Managing the use of medicines in hospitals: follow-up review 

Podcast transcript
1.	What’s this report about?

The report follows up on recommendations from a report we published in 2005, which looked at how medicines are managed in hospital.  It looks at the progress made by the NHS in budgeting for medicines, particularly those that cost a lot of money; promoting safe and cost-effective use of medicines; developing systems to provide better information on how medicines are used in hospitals; workforce planning and development for hospital pharmacy staff; and on education on medicines and prescribing for medical students and junior doctors.
2.	What have you found?

We’ve found that the NHS is doing more to make sure that medicines are cost-effective and used safely in hospitals and its getting better at budgeting for new medicine. It now needs better information on which medicines patients are taking, for different health conditions and how much they cost.  Hospital pharmacy staff are increasingly working directly with patients and other staff, checking patients are taking the right medicines and advising other staff.  But these staff aren’t always available when needed and therefore workforce planning needs to improve so that the NHS has the right numbers of pharmacy staff with the right skills to meet current and future needs.
3.	What is the impact/importance on the public?
This report will be of interest to the public generally because any one of us or someone we know will be admitted to hospital at some point in our lives and nearly all patients in hospital take medicines as part of their treatment. This is also something that costs a lot of public money. So, we all have an interest in making sure that the NHS is managing medicines well.  Our report shows that the NHS is making good progress towards implementing some of the recommendations from our earlier report – particularly those focusing on improving patient safety and on cost-effective prescribing; and it makes recommendations for further improvements.  
4.	How much is spent each year on medicines in hospitals?

Spending on medicines is a significant area of expenditure for the NHS and it spent around £222 million on medicines in hospitals in 2007/08. This is about six per cent of acute hospital running costs (exhibit 1).  
5.	What has been the progress since your last report?
Since our last report, the NHS has been doing more to make sure that medicines are used safely in hospitals, particularly through a new Scotland-wide patient safety programme. Boards have also developed local prescribing and other relevant guidance for staff who deal with medicines. Since our last report, the NHS has got better at budgeting for introducing new medicines and made progress in promoting the safe and cost-effective use of medicines.  
Progress has been much slower in developing a national electronic information system. The NHS needs this so it can get better information on how medicines are used in hospitals – but this is unlikely to be in place in Scotland’s hospitals in the next few years. We also found there has been limited progress in relation to workforce planning for hospital pharmacy staff and this still needs to improve.  
6.	What do you want to see happen now?
We’ve made a number of recommendations in our report which we hope will help hospitals continue to improve how they manage medicines.
Some of the key developments we would like to see are:
•	The Scottish Government working with boards to develop plans and timescales to ensure that an electronic information system is implemented across the country as soon as possible to give better information on how medicines are used in hospitals.
•	The Scottish Government, NHS Education for Scotland and the boards improving workforce planning for hospital pharmacy staff and boards completing the move to Agenda for Change as a matter of urgency.