FOI 2025/1255

I am writing to request information under the Freedom of Information Act 2000 regarding medicines wastage in your commissioning area, particularly within GP practices and primary care.

Please could you provide the following for the most recent 12-month period available:

1. The estimated financial cost of medicines wasted in primary care under your ICB’s remit, including:
   • Returned or uncollected prescriptions from patients
   • Stock expired or disposed of by GP practices or pharmacies
   • Medication wastage due to patient non-adherence, over-prescribing, or other causes
2. Any available quantitative data (e.g., volume/weight or item count) on wasted medicines.
3. Any audits, internal reports, or evaluations your ICB has conducted on medicines wastage or medicines optimisation.
4. Whether your ICB supports or commissions any initiatives, technologies, or systems to reduce or monitor medicines waste.

NHS Greater Manchester consists of the following 10 Greater Manchester Localities: Bolton, Bury, Heywood, Middleton and Rochdale, Manchester, Oldham, Salford, Stockport, Tameside, Trafford, and Wigan (former Clinical Commissioning Groups).

1. The estimated financial cost of medicines wasted in primary care is not collected. Therefore, NHS Greater Manchester (NHS GM) does not hold this information.
2. Quantitative data (e.g., volume/weight or item count) on wasted medicines is not collected. Therefore, NHS Greater Manchester (NHS GM) does not hold this information.
3. All localities work on initiatives that may reduce pharmaceutical waste – for example quantity alignment and patient led ordering but these are not specifically waste reduction pieces of work.

One locality has an audit document specifically titled ‘waste’ – this is attached below.

**A word document was sent to the requester with this response.  If you require a copy of the full response, together with the attachments, please contact NHS GM’s FOI team – nhsgm.foi@nhs.net.**

4. There are no systems in place to identify or monitor medicines waste specifically.

NHS GM commissions OptimiseRx and ScriptSwitch, which are systems that sit on the GPs’ computer systems – these both contain waste reduction messages that prompt the prescriber.

One locality specifically had a target in their GP quality scheme around waste:

Medicines optimisation sustainability indicator – Reduction in pharmaceutical waste & promoting efficient prescribing.

There were several specific requirements within this.

Please see below.

2025/2026:

Reduction in prescribing spend cost per head (ASTRO-PU) from baseline by:

• Continued reduction of DLCV/OTC prescribing
• Support implementation of prescribing CIP plan
• Quality improvement:  Practice to choose 2 areas from the list below to review and deprescribe. (Where treatment must continue ensure GMMMG formulary is adhered to). Alternatively, practice may choose 1 from the list below, and 1 specific to the practice.

*Non-steroidal anti-inflammatory drugs

*Proton-pump inhibitors

*Ferrous fumarate/sulfate/gluconate

*Laxatives

*Bisphosphonates prescribed >5yrs

2024/2025:

Reduction in prescribing spend cost per head (ASTRO-PU) from baseline by:

• Continued reduction of DLCV/OTC prescribing from 23/24 baseline
• Support implementation of prescribing QIPP plan
• Encouraging patients to take responsibility for managing their prescriptions
• Adherence to robust repeat prescribing policy
• Engagement with local community pharmacies to improve prescription processes