PrescQIPP

Polypharmacy MDT Clinic (2025)

University Hospitals of Leicester

Project summary

The Polypharmacy Multidisciplinary Team (MDT) programme is a unique service which provides holistic medication reviews for patients with complex polypharmacy. These comprehensive, in-depth reviews are undertaken by a specialist MDT (consisting of specialist pharmacists (primary and secondary care), general practitioners and medical consultants) and tackle overprescribing and inappropriate polypharmacy with the overall aim of reducing harm.
The clinic demonstrates excellent financial benefit with 559% return on investment over 5 years with low financial risk and cost. A pilot MDT polypharmacy clinic was undertaken between March 2023 – March 2024. An independent, external evaluation funded by Health Innovation East Midlands has estimated from pilot data that for every £1 spent in clinic there is a benefit of up to £1.70 in financial impact. Per patient seen in clinic there would be £221.10 worth of savings from medicine prescribing cost per annum. Additionally, the average savings from admission avoidance per patient in the clinic would be £200. Based on an updated clinic model there is a projected cost saving of £686,221 within 5 years of running the service.

Key Benefits

  • Reduced hospital admissions and subsequent bed days
  • Reduced prescribing and associated administrative costs
  • Reduced Adverse Drug Reactions (ADRs) — falls, cognitive impairment etc.
  • Better clinical outcomes: Medicines optimised as per evidenced-based practice
  • Reduced pill burden and carbon footprint through medicines wastage
  • Collaborative working / expertise sharing between primary and secondary care: clinicians up-skilled in the area of polypharmacy
  • Patient empowerment, reassurance, satisfaction and education. Improved medication adherence
  • Alignment to national and local prescribing priorities

These specialist reviews differ from typical ‘Structured Medication Reviews’ carried out in primary care and provide a holistic approach for patients that are most risk of harm from their medications. The clinic has a strong focus on educating and up-skilling patients and primary care clinicians in order to reduce deprescribing barriers and problematic polypharmacy rates in the Leicester, Leicestershire and Rutland (LLR) region. By improving prescribing practice and medicines management this service will tackle admission rates, prescribing costs, unequal access to care, improve population health and have a positive impact on the regional carbon footprint.