29 July 2005
The NHS in Scotland needs to improve the budgeting and cost control of hospital medicines, Audit Scotland has advised.
In its study Scottish prescription: managing the use of medicines in Scotland, the public sector watchdog found that spending on medicines was rising faster than NHS costs overall. It concluded that Scottish health service boards needed to improve planning and budget setting while promoting cost-effective prescriptions.
Audit Scotland noted that in recent years there had been an increase both in the numbers of medicines available to treat patients and in the types of staff who can prescribe them.
While overall hospital running costs increased by 32% in the four years to 2003/04, expenditure on drugs increased by 56% in the same period. Average spending on medicines per patient in Scottish acute hospitals has risen by 65% since 2001/02, the study found.
It identified several areas where improvements could be made. These included better information on new medicines' anticipated costs, benefits and recommended changes in use.
The inspectors said this would help managers set more effective budgets.
The report also called for better information on medicine use in hospitals, to monitor whether patients were getting the most appropriate treatment. It noted that a national 'hospital electronic prescribing and medicines' system, or Hepma, would help to address this. It called on the Scottish Executive's Health Department to develop a clear project plan for setting up this system.
The auditors also suggested staff guidance for medicine use while ensuring that there are sufficient numbers of qualified pharmacists to meet future needs. Although two-thirds of Scotland's hospitals have clinical pharmacists working on wards, there is a shortage of qualified workers, the report says.
Deputy auditor general Caroline Gardner said good progress had already been made by a number of NHS boards, particularly in providing staff guidance and advice for prescribing the most appropriate medicines.
But she added: 'Our recommendations are aimed at helping all the organisations involved in health service planning and patient care make best use of medicines and maximise their benefits.'
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