Cluster page — medicines optimisation
Medicines optimisation for Primary Care Networks
PCN context
Why MO is the PCN's highest-value DES workstream
The SMR & Medicines Optimisation service specification of the Network Contract DES is the only DES workstream that simultaneously: (a) unlocks ARRS reimbursement through the clinical pharmacist and pharmacy technician roles, (b) generates QOF achievement payment through medication review indicators, (c) reduces unplanned admissions through deprescribing in the over-75 frailty cohort, and (d) generates measurable prescribing cost savings reported to the ICB. No other DES workstream stacks four returns this cleanly.
Most PCNs operate the MO programme as a hub-and-spoke: a Lead Pharmacist (IP, ~0.4 WTE allocation) provides supervision, scope of practice sign-off and QA sampling across the network; 2–3 WTE clinical pharmacists rotate practices delivering SMR clinics, HRD reviews and reconciliation; a pharmacy technician runs daily cohort identification, recall and prescribing safety dashboards. Smaller or under-recruited PCNs commission this entire layer through a managed-service provider.
Network-scale benchmarks
PCN MO sizing for a typical 50k network
DES delivery checklist
What every PCN must evidence quarterly
- Named Lead Pharmacist with documented supervision schedule and QA sampling
- Scope of practice on file for every ARRS pharmacist and pharmacy technician
- Monthly SNOMED-coded activity extract — SMRs, HRDs, reconciliation, deprescribing
- Prescribing safety alert closure log against MHRA/ICB timeframes
- Care home MO programme aligned to the Enhanced Health in Care Homes DES
- Quarterly ICB MO dashboard return with cohort breakdown and exception narrative
- Annual SEA review and prescribing safety culture audit
Cluster deep-dives
Where to go next in the cluster
SMRs at PCN scale
Cohort identification, clinic design, IP-led delivery, coding.
KPIs & reporting
The exact MO dashboard the PCN Clinical Director should hold.
Governance & supervision
What ICBs audit and what CQC asks for.
ROI & impact
What MO is worth to a 50k PCN.
Frequently asked questions
PCN MO — FAQs
What does the PCN DES require for medicines optimisation?+
The Network Contract DES SMR & Medicines Optimisation service specification requires every PCN to deliver structured medication reviews to a defined population cohort (frailty, polypharmacy, care homes, high-risk drugs), with named clinical leadership, IP-qualified pharmacist capacity, supervision evidence and quarterly ICB reporting.
What is the SMR cohort target for an average-size PCN?+
An average 50,000-patient PCN typically holds 1,800–2,400 patients eligible for SMRs annually (over-75s on 10+ medicines, care home residents, polypharmacy plus frailty, structured high-risk drug cohort). Delivery requires ~2 WTE IP pharmacist capacity supported by a pharmacy technician.
How do PCNs evidence MO delivery to the ICB?+
Monthly SNOMED-coded activity extract, quarterly KPI dashboard (SMRs completed, HRD reviews, reconciliation rate, prescribing safety alert closure, deprescribing), supervision log, named scope of practice for every ARRS pharmacist, and exception reports for cohort under-delivery.
Does MO sit inside QOF as well as the DES?+
Yes — QOF medication review indicators, prescribing safety domains, and the IIF (where retained) all overlap with DES MO delivery. A well-designed PCN MO programme satisfies all three in a single workflow.
Talk to our Service Development team
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