular full medication review by either a GP or pharmacist or in some cases both.

In my own practice the reviews undertaken by myself and the practice pharmacist have been very successful for all parties, but they can take up to an hour per patient. The NSF for older people has medication reviews within its framework. PCTs are going to have to find a lot of finance to fund a large amount of GP time in order to deliver medicines management and implement the NSF on older people properly.

I suspect the £30 million could have been better spent.

Dr Alex Muir


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