Medicines management

Private healthcare companies invoice their clients for every medicine given. Although I am not suggesting that we invoice NHS patients in this way, learning about the cost of medicines will make us think about what we are using, and be more careful about wastage. I would recommend looking at the NHS cost of medicines in the British National Formulary.

Medicines on shelves could be labelled with the cost per item. Sometimes it works out cheaper to also look at using different quantities of medicines. For example, a 5 x 10ml sodium chloride ampoule is £1.50, whereas 1x 50ml saline ampoule is £3.41.

Liquid formulations are often more expensive than capsules or tablets, so consider whether or not your patient really needs the medicine in liquid form. Flucloxacillin is a great example of this. Capsules – 28 x 250 mg capsules costs £1.64 – are a fraction of the cost of the oral solutions, where 100ml of 250mg/5ml is £26.04. Another example is prednisolone, where the soluble tablets are much more expensive (30 x 5mg tablets cost £53.48) than the normal tablets (28 x 5mg tablets cost £1.29).

It is also important for ward staff to ensure that medicines follow patients. If a patient is going home or transferring wards, do they still need these medicines or can they be returned to pharmacy?

In my role as the senior nurse for medicines, I saw how audits of fridges on wards would often show hundreds of pounds’ worth of medicines that had been dispensed for named patients who had been discharged, going out of date instead of being returned to pharmacy.

These measures can save wards, hospitals and primary care practices a huge amount of money. Speak to your local medicines management nurse or pharmacist about getting help highlighting these issues with staff.

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