A centre for medicines optimisation research and education

Source: NHE Jul/Aug 2017

Dr Yogini Jani, a consultant pharmacist at University College London Hospitals NHS FT (UCLH), discusses a collaboration with UCL School of Pharmacy that aims to transform patient care by making medicines safer and easier to take.

Left to right: Professor David Lomas, UCL’s vice-provost (health); Professor Ian Wong, CMORE’s co-director; Dr Yogini Jani, CMORE’s director; and Professor Marcel Levi, UCLH’s chief executive

Established in May, the Centre for Medicines Optimisation Research and Education (CMORE) will combine the two partners’ experience and expertise in the effective use of medicines, medication safety and pharmaceutical science and build on education and training initiatives. 

Medicines are the most frequently used intervention in healthcare. Modern medicines are effective but also more complex. With the growing number of patients with long-term conditions and an associated increase in the number of prescription items per patient per year, there is also recognition that nearly 30-50% of medicines for long-term conditions are not taken as prescribed. The issues of multimorbidity and polypharmacy were highlighted in a King’s Fund report published in 2013, and ways of optimising the use of medicines by the Royal Pharmaceutical Society in the same year. In 2015, NICE guidance for medicines optimisation identified key priorities for implementation to enable the best possible outcomes from the safe and effective use of medicines. 

Patient safety concerns in relation to medicines due to adverse events, mistakes and communication breakdown during transfers of care between hospital and other care settings are also well recognised. National initiatives, such as the MHRA yellow card reporting system, the NHS Medication Safety Thermometer and a national alert requiring designated Medication Safety Officers, exist to enable reporting and learning to improve safety. However, there is global acknowledgement through the recent announcement of the WHO’s third global patient safety challenge that “unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in healthcare systems across the world”.  

Medicines optimisation is an umbrella term often used to encapsulate a range of principles and activities to help healthcare professionals and patients to get the best from medicines. These include understanding the patient’s experience of medicines and enabling involvement in their own care, ensuring medicines use is as safe and effective as possible, and having systems for identifying, reporting and learning from medication-related patient safety incidents. Medicines optimisation continues to be an important component of improving health service provision as identified in the Carter report. 

CMORE combines the clinical knowledge and experience of the pharmacy department at UCLH with the academic expertise from UCL School of Pharmacy in areas of medicines use and optimisation, pharmacoepidemiology and medication safety, and age-related medicines development and use.  

Research areas and focus 

The centre will focus on informing design, safety and effective and optimal use of medicines through leading research, improvement initiatives and educational development. 

One example of CMORE activities is a research project to explore ways in which specialist medicines can be administered close to home for cancer patients. The work has been funded by the BOPA-PRUK Research Award for developing research capability of pharmacists. The project will benefit patients by providing deeper insights into the barriers and enablers based on patients’ views and opinions, as well as GP perspectives. Depending on the findings, there is potential for better patient experience and less travelling time, and the opportunity to review and redesign cancer services. 

Another research area is improving the use of antibiotics in patients with penicillin allergy. Nearly 10% of the general population claim to have a penicillin allergy, which will affect the choice of antibiotic they may receive. The project has been funded by the Health Foundation through an Improvement Science Fellowship. It aims to develop, test and implement strategies for improvement by studying how well and what information relating to penicillin allergies is recorded, how healthcare professionals choose antibiotics based on the recorded information, and how this might impact on patient safety and clinical outcomes. Outputs will be disseminated and spread via the National Medication Safety Officer Network for wider patient benefit. 

The educational stream of CMORE builds on the Berwick report recommendations to build training and capacity for quality and patient safety sciences. The centre provides placement and research opportunities for undergraduate and postgraduate students from UCL School of Pharmacy, thus bridging the gap between ‘knowing’ and ‘doing’. Going forward, CMORE will provide training and support in research methods and quality improvement approaches to pharmacists and pharmacy staff, and opportunities for inter-professional learning with doctors and nurses. 

Ultimately, CMORE is based on the premise that medicines are fundamental to modern healthcare and require collaboration between patients and healthcare professionals to study, understand, identify and improve so that we can make the most of the medicines that we have.




There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

latest healthcare news

London trust told to improve for third time in three years

17/08/2017London trust told to improve for third time in three years

A major London NHS trust has been told by inspectors that it needs to urgently improve after it received its third ‘Requires Improvement&rs... more >
Third of trainee GPs not planning to work in NHS general practice

17/08/2017Third of trainee GPs not planning to work in NHS general practice

Only two-thirds of trainee GPs are planning to go on to work in general practice in the NHS, a new study has today warned. The research carr... more >
Longest serving NHS chief executive sacked for ‘gross misconduct’

17/08/2017Longest serving NHS chief executive sacked for ‘gross misconduct’

The NHS’s longest serving CEO Sir Leonard Fenwick has been sacked by Newcastle upon Tyne Hospitals NHS FT (NUT) for “gross misconduct... more >
681 149x260 NHE Subscribe button

the scalpel's daily blog

Turbo-boosting STPs? It’s time we got serious about ‘partnership’

27/07/2017Turbo-boosting STPs? It’s time we got serious about ‘partnership’

Merron Simpson, chief executive New NHS Alliance, argues we’re missing the point of what ‘partnership working’ truly means if we refuse to recruit help from those outside the health service. Jeremy Hunt and Simon Steven’s recent announcement to ‘turbo-boost’ sustainability and transformation partnerships (STPs) provides a welcome shot-in-the-arm for those across the system who are ... more >
read more blog posts from 'the scalpel' >


Improving care at the touch of a screen

08/08/2017Improving care at the touch of a screen

When it comes to dementia, having a calm and safe environment can have a substantial impact on a patient’s quality of life. NHE’s Jos... more >
A new approach to talent management

25/07/2017A new approach to talent management

Martin Hancock, national lead for talent management at NHS Leadership Academy, and Gill Rooke, the organisation’s senior operations manager... more >
Enabling greater integration through ACSs

25/07/2017Enabling greater integration through ACSs

At this year’s NHS Confed, Simon Stevens revealed the first wave of accountable care systems (ACSs). NHE speaks to Ian Dodge, the director ... more >
How NHS organisations can protect themselves against cyber crime

25/07/2017How NHS organisations can protect themselves against cyber crime

On 12 May, a global cyber-attack occurred on an unprecedented scale. It affected organisations across the globe and, though it did not specifical... more >

last word

Your personality, your leadership

Your personality, your leadership

Deirdre Wallace, clinical skills manager at UCL Medical School, discusses the importance of learning about leadership and self while at medical school. Approximately five years ago, I was ch... more > more last word articles >

editor's comment

13/06/2017Tackling the major challenges facing the NHS

As you will have gathered from the front cover, a theme that runs throughout this edition of NHE is about empowering and involving the workforce in order to deliver innovative change across the system.  Professor Jane Dacre, president of the Royal College of Physicians, highlights on page 16 the importance of sustainability and trans... read more >

health service focus

Securing the health service with openness and transparency

08/08/2017Securing the health service with openness and transparency

Mike Lees, head of business security at Barns... more >
Transforming health and care: the Dorset story

08/08/2017Transforming health and care: the Dorset story

Phil Richardson, Dorset STP lead director, ex... more >