1. Prudent Healthcare Prescribing Workshop April 2014
Howard Rowe
Clinical Director:
head of medicines management

2. Introduction and Aims
Aims
Format
Set the Scene

3. Aims
Understanding of Prudent Healthcare and its application to Prescribing
Produce recommendations for Change in prescribing arrangements
Identify where more work is needed
Capture lessons on "the workshop process"

4. Format Presentations Group Work Next Steps
Understanding Prudent Healthcare and the underpinning Principles
To test the current arrangements for Prescribing against those Principles
Patients' perspective
Clinicians' perspective
Group Work
Define "what would good look like?"
Test and Prioritise the Ideas that emerge
Next Steps

5. Set the Scene: use of medicines
14,000 prescribed doses in a lifetime
Age and Use of Medicines
Percentage of adults who reported being on regular prescribed medication (for a year or more), by age and sex

6. Set the Scene
Use of three or more prescription drugs in the past 30 days

7. Set the Scene
65+
10% of Population, Account for 30% of Medicines Expenditure in Primary Care

8. Set the Scene Use of Medicines: Prescribing Volume Primary Care
7.6 million items per annum
200 million doses per annum or
550, 000 doses per day
Primary Care: rate of increase
Volume: Wales 2.62%, Cwm Taf (gold)

9. Set the Scene Medicines Expenditure Primary Care
£56 million per annum
£220,000 every working day (like today)
Primary Care: rate of increase
Spend: Wales 2.05%, Cwm Taf 1.72% (bronze)

10. Set the Scene Medicines Expenditure Secondary Care (within Cwm Taf)
£20 million per annum
£6 million arising from NICE/AWMSG
need £1m (26%) to £2.5m (42%) for NICE/AWMSG

11. Set the Scene Do No Harm “Grandfather wins £1m drug blunder payout”
Prescribing: Lithium
“Grandfather wins £1m drug blunder payout”
(at East Glamorgan Hospital)

12. Set the Scene Do No Harm Dispensing: Peppermint Water
Wednesday, 1 March, 2000, 18:31 GMT
“Chemists fined after baby death”
Administration: Penicillin Allergy
30th October 2013
“Grandmother, 61, 'died after nurse gave her
penicillin despite SEVEN warnings that
she was allergic to it‘ “

13. Set the Scene
Culture in the Community

14. Set the Scene
Quality: Prescribing Indicators

15. Set the Scene
Quality
Realising potential from being Integrated Health Board
Diclofenac