1. Walsall Medicines Waste Walsall Medicines Management Team

2. Question How much Money do we know is wasted on medicines each year in Walsall?

3. Answer £1-3 million Potentially the cost of 3401 Cataract operations or 909 Percutaneous coronary interventions – stents or 588 Hip replacements or 340 Coronary Artery Grafts

4. What a waste

6. Pharmacy waste collection in Walsall – July 2010 61 collections 46.6kg average per collection. Nearly 3 tonnes of waste Est. £500k of waste Usually collected every 8 weeks The Department of Health has estimated that £100million in unwanted medicine is returned every year in England alone - this does not account for medicines that are thrown away with domestic waste or flushed away Could be as high as £800 million across the NHS per year £1.5million spent by PCTs destroying this waste

7. Why does it occur? Suggestions

8. Why does it occur Education and training Lack of understanding Patient unaware that unused medicines cannot be recycled, even if you never open them, once medicines have left the pharmacy or dispensary they cannot be recycled or used by anyone else. Patient may not be able to appreciate the true cost of their medicines Lack of responsibility by patient – order all medication on repeat slip, patient not determining what they need. Lack of responsibility by healthcare professional-HCP not synchronising the medication, Care homes disposing of “when required” medicines monthly

9. Examples Treatment is changed by GP or hospital Prescription quantities are not synchronised Patient decides not to use or to use intermittently – side effects, beliefs, interference with daily activities Medicines are dispensed but remain uncollected Patients no longer need medication due to recovery In patient medication may be transferred to primary care and continued unnecessarily e.g. antibiotics Acute medicines are transferred to repeat and issued every time Seasonal medication remains on a repeat prescription all year Patient may stockpile medicines “just in case” Lack of review

10. How would you tackle the problem? Suggestions

11. How we can reduce this waste? Understand the implications and communicate these key messages to patients and carers: Let your GP or Pharmacist know if you've stopped taking any of your medicines. Check what medicines you still have at home before re-ordering. Discuss your medication with your Pharmacist or GP on a regular basis. Think carefully before ticking all the boxes on your repeat prescription forms and only tick those you really need. If you don't need the medicine now - don't order it! If you need the medicine in the future you can still request it. If you need to go into hospital, please take all your prescription medicines with you. Stock-piling of medicines is both wasteful and dangerous. Try to understand how much wasted medicines cost the NHS This wasted money means less money to be spent on other health services And finally Signpost patients to services that can help optimise their medicine taking and reduce potential wastage

12. What are we doing Medicines waste campaign Medicines management technician – supports meds management in care homes Medication reviews Repeat dispensing Reduced quantities prescribed Repeat prescription management by Pharmacists/technicians

13. Summary Medicines waste is a massive drain on NHS resources Its everyone's problem More waste = less resources for you and your loved ones Raised awareness of the campaign will help get the message across Services are available through the pharmacy or GP to help tackle the problem The least cost-effective medicine is one that is never used Remember, once a medicine leaves the pharmacy it cannot be re-used or recycled

14. Resources 1. http://www.medicinewaste.com/http://www.medicinewaste.com/ 2. The Department of Health has quoted this estimate for some years, e.g. Hansard 10 November 2003, column 130W; 5 June 2006, column 385W. 3. 26 Department of Health, Management of Medicines: A resource to support implementation of the wider aspects of medicines management for the National Service Frameworks for Diabetes, Renal Services and Long-Term Conditions, July 2004, available at http://www.dh.gov.uk/assetRoot/04/08/87/55/04088755.pdfhttp://www.dh.gov.uk/assetRoot/04/08/87/55/04088755.pdf 4. http://www.nao.org.uk/publications/0607/prescribing_costs_in_primary_c.aspx