Tell us about your experience of taking many medicines

Our journey of involving people and communities in tacking overprescribing in South East London

The SEL Overprescribing program is a strategic response to the National Overprescribing Review Report and our goal is to ensure that local patients receive medications only when necessary and suitable for their individual circumstances and needs.

To learn from people’s experiences and make improvements during June - December 2023 we undertook an engagement exercise to seek feedback from patients, individuals, and groups identified as being impacted.

We would like to thank you to everyone involved and all voluntary sector and community groups who supported us to involve many people including those from under-served communities.

Our results and successes

Insight from the engagement phase was essential in achieving our plans to tackle overprescribing and improve patients’ health.

• A patient’s story about the impact that Overprescribing team had on her life following an outreach visit that she attended. Hear how Eileen improved her health after engaging conversations with her GP about the effects of taking many medicines during a structure medication review (SMR).

For more information about how to prepare for a SMR click here

• In partnership with Health Innovation Network (HIN) we developed the Polypharmacy Community of Practice. Since started six individuals with lived experience attended. The Network is focussing on the following four priorities that highlighted during the engagement phase.
  • better initiation of medicines
  • continuity of care
  • patient-centred empowerment
  • improved communication between patients and clinicians
• The team developed and shared resources to support patients to have better conversations about their medicines during a structure medication review
• Training for clinicians was delivered using case scenarios and managing risks/uncertainties, feedback and recommendations from people involved during the engagement phase.
  
• The team re-visited groups and communities between May to July 2024 that we engaged with during 2023 to feedback and share progress and how people’s recommendations contributed to sustainable changes and improvements to overcome overprescribing. These visits highlighted the importance of effective communication, thorough medical assessments, cultural sensitivity, and continued education and support for both patients and carers in managing medications. See key insights on the right side of the page.

Background

Since June 2023, the South East London Integrated Care System has developed a program to tackle the complex causes, as well as weaknesses in local prescribing systems and existing medication cultures that lead to overprescribing.

Overprescribing is when people, such as those with multiple long-term conditions are taking medicines to manage their conditions that are not necessarily helpful or are not addressing what matters to them about their health.

How we involved people and communities?

• Two online webinars were hosted in July 2023 where participants had the opportunity to find out more about the project, ask questions, feedback on what works well and what could be improved. You can read more about the webinars here.

You can read the key themes and what we heard from local people here.

• An online survey and a chat forum for people taking 5 or more medicines and their carers. The survey was open from June to November 2023, and 78 respondents, who take five or more medications daily, participated.
• A programme o face to face outreach sessions with groups and communities that are disproportionally affect by overprescribing such as: people from Black, Asian, and Minority Ethnic communities and people living in deprived neighbourhoods. During August to October 2023 we visited the following groups:
  • Southwark Carers
  • Bromley Asian Cultural Association (BACA)
  • Southwark Pensioners Centre
  • Ageing Well Festival, Lambeth
  • Bengali Women’s Group, Greenwich
  • Lewisham Irish Community Centre (LICC)
  • Lewisham Diamond Club
  • Ajoda Community Alliance
  • Ethnic Mental Health Carers Forum
  • Glebe Court - residential care home, Lewisham

The outreach visits facilitated maximum participation and feedback was received from over 200 residents and carers.

You can read more including key themes from our conversations here.

• In addition, the Overprescribing project engagement work was presented for feedback and assurance at:
  • The NHS South East London Integrated Care Board
  • The South East London Engagement Assurance Committee on 26 September 2023 (read more) and 19 March 2024 (read more)
  • The Royal Pharmaceutical Society Annual Conference on 10 November 2023 to pharmacists and patient engagement advocates from all over the UK.

What we heard from people and communities?

Participants involved highlighted several factors important to them and key issues we need to address:

• the importance of active dialogue and communication between patients, doctors, and carers about their medicines including professionals being able to listen and patients and carers being empowered to raise issues.
• the importance of shared decision making with patient.
• the need to review prescribed medicines regularly and for people to know about medicines reviews.

Next steps

The full feedback results from the patient engagement work continues to be to draw out the key themes which will inform the changes, strategies, training and education needed to reduce overprescribing.

In response to what we have heard, the programme team is:

• developing a clear workplan, including creating good working relationships with other programme boards and committees as well as Local Care Partnerships to deliver relevant aspects of the plan.
• building on the learning from successful local or national initiatives to develop and implement high impact evidence-based interventions to reduce overprescribing.
• developing metrics and performance monitoring to track progress.

The project team will disseminate the findings from the engagement work and continue to engage with patients and communities through the SEL ICB Community of Practice for Polypharmacy in partnership with Health Innovation Network (HIN) to ensure this work is patient centred, incorporates the patient voice so we deliver what matters most to them when taking medicines.

If you have any questions please email at: lambethmedicines@selondonics.nhs.uk or engagement@selondonics.nhs.uk