The Hidden Burden of Medicines Management in General Practice

General practice is under immense pressure. Nearly half of all GPs (44%) report that workload is their biggest struggle, compared with 29% of all doctors, and they are twice as likely to cite workload pressure as a barrier to providing care. Yet one area of that workload remains consistently overlooked: medicines management.

While prescribing is a core function of primary care, the volume and complexity of medication-related tasks have expanded significantly over recent years. What was once largely confined to issuing prescriptions has grown into a multifaceted responsibility covering safety monitoring, medication reviews, hospital discharge reconciliation, shared care prescribing, medicines optimisation, and responding to an ever-increasing volume of medication queries.

NovaHS supports GP practices across 32 Integrated Care Boards in England through NovaMed, its pharmacy technician support and medicines optimisation service. Having worked alongside clinical and administrative teams in general practice, we understand the scale of this workload and what is required to manage it safely.

What medicines optimisation in GP practice actually involves

Modern medicines management in general practice extends far beyond writing prescriptions. Every day, practices are required to process discharge summaries, action outpatient medication changes, review blood test monitoring, manage repeat prescription requests, respond to community pharmacy queries and ensure compliance with national guidance.

The NHS primary care system dispenses over one billion prescription items every year. Behind each of those items is a clinical decision, a monitoring requirement, or an administrative action that falls to someone in the practice to complete.

The ageing population has compounded this challenge significantly. In March 2025, more than 718,000 people aged 65 and over in England were taking ten or more medicines, a figure projected to exceed 1.1 million by 2035 without effective intervention. Each additional medicine increases the need for monitoring, review and ongoing clinical oversight.

NHS England’s national medicines optimisation opportunities for 2024/25 identified problematic polypharmacy as a key priority. For GP practices already stretched on capacity, meeting that priority requires dedicated resource.

The administrative burden on practice teams

Much of medicines management work is clinically important but administratively intensive.

A single hospital discharge can generate multiple actions: medication reconciliation, updating repeat prescriptions, reviewing interactions and contraindications, arranging monitoring tests, communicating changes to patients and liaising with community pharmacies. Multiply that across a list of several thousand patients and the cumulative demand becomes significant.

Similarly, routine prescribing generates a constant flow of requests that require clinical judgement. Repeat prescriptions are rarely as simple as clicking approve. Clinicians must consider monitoring requirements, recent clinical changes, potential safety concerns and whether treatment remains appropriate before each decision is made.

Pharmacy technician support for GP practices

The integration of clinical pharmacists and pharmacy technicians into general practice has been one of the most significant developments in primary care over the last decade.

According to NHS Digital data, as of December 2024 there were 7,329 pharmacists and 2,531 pharmacy technicians working in primary care and general practice. These professionals bring specialist expertise in medicines optimisation and support practices by conducting structured medication reviews, managing repeat prescribing systems, reconciling medicines following hospital discharge and reducing inappropriate prescribing.

The evidence base for their impact is well established. A longitudinal cohort study published in the British Journal of General Practice in February 2025 found that practices employing clinical pharmacists recorded statistically significant reductions in total medicine costs per 1,000 patients, opioid prescriptions per 1,000 patients and average daily anxiolytic use.

Funding reviewed, 7 October 2026: clinical pharmacist and pharmacy technician roles are recognised under the Additional Roles Reimbursement Scheme (ARRS), subject to the role and delivery requirements. The 2026/27 NHS England specification lists national annual equivalent ceilings of £71,725 per clinical pharmacist and £46,447 per pharmacy technician, including eligible employer on-costs. London ceilings differ. Claims depend on actual eligible costs and the available PCN budget, not automatically the full service invoice. If the available ARRS budget does not cover the agreed NovaMed cost, it can be supplemented with other funding.

Patient safety at the centre

Despite the workload pressures, medicines management remains one of the most critical patient safety functions in primary care.

More than 237 million medication errors occur every year in England, the avoidable consequences of which cost the NHS upwards of £98 million and more than 1,700 lives annually. Around a third of all potentially harmful medication errors are made during prescribing in primary care.

Robust medicines management processes help identify risks before they result in adverse outcomes. Whether preventing duplicate therapy, recognising inappropriate prescribing or ensuring timely monitoring of high-risk medicines, these activities play a vital role in protecting patients.

The challenge for practices is balancing safety with capacity. When teams are overwhelmed, clinical time risks being consumed by administrative processes rather than direct patient care. That is the problem NovaMed is designed to address.

How NovaMed supports medicines management in general practice

NovaMed provides pharmacy technician support and medicines optimisation services to GP practices, Primary Care Networks and Integrated Care Boards across England. Our team works as an extension of your practice, handling the medicines management workload that pulls clinical staff away from patient-facing care.

NovaHS is CQC regulated and clinician-led. Every process is underpinned by clinical oversight and a triage protocol built around patient safety. We have supported practices across 32+ ICB areas in England and processed over 10 million documents since NovaHS began. Across our services, estimated clinical time savings exceed 100,000 hours per year, calculated from average time saved for the work delivered.

If your practice is managing an unsustainable medicines management workload, we can help. Book a free consultation with our team.

Frequently asked questions

What does a pharmacy technician do in a GP practice?

A pharmacy technician in general practice supports the operational elements of medicines management. This includes reconciling medicines following hospital discharge, managing repeat prescribing systems, processing medication requests and supporting compliance with monitoring requirements. They work under the oversight of a clinical pharmacist or GP, freeing clinical staff to focus on direct patient care.

What is medicines optimisation in primary care?

Medicines optimisation is the clinical process of ensuring patients receive the right medicines, at the right dose, for the right duration. In general practice it involves structured medication reviews, management of polypharmacy, identification of inappropriate prescribing and systematic monitoring of high-risk medicines. NHS England has identified problematic polypharmacy as a national medicines optimisation priority for 2024/25.

How can GP practices reduce their medicines management workload?

Practices can reduce medicines management workload with clinical pharmacist and pharmacy technician support through their PCN, or an agreed managed service such as NovaMed. Eligible support can be paid for through ARRS, subject to the scheme requirements and available PCN budget. If that budget does not cover the agreed cost, it can be supplemented with other funding. Eligibility and the funding arrangement must be confirmed with the PCN and commissioner before commissioning. NovaHS can offer a net saving compared with delivering the same work in-house. Savings depend on your workload, current staffing costs and agreed service scope.

What is the difference between a clinical pharmacist and a pharmacy technician in general practice?

Clinical pharmacists are responsible for clinical decision-making in medicines management, including structured medication reviews, complex prescribing decisions and deprescribing. Pharmacy technicians manage the operational and administrative elements: reconciling discharge medicines, processing repeat prescriptions and managing medication queries. Both roles are recognised under ARRS, subject to the scheme requirements, and are available through NovaMed.

What is shared care prescribing and why does it increase GP workload?

Shared care prescribing occurs when a specialist initiates a medication and then transfers ongoing prescribing responsibility to the GP practice. This frequently happens without equivalent resource allocation, creating additional monitoring, prescribing and safety obligations for the practice. Managing shared care agreements is one of the most time-intensive elements of medicines management in general practice.

Can ARRS funding cover pharmacy technician support?

Eligible pharmacy technician support can be funded through ARRS via a PCN. Eligible support can be paid for through ARRS, subject to the scheme requirements and available PCN budget. If that budget does not cover the agreed cost, it can be supplemented with other funding. Eligibility and the funding arrangement must be confirmed with the PCN and commissioner before commissioning. Separately, NovaHS can offer a net saving compared with delivering the same work in-house. Savings depend on your workload, current staffing costs and agreed service scope. This does not mean the service is free.