Patient Power: Unleashing choice over routine medications

Despite patient choice on medication being essential to the NHS Constitution, our report Patient Power shows it is rarely happening on the ground.

When the NHS in England considers how to build back from its crisis response to the Covid-19 pandemic, there is an opportunity to reconsider the nature of the ongoing relationship between patient and doctor, and in particular the way in which routine medications are prescribed.

The report, supported by AbbVie, found that many patients are not fully aware of the level of control they are entitled to when it comes to choosing medication. It suggests that pharmacists could play a greater role in the patient care pathway to support patients make choices about their medication, where doctors do not have the time or capacity.

The research has found that 61% of the public support joint decision making between patient and doctor when it comes to choosing medication, but that an even larger majority of the public (74%) believe that the final decision ultimately lies with the doctor. Half of these people (36% of the total population) believe their own preferences are not relevant to that decision at all.

The research also found that a large majority (62%) of the population were satisfied with their personal level of involvement in deciding their most recent medication, however a significant proportion (30%) of the population wanted to be more involved.

The report shows the need for the medical profession to continue to encourage and enable patients to be more involved in the choice of medication, as it would improve financial efficiency, medical efficacy, and is more ethical.

The report’s recommendations to improve the patient care pathway include:

  • Pharmacists should play a significantly increased role in the patient care pathway, including the possible opportunity for pharmacists to recommend prescriptions for GPs to consider or sign off.
  • NHS England and Clinical Commissioning Groups (CCGs) should make sure patients are able to access support from their pharmacist and/or clinical nurse as they consider their options throughout their care pathway.
  • The Department of Health and Social Care (DHSC) and the NHS should ensure patient rights in the NHS Constitution are enforced and implemented through healthcare policy and delivery.

Commenting on the findings, Rose Lasko-Skinner, Researcher at Demos and co-author of Patient Power, said:

“There is a disconnect between policy and patient experience on the ground. While patients have the right to choose their medications, many feel they have been unable to do so, or would rather the doctor decided. 

“It’s vital that patients exercise their right, and are aware of the value their personal expertise can bring to their healthcare – patients who are more involved tend to have better health outcomes. Our new report outlines some important next steps to improve patients’ experiences of choosing healthcare treatments as we start to recover from the pandemic.”

Read the full report here.