News & Views
Home > Case Study > Wirral integrated care medicines optimisation project

Wirral integrated care medicines optimisation project

Our integrated care medicines optimisation project in Wirral resulted in better patient care and potential cost improvements of almost £0.5million.

An estimated five percent of all hospital admissions are related to medication, with half of those being preventable. It has also been suggested that 50 percent of medication is not taken as directed, leading to waste. Wirral Clinical Commissioning Group (CCG) commissioned us to undertake a 12-month integrated medicines optimisation project to address these issues locally.

We undertook a pilot project from July 2017 to July 2018 to identify the benefits of a pharmacist working with the community integrated teams.

We identified 20 GP practices for involvement in the project by using data relating to high rates of unplanned admissions collated by the CCG’s business intelligence team. Patients were targeted if they were:

  • aged over 85 with one or more hospital admission;
  • taking six or more medications with more than one hospital admission;
  • taking 10 or more medications with unplanned hospital admissions; or
  • being transferred to care home intermediate bed for assessment.

Other patients referred to the integrated team pharmacist included those who were:

  • stockpiling medicines at home
  • confused about their medication
  • non-compliant
  • prone to falls and taking more than four medications
  • post-discharge with changes made to their medication
  • suitable for deprescribing.


Outcome measure Outcome
Total potential cost improvement  £488,985
Annualized cost savings due to medicines optimisation (e.g. deprescribing, dose optimisation, switching to cost effective medication)  £159,925 (p.a.)
Reduction in potential hospital admissions (RiO tool level 3 interventions) 104 potential hospital admissions avoided in patients >65 years
14 potential hospital admissions in patients <65 years
Estimated cost avoidance = £329,060
Total number of medication reviews completed between 1 July 2017 and 31 July 2018  1459
Total number of ‘transfer to assess’ patient reviews completed  85
Total number of high risk medicines optimised or stopped  273
Number of medications stopped/switched due to contra-indications and/or adverse drug reaction  85

With a total cost of £65,900 for implementing and delivering the service, the return on investment (RoI) was more than 2:1 with respect to annualised cost saving from medicines optimisation interventions only. The total potential cost improvements for the Wirral healthcare system was £488,984, giving an overall maximum RoI in excess of 7:1.

The suggestions I am aware of have been very useful. It is particularly good that you have been able to review some of the patients we often don’t see or those for whom we don’t have enough time to review their medication within a consultation.
Dr K. Grey, West Wirral Group Practice

Thanks so much for the help with my medicines ordering. I was getting awfully confused with it ‘all over the shop’. I just didn’t realise it would be so simple for you to sort it out for me. You’ve really explained things to me so I can understand what each medicine is for and how they work together.
Elderly female patient

Get in touch

Kingston House

438-450 High Street
West Bromwich
West Midlands
B70 9LD

0121 612 1500
  • Heron House
  • Springfields Health & Wellbeing Centre

Midlands and Lancashire CSU
120 Grove Road
Stoke on Trent

0300 404 2999

Midlands and Lancashire CSU
1st Floor
Lovett Court
WS15 2QD

0300 404 2999
Jubilee House

Midlands and Lancashire CSU
Lancashire Business Park
PR26 6TR

01772 214200
Liverpool Innovation Park

Office 2
2nd Floor
Building 2
Liverpool Innovation Park
360 Edge Lane
L7 9NJ

0151 295 8612/8619
  • 1829 Building, Chester
  • Old Market House
  • Clark House

1829 Building
Countess of Chester Health Park
Liverpool Road

01244 650 300

Hamilton Street
CH41 5AL

0151 514 2335 EXT 1487

Hulley Road
SK10 2LU

01606 544 791
Cardinal Square

3rd Floor North Point,
10 Nottingham Road,
Derby DE1 3QT
East Midlands

01332 888231
St Johns House

St Johns House
30 East Street
United Kingdom

0121 611 0100