Posted on May 26, 2026
Led by Health Innovation West of England, the National Polypharmacy Programme: Getting the balance right was a multi-year national initiative designed to address the growing clinical risks associated with problematic polypharmacy. Running from April 2022 to September 2025, the programme engaged all 42 Integrated Care Boards (ICBs) across England and focused on helping healthcare professionals and patients have better conversations about medicines.
As people live longer with multiple long-term conditions, they are increasingly prescribed multiple medicines. While often clinically necessary, polypharmacy can become problematic when medicines are no longer appropriate or combinations of medicines cause harm. In March 2025, more than 718,000 people aged 65 and over in England were taking 10 or more medicines, with this number projected to rise to 1.1 million by 2035.
The programme was built around three core pillars:
- Population health management
- Specialist education and training
- Public behaviour change
It focused primarily on older people living with multiple long-term conditions, while also supporting seldom-heard communities, people with learning disabilities and patients in prison.
The challenge
Problematic polypharmacy can lead to poorer patient outcomes, avoidable harm and preventable hospital admissions, while also increasing pressure on healthcare services and costs to the NHS.
Without intervention, projections suggest problematic polypharmacy could contribute to an additional 77,700 unplanned hospital admissions annually by 2035. Despite the scale of the challenge, there was limited nationally available support to help patients prepare for structured medication reviews (SMRs) or to support clinicians in confidently deprescribing unnecessary medicines.
There was also a need to improve access to medication reviews for underserved and marginalised communities, ensuring patients could participate meaningfully in shared decision-making conversations about their care.
Our approach
The programme adopted a nationally coordinated but locally adaptable model, enabling local health innovation networks to tailor delivery to the needs of their systems while maintaining a consistent evidence-based approach.
Population health management
The programme delivered webinars and practical support to help healthcare professionals use NHSBSA Polypharmacy Prescribing Comparators data to identify and prioritise patients for structured medication reviews. Local teams also developed bespoke dashboards and “case for change” packs for system leaders.
Education and training
A comprehensive education offer was delivered through evidence-based Polypharmacy Action Learning Sets (ALS), masterclasses and a train-the-trainer model. Forty local educators were accredited to deliver bespoke training within their regions, helping clinicians build confidence in safely stopping unnecessary medicines and improving shared decision-making with patients.
The ALS model, originally developed by Health Innovation Wessex based on previous work by The Health Foundation, had previously been piloted in Southampton and Bournemouth before being scaled nationally through the programme.
Public behaviour change
Working in partnership with patients, academics and voluntary, community and social enterprise (VCSE) organisations including Age UK, the programme co-developed evidence-based resources to help patients understand structured medication reviews and prepare for conversations about their medicines.
To improve accessibility, materials were translated into 12 community languages and produced in Easy Read and audio formats. Resources were also co-designed and tested with specific groups, including Mencap Liverpool and Sefton.
Patient and public involvement was central throughout the programme. Eleven health innovation networks ran patient focus groups to refine early-stage materials before national rollout, while 27 primary care networks received targeted funding to deliver quality improvement projects engaging seldom-heard communities.
The programme also established 124 communities of practice to support collaboration and shared learning across primary and secondary care.
“I feel this is our best review because my mum had a chance to read the information about why we need to review the medicines in Bengali.”
Patient feedback
Impacts to date
The programme delivered significant patient, workforce, system and economic benefits across England.
Patient impact
The programme created the first nationally available patient resources designed specifically to help people prepare for structured medication reviews. These resources were downloaded more than 9,600 times.
Patient surveys showed:
- 86% felt able to have meaningful conversations about their medicines after reading the materials
- 64% felt more confident talking to their clinician
- 71% said the resources helped them prepare for their appointment
Clinicians reported that patients arrived at appointments better informed, more engaged and more empowered to ask questions about their medicines. Case studies also highlighted patients identifying medicine-related symptoms and moving to simpler, more manageable treatment plans following deprescribing.
Workforce and system impact
The programme trained 12,891 healthcare professionals nationally, with 613 health and care professionals attending polypharmacy training events in the West of England alone.
Among participants in the Polypharmacy Action Learning Sets:
- 99% said they would recommend the course
- 83% reported making changes to their practice
These changes included increased shared decision-making, improved patient communication and greater confidence in deprescribing.
Twenty-one ICBs demonstrated evidence of declining or stabilising prescribing trends in therapeutic focus areas, while weekly usage of the national polypharmacy data dashboard increased by 90% between 2021 and 2025, demonstrating growing adoption of data-driven patient prioritisation.
“This will change my practice more than any learning event I have ever done. The course has given me more confidence to stand my ground… to individualise treatment.”
GP, South London
“Attending the polypharmacy ALS has reignited my passion for doing good medicine in older people… Reassuring to know that many of the reasons I struggle [are shared].”
Pharmacist, Cohort 12
Economic and environmental impact
A health economic analysis led by Unity Insights, based on five ICB case studies, estimated that the programme:
- Prevented approximately £20,000 in hospital admission costs
- Saved approximately £76,000 in medicines expenditure between 2022 and 2025
When extrapolated nationally, the programme could deliver an estimated £1.1 million total saving over three years, including:
- £280,000 in avoided healthcare utilisation costs
- £880,000 in reduced medicines costs
Regional examples included:
- Surrey Heartlands ICB saving an estimated £10,200 on antiplatelet and anticoagulant prescribing
- Derby and Derbyshire ICB saving an estimated £10,200 through reducing anticholinergic burden
The programme also reduced environmental impact. Across five case study areas, reducing unnecessary prescriptions avoided an estimated 33,002 kgCO2e — equivalent to a social value of more than £8,500.
“The Health Innovation Network has successfully developed structured approaches for healthcare professionals that provide a valuable resource to help ensure that medicines are being used effectively and safely.”
Professor Tony Avery – GP, Professor of Primary Health Care and an NIHR Senior Investigator.
Next steps
Although the National Polypharmacy Programme formally concluded in September 2025, the work will continue from April 2026 through a remodelled cluster programme led by Health Innovation West of England in partnership with Health Innovation Wessex and Health Innovation East Midlands.
Building on the success of the original three-pillar model, the next phase will place a stronger focus on frailty and repeat prescribing. Through support for neighbourhood teams, the programme aims to help ICBs deliver their five-year prevention plans and address the growing challenges associated with ageing and frailty.
Start and end date
April 2022 to September 2025
Find out more
Amy Semple, Programme Manager, Health Innovation Network Polypharmacy Programme, a.semple@nhs.net
