Medicines optimisation must sit at the heart of the new integrated care board agenda
Medicines optimisation must sit at the heart of the new integrated care board agenda
Medicines optimisation is no longer a specialist function operating at the edge of NHS decision-making, it must be at the centre of integrated care board (ICB) strategy, commissioning and clinical leadership going forward. This was the central message from the Clinical Pharmacy Congress (CPC) 2026 keynote session, Value of medicines optimisation within the new ICB structures and systems, which brought together senior pharmacy leaders from across England to explore how medicines teams can shape the next phase of system working.
The panel featured chief pharmacists and chief pharmacy officers from across the UK, including Alex Molyneux, Minesh Parbat, Neveen Sorial, Laura Angus and Yousaf Ahmad. The group reflected on the evolving role of medicines optimisation leaders as ICBs respond to financial pressure, rising prescribing demand and the need for safer, more consistent care across pathways.
A key theme that emerged from the conversation was that medicines optimisation touches almost every part of an ICB’s work. The panel argued that this means medicines expertise must be visible earlier in strategic discussions, rather than being brought in only once commissioning decisions have already been made.
The discussion also highlighted the need to move beyond narrow definitions of cost control. With prescribing budgets under increasing pressure, the speakers stressed that value must be understood in clinical, operational and population health terms. Medicines optimisation can reduce harm, support earlier intervention and prevent avoidable demand elsewhere in the NHS. There is opportunity for pharmacy leaders to demonstrate this broader value clearly to boards and executives.
Commissioning and contracting were identified as important levers for change. The panel explored how ICBs can use these mechanisms to align incentives, reduce unwarranted variation and ensure that medicines priorities are reflected in service design. Rather than treating medicines optimisation as a separate workstream, the panel suggested that systems should embed it into pathway redesign.
Another notable insight was the changing nature of pharmacy leadership. In the new ICB environment, medicines optimisation leaders need to operate as system influencers, not only technical experts. This requires confidence in board-level conversations, the ability to translate medicines data into strategic priorities and strong relationships across departments, including medical, finance and commissioning colleagues.
The panel also reflected on the role of medical expertise in this new landscape. Effective medicines optimisation depends on multidisciplinary leadership, with pharmacy professionals, doctors and other clinicians working together to balance quality, safety, access and affordability. The speakers pointed to the importance of shared ownership, particularly where prescribing decisions cross organisational boundaries and care settings.
The speakers noted that medicines teams have access to powerful intelligence and data on variation, risk and outcomes, but this information must be presented in ways that support action. Good medicines data should help systems identify gaps or pitfalls where patients are not receiving optimal therapy and consequently where safety risks are emerging, as well as where investment could deliver measurable benefits.
The clear takeaway for delegates was that medicines optimisation must be framed as a strategic enabler, spurred forward by pharmacy leaders acting as active drivers in ICB decision-making. The value of medicines must be described in terms that resonate beyond pharmacy to contextualise and establish the importance of collaboration across organisational boundaries.
The keynote closed with a reinforcement of the opportunity available. While the restructuring of NHS systems brings uncertainty, it also gives pharmacy leaders a chance to redefine their contribution. By combining clinical expertise, data-driven insight and system leadership, medicines optimisation can play a central role in improving outcomes and ensuring patient safety.
Want to hear more? The full session recording is available in the CPC app via the programme page.
