PrescQIPP

Supplement the service: Extending the Pharmacy Technician role to conduct Oral Nutritional Supplement reviews (2025)

Cwm Taf Morgannwg University Health Board

Project summary

Oral nutritional supplements (ONS) are used extensively within the community. Expenditure on ONS across England, Wales and Scotland was estimated to be 170 million back in 2021(1). Cwm Taf Morgannwg University Health Board (CTM UHB) has a population of 450 000 people, with varying levels of deprivation. ONS is prescribed by the 45 GP practices within the Health Board, and expenditure on ONS was projected to be 2.4million by the end of the 24-25 financial year. Waste is also thought to be significant.
Ongoing reviews are necessary to identify when treatment needs to continue or can stop, but recruitment challenges within the medicines management dietitian team prevent this from happening consistently. Budgets could only accommodate two band 5 dietitians to work under the direction of a senior dietitian, and while excellent dietitians are recruited, they tend to move on quickly for promotions, slowing the momentum of any work streams. The solution – upskill Pharmacy Technicians (PTs) to conduct specific ONS reviews as part of their core role. One of the band 5 dietitian vacancies was changed to a band 5 Pharmacy Technician instead, but rather than the magnitude of reviews being expected to be delivered by 2 staff members alone, each PT in the team conducted half a day of ONS reviews per week, providing the same resource, but shared to give resilience to the system and have a wider reach.
The do this, each PT underwent a competency-based training programme, aligning the framework to the primary Care PT competency framework. Ongoing peer review and supervised learning events have been key governance processes throughout.
12 month cost-avoidance savings estimated via Medoptimise ® software totalled £490,894. The PTs enjoyed the opportunity to extend their role and work closer with patients.

  1. PrescQIPP (2021). Guidelines for the appropriate prescribing of oral nutritional supplements (ONS) for adults in primary care. Available at: index (index (prescqipp.info)) (Accessed 1 January 2024)