The NHS is a behemoth that spends around £136 billion annually treating the UK population.
Politicians are constantly discussing cost-saving measures or opportunities to streamline the NHS and gain efficiencies. But it seems that so many of the ideas reflect a top-down approach from people who have never spent an actual day working in an NHS setting.
I often wonder why health secretaries aren’t forced to spend at least a day working in each major NHS environment (hospital, GP surgery, pharmacy, the list goes on) instead of just posing for photos without ever understanding problems from the ground up.
Free prescriptions cost the NHS around £9bn. But given this is less than 10% of the overall budget, the topic doesn’t get talked about very much. Yet there are a variety of simple, cost-saving measures that could save the country millions every year.
While the millions of pounds that could be saved aren’t strictly significant to the overall NHS budget, this could have a material impact and save a large number of lives by freeing up resources for vital operations, hiring extra staff, or buying more modern equipment.
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As a pharmacy operator, Landys Chemist has seen the extraordinary wastage of a small number of patients first hand. People have returned expired medicine for disposal and when we’ve examined the contents, we’ve found thousands of pounds worth of stock – representing money that could have been spent on helping others. When we have pointed this out to the culprits, they shrug their shoulders and say they just never got around to telling their GP that they didn’t take a particular medicine.
In other cases, the reasons for wastage are a little different; some elderly patients almost have an insecurity about their medicine supply and so choose to hoard items, worrying that when they’re most in need the item might not be available. While I can sympathise with this mindset, the sum of a large, ageing population making choices like this again results in vastly unfair outcomes for many who desperately need urgent care but are left waiting.
There are a variety of possible solutions. I have heard many pharmacists suggest that a 10p per item charge, without exemptions, would be sufficient to reduce wastage. This idea works in practice, as evidenced by the reduction in UK consumption of plastic bags following the introduction of a 10p charge.
That said, putting a price on people’s healthcare is a huge gamble politically and any government seen to be pushing the NHS towards privatisation would face an enormous backlash from the public. With the current cost of living crisis in mind, adding extra expenses to people’s lives right now is especially unpalatable.
There is, however, a simpler solution. If patients were required to return – or at least present – an almost empty packet of medicine at their local pharmacy as proof that there had been no wastage, then it would mean the NHS would remain free at the point of access for the majority of users.
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Customers could obviously come to the pharmacy just before they ran out of their medicine to ensure no disruption to their medication. This would mean that if someone was simply warehousing medicine without taking it, they would not be able to continue obtaining repeat prescriptions.
There are risks to this approach. Some pharmacists would be concerned over dwindling numbers of dispensed items and might continue to issue repeat prescriptions without properly monitoring. That said completely ignoring such guidelines would quickly become clear during pharmacy inspections.
The simple truth is that in a post-COVID-19 world, where NHS waiting lists are at all-time highs and Brexit continues to disrupt the supply of goods, it is more important than ever for the NHS to consider and evaluate new ways to efficiently use the resources at its disposal.
The vast majority of players in the NHS are inclined to want to help and serve as many patients as possible. A measure like this might save enough money for a few extra life-saving treatments. Given the cost of administering such a change would be quite low, it is worth exploring in more detail.
Mitesh Desai is the head of e-commerce at Landys Chemist