Cluster page — medicines optimisation
Medicines optimisation for Integrated Care Boards
ICB role
What the ICB MO function controls — and what it has to influence
ICB medicines optimisation teams sit at the intersection of population health, prescribing cost containment and patient safety. They directly control the Joint Formulary, the local therapeutic switch programme, the prescribing safety alert cascade and the commissioning of supplementary MO programmes. They influence — but do not control — the day-to-day delivery of MO inside the PCN, which is owned by the PCN Clinical Director and the Lead Pharmacist team.
That split makes assurance and benchmarking the ICB's most important lever. ICBs that publish clean prescribing benchmarks against ePACT2 and OpenPrescribing, set a clear MO dashboard return, and engage Lead Pharmacists in shared learning consistently outperform peers on prescribing safety and cost outcomes — without micromanaging PCN delivery.
ICB MO function
The core ICB MO portfolio
- Joint Formulary maintenance and exception process
- Prescribing safety alert cascade (MHRA, ICB-issued, PINCER outputs)
- Therapeutic switch and biosimilar transition programmes
- Antimicrobial stewardship — TARGET, ESPAUR reporting, AMS dashboards
- Controlled drug governance and accountable officer reporting
- DES MO assurance — quarterly cohort return, supervision evidence
- Population-level MO programmes (frailty, opioids, antipsychotic deprescribing)
- Workforce development — IP conversion, designated supervisor training
Benchmarks
What strong ICB MO performance looks like
Frequently asked questions
ICB MO — FAQs
What does an ICB medicines optimisation team do?+
Set the Joint Formulary, lead therapeutic and biosimilar switch programmes, issue and assure prescribing safety alerts, benchmark prescribing quality across PCNs, commission targeted MO interventions (antimicrobial stewardship, opioid stewardship, polypharmacy), and assure DES MO delivery at network level.
How do ICBs assure PCN MO delivery?+
Through the DES quarterly return (SMR cohort delivery, supervision evidence, scope of practice currency), ePACT2 prescribing benchmarks, MHRA alert closure logs, OpenPrescribing comparators and direct conversations with the PCN Clinical Director and Lead Pharmacist.
What prescribing data sources do ICBs use?+
ePACT2 (NHS BSA dispensing data), OpenPrescribing.net, the NHS RX summary, MHRA Yellow Card, NRLS incident data, and PCN-extracted SNOMED activity from EMIS/SystmOne. PINCER results feed prescribing safety prioritisation.
Can an ICB commission MO programmes outside the DES?+
Yes — ICBs commission additional MO programmes (e.g. structured opioid review, antipsychotic deprescribing in dementia, biosimilar transitions) often using PCN clinical pharmacist capacity supplemented by managed-service providers where in-house supply is constrained.
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