Polypharmacy Masterclasses

Health Innovation North East and North Cumbria (HI NENC) ran Polypharmacy Masterclasses as part of their delivery of the Health Innovation Network National Polypharmacy Programme. The Polypharmacy Masterclasses aim to help GPs, Pharmacists and Advanced Nurse Practitioners (ANPs) carry out structured medication reviews and stop inappropriate medicines. The local masterclass sessions are run by a Lead Senior Advanced Clinical Pharmacist Practitioner and accredited Polypharmacy Action Learning Set trainer.
On day one of the masterclass sessions, the attendees explore all the contributing factors to the issue of problematic polypharmacy and experience peer learning around this complex topic.
For day two of the masterclass, two local Geriatricians are invited to provide additional insight where attendees might have questions/queries and are a key component in increasing clinician’s confidence to stop medicines safely in older people.

Contact Details

Project Dates

Project Start 01/08/2023
Project End Ongoing



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• After your polypharmacy training yesterday, I have reviewed a 94 year old lady in care home and thought to myself we need to discuss stopping at least 3 medications and why is she on this medication as I was reviewing. Her last BP was over 6 months and I have rechecked today it was 187/82. She is displaying signs on confusion, and I have transferred her to the on call GP. This is what your masterclass put in motion.
Clinical Pharmacist IP
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Medicines, we know, have saved and improved the lives of millions of people. However, as more and more people live longer with multiple long-term conditions, the number of medicines they take increases.

This can have a significant burden on the person managing and trying to adhere to multiple medicines regimes and can also be harmful. Studies have shown that over 50% of older people are prescribed a medicine with more harm than benefit leading to avoidable morbidity, hospitalisation and mortality (1). Polypharmacy adds preventable cost to the healthcare system and diminishes quality of care for the patient. (2)

Clinicians need to have open and honest conversations with patients about their medicines. Clinicians and patients will need to explore what is important to the patients. What are their concerns, issues and expectations about treatment.

Medicines currently contribute to 25% of the NHS carbon footprint (3). It is hoped that reducing the overprescribing of inappropriately prescribed medicines will reduce patient risk and support the aim to reach carbon net zero.


1 – Gallagher P, Lang PO, Cherubini A, et al. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals. Eur J Clin Pharmacol. 2011; 67 (11): 1175-1188.

2 –  Elliott, R., Camacho, E., Campbell, F., Jankovic, D., St James, M.M., Kaltenthaler, E., Wong, R., Sculpher, M. and Faria, R., 2018. Prevalence and economic burden of medication errors in the NHS in England. Rapid evidence synthesis and economic analysis of the prevalence and burden of medication error in the UK.

3 – The Royal Pharmaceutical Society, Sustainability Policies 2021

Tackling overprescribing is North East North Cumbria ICB’s overarching medicine priority. It is also identified in the National Medicines Opportunities for ICBs.

Building on the National Overprescribing Review, this publication states:

“The focus of this opportunity is on identifying and reviewing patients with problematic polypharmacy supporting cultural and behavioural changes”.

“Structured Medication Reviews (SMRs) can be used to review patients identified as having problematic polypharmacy. They provide a comprehensive and clinical review of a patient’s medicines and detailed aspects of their health and are facilitated by shared decision-making conversations with patients around whether medicines are safe, effective and personalised to their needs and current situation”.

The local polypharmacy masterclasses provide clinicians with the tools, techniques and confidence to have these conversations during an SMR with a patient. We plan to provide the training consistently across the ICS in both primary and secondary care.

Kayleigh Davison, a local pharmacist attended National Polypharmacy Action Learning Sessions and associated train the trainer accreditation process in order to deliver the masterclasses within the NENC region. The national information was condensed and modified for the NENC region and is now available as an ‘off the shelf’ training package.

One cohort of training has been delivered in October and November 2023 which consisted of three day one sessions (2 online and 1 face to face) and one day 2 session.

Session Method of Delivery Audience Notes
Day one

5th October 2023

Online half day In house GP practice learning time Open to all
Day one

19th October 2023

Face-to-Face half day Prescribers including GPs, Pharmacists, ANPs Primary and Secondary Care
Day one

9th November 2023

Online half day In house GP practice learning time Open to all
Day two

28th November 2023

Online 1.5 hours All staff that attended Day one sessions


1 NENC specialist trainer accredited nationally (a further pharmacist is also being trained)

  • A total of 138 delegates attended all day one sessions.
  • 47 of these were from Core20 practices/PCNs.
  • An evaluation survey was completed by 53 delegates at the end of day 1 sessions. Respondents reported that:

94% will implement an action as a result of attending the training.

88% that were prescribers felt the masterclass would influence their prescribing practice.

81% will change their approach to having conversations with patients.

Overall rating for the sessions was 4.45 out of 5.

Investing in clinical leaders – Training of Polypharmacy Trainers and delivery of local Polypharmacy Masterclasses to upskill the primary care workforce to be more confident about stopping unnecessary medicines. (The Action Learning Set model, on which the local masterclasses have been based, was originally developed and piloted by Wessex AHSN and supported by Health Education England (HEE)).

Reduce risk to patients and hospital admissions – Patients aged 75 and over on 10 or more medicines are at increased risk of adverse incidents. Tackling polypharmacy and the associated risk for patients will mean better outcomes and reduce risk of adverse incidents for patients.

A change in patient expectations – to anticipate having a shared decision-making conversation about their medicines regularly, especially as they get older.

  • Funded Lead Senior Advanced Clinical Pharmacist Practitioner and accredited Polypharmacy Action Learning Set trainer to develop training and deliver cohort one session (Q3 2023/24).
  • Cohort 2 sessions are planned for Q4 2023/24.
  • Funded prescribing data packs obtained from North East Quality Observatory service (NEQOS) so delegates were provided with bespoke data on their prescribing habits.
  • Set up, delivered and funded the masterclasses from an operation perspective.
  • HI NENC are assisting the ICB with their patient facing campaign ‘Are the Medicines Working?’

Cohort 2 sessions are planned for Q4 2023/24

Plans are in place to understand the impact on prescribing and structured medication reviews

Potential for further sessions on specific topics e.g. respiratory