House of Lords Science and Technology Committee<\/a>\u00a0session\u00a0on 24 June 2026, Jonathan Benger, chief executive of the National Institute for Health and Care Excellence (NICE), expressed concerns over the delay between NICE approval of a treatment and the NHS\u2019s provision of that treatment to patients.<\/p>\n\u201cThere is a funding mandate that says that those medicines should be provided within 90 days of a positive NICE recommendation, and we know that that doesn\u2019t happen universally,\u201d Benger said.<\/p>\n
A few days later, on 29 June 2026, a national AMR surveillance report published by the UK Health Security Agency (UKHSA) revealed an increase in\u00a0cases of bacteraemia resistant to one or more critically important antibiotics\u00a0by\u00a013.1% from 2019 to 2024, reaching 20,484 episodes in 2024 \u2014 an average of nearly 400 resistant cases per week.<\/p>\n
Where are cuts happening?<\/p>\n
Despite the clear need for pharmacists focused on these issues at local levels, ICBs have confirmed to\u00a0The Pharmaceutical Journal\u00a0that they intend to reduce headcount within medicine optimisation teams.<\/p>\n
\u201cAs part of the wider organisational changes being implemented across integrated care boards, the medicines optimisation team within NHS North East and North Cumbria ICB is undergoing changes to its structure and ways of working,\u201d says Ewan Maule, director of medicines at North East and North Cumbria ICB.<\/p>\n
\u201cThe team will see a reduction in headcount as part of the ICB\u2019s overall workforce changes; however, the medicines optimisation function is not being merged with other teams and will continue to play an important role in supporting the safe, effective and cost-effective use of medicines across the health and care system.<\/p>\n
While some roles are changing, we remain committed to maintaining strong pharmacy leadership within the organisation<\/p>\n
Ewan Maule, director of medicines at North East and North Cumbria ICB<\/p>\n
\u201cWhile some roles are changing, we remain committed to maintaining strong pharmacy leadership within the organisation. As part of this, we are currently recruiting to a new community pharmacy clinical lead role, which will help strengthen our engagement with community pharmacy and support the delivery of key clinical and strategic priorities across the system,\u201d Maule adds.<\/p>\n
As a result of the cost reduction targets, some ICBs are \u2018clustering\u2019 with others to save costs.\u00a0The resulting mergers mean cuts to some medicines optimisation teams.<\/p>\n
A spokesperson for NHS Dorset ICB says this is the case as it merges with NHS Somerset and NHS Bath and North East Somerset, Swindon and Wiltshire ICBs from April 2027.\u00a0<\/p>\n
\u201cAfter an extensive consultation, the medicines optimisation teams are being aligned with changes in roles and responsibilities focusing on strategic commissioning. This will result in the three legacy ICB teams being merged and more than a 50% cut in head count across the cluster ICBs,\u201d they explain, going on to confirm that 24 posts from the medicines optimisation teams had either been cut from the clustering ICB organisations or been affected by the consultation.<\/p>\n
Meanwhile, a spokesperson for NHS South Yorkshire ICB has also confirmed cuts to its medicines optimisation team. \u201cFollowing an extensive period of consultation with staff, the ICB has now confirmed the outcome document for the organisational structures required to deliver the Model ICB Blueprint and meet the reduced operating cost budget of \u00a330.6m (a 51% reduction).\u00a0<\/p>\n
\u201cThis is reflected in the reduced size of the retained medicines optimisation team (sitting with the chief medical officer portfolio); they will be responsible for delivery of statutory requirements related to the safe and effective use of medicines.\u201d<\/p>\n
Four ICBs \u2014 Shropshire, Telford and Wrekin; Staffordshire and Stoke-on-Trent; Lancashire and South Cumbria; and Thames Valley \u2014 have confirmed they are still consulting on changes to their teams.<\/p>\n
What does this mean?<\/p>\n
Speaking at the Community Pharmacy and General Practice Conference in Birmingham, West Midlands, on 22 June 2026, Adrian Hayter, medical director in clinical policy at the Royal College of GPs said the changes to ICB medicine optimisation teams \u201cwill be at the detriment of managing our patients\u201d.<\/p>\n
If we start to let go of those medicines optimisation teams, we\u2019re not going to be able to collaborate and we are not going to improve the care<\/p>\n
Adrian Hayter, medical director in clinical policy at the Royal College of GPs<\/p>\n
\u201cIf we start to let go of those medicines optimisation teams, we\u2019re not going to be able to collaborate, and we\u2019re not going to improve the care and live within the resources that are allocated to us,\u201d he explained, referring to collaboration between GPs and pharmacists.\u00a0<\/p>\n
Accoring to Maule, the reduction in medicines optimisation teams will mean a change in ways of working, but also a loss in expertise. \u201cThe reduction in resourcing of medicines optimisation teams across ICBs will inevitably mean we need to work differently,\u201d he explains.<\/p>\n
\u201cThat is consistent with the direction of travel for ICBs as strategic commissioners: less direct delivery, and more focus on using data, clinical leadership, commissioning levers and system influence to improve outcomes, reduce variation and make best use of NHS resources.<\/p>\n
\u201cBut we should also be honest about what is being lost. Across ICBs, medicines optimisation teams include incredibly valued and valuable colleagues, many with deep expertise, local relationships and organisational memory that cannot simply be replaced overnight.\u00a0<\/p>\n
\u201cTheir contribution to patient safety, prescribing quality, access to medicines and financial sustainability has often\u00a0been significant, even when it has not always been visible.\u201d<\/p>\n
Perception of teams<\/p>\n
Also speaking at the Community Pharmacy and General Practice Conference, Danny Bartlett, clinical lead at Kent, Surrey and Sussex Primary Care School, and associate programme lead in postgraduate pharmacist prescribing at the University of Brighton, suggested that visibility of medicines optimisation teams has been part of the problem in leaving them vulnerable to cuts.<\/p>\n
\u201cI\u2019ve had medicines optimisation teams at an ICB level allocated to my practices or primary care networks, and I\u2019d go as far as to say that they\u2019re hamstrung by the structures that created them,\u201d he told delegates.<\/p>\n
Why are we not using all the skills of the pharmacists in medicines optimisation teams?<\/p>\n
Danny Bartlett, clinical lead at Kent, Surrey and Sussex Primary Care School<\/p>\n
\u201cThey don\u2019t have the ability to do two days a week in practice [and] one day a week of clinical leadership, where they can say, this is what I\u2019m seeing on the ground, this is what my patient population needs.<\/p>\n
\u201cIt\u2019s the equivalent of the community pharmacy having the most qualified independent prescribing pharmacist, and then locking them in a stock room, and getting them to date check. Why are we not using all the skills of the pharmacists in medicines optimisation teams?\u201d<\/p>\n
Having seen how ICBs have restructured, he pointed out that medicines optimisation teams \u201cdidn\u2019t make themselves unavoidable to be reduced, and we\u2019ve seen them shrink loads\u201d.<\/p>\n
How should teams work in the future?<\/p>\n
With the scale of the cutbacks in medicine optimisation teams still to be confirmed as many ICBs continue consulting their workforce, Maule says the challenge for ICBs now \u201cis to preserve that expertise and influence in a different model\u201d.<\/p>\n
\u201cICB medicines optimisation teams will continue to act professionally and do an excellent job, but the nature of that job will change,\u201d he says.\u00a0<\/p>\n
\u201cThe future role will be less about doing everything directly, and more about shaping the conditions in which safe, effective and value-based medicines use happens across the whole system.\u201d<\/p>\n
Both he and Barlett have suggested embedding medicines optimisation pharmacists as clinical leaders.<\/p>\n
\u201cImagine if you freed up one of their days \u2014 and it was funded through the ICB \u2014 and you said\u2026 go out to that practice and run a chronic disease clinic for them, but they [the practice] determine what they\u2019re struggling with,\u201d Bartlett said at the conference.\u00a0<\/p>\n
\u201cThey might have had an asthma nurse retire, they might be struggling with their CVD data, and if you offer a day a week as a clinic, I guarantee you\u2019re taking back messages to your medicines optimisation team in the ICB, with real intuitive things that you\u2019re seeing on the ground.\u201d<\/p>\n
Maule adds: \u201cPharmacy leadership cannot sit only within ICB medicines optimisation teams. ICB chief pharmacists and medicines optimisation teams will continue to be valuable and vocal system leaders, but the next phase will require leadership from all parts of pharmacy: hospital, community, general practice, mental health, primary care networks, academia, industry and national bodies.\u00a0<\/p>\n
\u201cIf more responsibility moves closer to providers and neighbourhood teams, pharmacy leaders in those settings will need to step forward too.\u201d<\/p>\n
It is a period of transition for medicines optimisation teams. As they are reduced or reconfigured in some areas, emerging models point towards more system-wide, collaborative approaches to delivering this work. As the NHS ten-year plan progresses and care is brought into neighbourhoods, perhaps medicines optimisation teams will be brought to the frontline, highlighting their value.<\/p>\n
How these evolving structures operate in practice \u2014 and the extent to which they can maintain focus on quality, safety and value \u2014 will shape the future role of medicines optimisation across the NHS.<\/p>\n
2.<\/p>\n
NHS England sets target to save \u00a31bn on medicines by 2029. Pharmaceutical Journal. Published online 2025. doi:10.1211\/pj.2025.1.353405<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"In March 2025, then health secretary Wes Streeting announced a swathe of NHS reforms. Among these was a\u00a0mandate…\n","protected":false},"author":2,"featured_media":753182,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[58],"tags":[97,243],"class_list":["post-753181","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-health","tag-medication"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/753181","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=753181"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/753181\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/753182"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=753181"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=753181"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=753181"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}