Overview
In March 2026, the fourth instalment of Medicines Optimisation Centricity, the ongoing collaboration between Aspire Pharma and HSJ Information, commenced. The programme brings together key NHS and pharmacy stakeholders to explore some of the most pressing questions in medicines optimisation.
Executive Summary: Understanding the Deprescribing Landscape
Polypharmacy is one of the key challenges of an ageing population, and, evidence suggests, is associated with adverse drug reactions leading to higher hospital admissions, and a projected annual cost to the NHS of £2.21 billion. The clinical case for deprescribing, defined as the systematic process of identifying and stopping medicines where harm outweighs the benefits, is well established but not widely and effectively implemented.
This white paper, developed by HSJ Advisory in partnership with Aspire Pharma, explores the current deprescribing landscape within the NHS, seeking to understand cultural, behavioural and operational factors influencing progress. The paper provides an evidence-based picture of the challenges and key enablers for change, and the factors that could help deprescribing be translated into practice as a safety-focused, patient-centred intervention.
Key Findings
The paper found that while deprescribing is recognised as important, delivery varies significantly between systems, organisations and care settings.
Barriers to progress include insufficient training, lack of time and capacity, unclear responsibility and ownership across primary and secondary care, and concerns about medico-legal risk.
Confidence in deprescribing amongst clinicians remains a key issue, with over half of respondents stating that they do not feel comfortable stopping a medicine initiated by another specialty.
Patient engagement shows promise, however, with 82% of respondents agreeing or strongly agreeing that patients and carers understand and are willing to accept deprescribing when it is explained clearly as a safety-focused, patient-centred intervention.
Strategic Recommendations for System Leaders
The paper encourages system leaders to consider:
- Formalising deprescribing as a governed workstream within medicines optimisation, frailty and patient safety strategies, with named leadership, agreed pathways and routine outcome reporting.
- Protecting time for structured medication reviews.
- Scaling pharmacist-led multidisciplinary models across primary, secondary, mental health, frailty and care-home settings, supported by clear prescribing authority.
- Embedding practical tools into routine workflows, including structured review templates, anticholinergic burden scoring and electronic prompts.
- Investing in training on shared decision-making and risk communication to build clinician confidence.
- Aligning incentives, data dashboards and performance measures with medicines safety outcomes.
Call to Action
In existing healthcare systems, where deprescribing is embedded into practice, respondents reported benefits including reduced falls, safer prescribing and more sustainable services.
NHS leaders are encouraged to strengthen their approach to deprescribing through developed governance, workforce capacity, training and pathways to deliver the intervention consistently and safely.
Read the full report here: https://meds-ops-centricity.co.uk/general-public/understanding-the-deprescribing-landscape/
MAT-UK-COR-0136-1 | October 2026
