Scotland’s hospitals getting better at managing medicines

The NHS in Scotland is doing more to make sure that medicines are used safely in hospitals and to plan for new medicines. It now needs better information on how medicines are used in order to further improve patient care.

An Audit Scotland report, Managing the use of medicines in hospitals: follow-up review, looks at progress since our 2005 report on how medicines are used in Scotland’s acute hospitals. Almost all patients in hospital take medicines and this costs the health service over £220 million a year.

The health service is working to make sure patients in hospital get medicines that will benefit them most; reduce mistakes involving medicines; and ensure medicines are used safely. The NHS now has better information on the cost of new medicines which helps boards set their budgets. Hospital pharmacy staff are increasingly working directly with patients and staff in wards and outpatient clinics, checking patients are taking the right medicines and providing advice to other staff.

The report says that with better information the NHS could further strengthen patient safety and cost-effective medicine use. Hospitals need systems that provide staff with up-to-date information about the medicines each patient is taking. They also need better information to monitor what medicines are being prescribed, for what health conditions and how much they cost.

Progress on a hospital electronic system to help support this has been slow and a national system is unlikely to be in place in the next few years. While all boards have systems to report mistakes and near misses involving medicines, there is no national approach in Scotland to collate and share this information to help reduce the risk of future incidents.

Hospital care is changing but workforce planning for pharmacy staff has not kept up with developments, and some boards have difficulty in recruiting and retaining hospital pharmacy staff. The NHS needs to ensure it has the right number of pharmacy staff with the right skills to meet current and future needs.

Deputy Auditor General for Scotland Caroline Gardner said:

“Almost all patients take medicines while in hospital and these treatments can have a positive effect on patients’ health and recovery. Scotland’s hospitals are doing more to make sure that medicines are used safely and to reduce the risks to patients.

“Medicines also need to be used cost-effectively, and high cost medicines are a particular pressure on budgets. The NHS has got better at planning for new medicines and it is doing more to promote cost-effective prescribing. But it needs better information on what medicines are being used to treat what conditions.”