A programme that successfully reduced NHS medicine costs and improved patient safety has been forced to close due to a lack of funding, just as NHS medicine costs appear set to rise sharply.
The National Polypharmacy Programme, established by doctors and pharmacists in April 2022 and operated by the NHS’s Health Innovation Network (HIN), aimed to reduce the number of medicines each patient takes in several ICB areas. Tangible benefits for patient safety were achieved, as well as for the environment and the NHS’s budget, but the government’s plan to abolish NHS England has left the programme without funding.
Patient impact
With an ageing population and rising drug costs, overprescribing among those aged 65 and older is becoming an increasingly pressing issue. In March 2025, it was reported that 718,577 elderly patients were taking ten or more medications—around 9.1% of this demographic. Experts warn that by 2035, the number could reach over 1.1 million, highlighting concerns about healthcare costs, patient safety, and the increased workload for medical providers.
Patients on 10+ medicines are significantly more likely to have an unplanned hospital admission than those on 1-3 medicines. The report noted that this increase in patients on 10+ medicines could mean an additional 77,703 unplanned hospital admissions annually. A slight reduction to 9 medicines would reduce this number to an estimated 46,217.
The report outlined three case studies: antiplatelet and anticoagulant use, where a reduction in the number of this type of drug reduces hospitalisation for bleed-related conditions; anticholinergic drugs (a range of antidepressants, antiemetics, antipsychotics and some drugs for incontinence) whose use is associated with dementia, cognitive impairment and an increased fall risk; and analgesics, where money can be saved by reducing medicine use.
Public and environmental impact
Curbing excess medication use is also essential for reducing carbon emissions from manufacturing, packaging, distribution, and disposal, as well as packaging waste. Plus, reducing water pollution from excreted drug residues.
According to research,a wide range of pharmaceuticals are present in treated drinking water, but overall, the evidence for harm seems low, but more long-term research is needed.
“The limited toxicological and epidemiological evidence should not be interpreted as evidence of absence of harm, but rather as a signal of insufficient long-term investigation.”
– European Environment Agency (EEA, 2024 draft report on Emerging Pollutants):
An earlier UN report from 2020 examined the broader impact of Environmentally Persistent Pharmaceutical Pollutants (EPPPs)
“Their presence in the environment may result in different adverse effects on wildlife and ecosystems; some well-known cases include endangerment of some vulture species, reproductive failures in fish, and the development of antimicrobial resistance. “
Potential savings
Although the savings the programme identified may seem like a drop in the ocean compared to the millions the NHS spends on medicines each year, previous work has found that overprescribing is a significant problem. The programme was set up in the wake of the National Overprescribing Review in 2021. In a foreword to the report, Dr Keith Ridge MBE, the then Chief Pharmaceutical Officer for England, noted that as the NHS prescribes over one billion items per year, tackling overprescribing could yield “a huge prize” of “improving the health of millions of people – comparable to a new ‘blockbuster’ medicine.”
The three-year programme had considerable success. According to its final report, published by HIN in September 2025, the programme has saved an estimated £20k in hospital admissions and related care costs (for example, by avoiding bleed- and fall-related admissions), and £76k in medicines expenditure over 2022–2025. If extrapolated across England, this equates to a potential £280k in healthcare utilisation costs avoided and £880k in drug costs saved – for a total of over £1.1 million in potential savings in three years.
In late September, the programme held a final conference celebrating its achievements, at which the programme’s managers reported that, since the announcement of the abolition of the wider organisation – NHS England – they had been unable to secure ongoing funding.
A spokesperson for HIN has said:
“There was a hope that during this time further funding could be found or an alternative ‘home’ to continue the work of the programme but, while discussions continue, nothing as yet has been secured.”
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