Between 2000/01 and 2004/05 NHS drug expenditure in primary care nationally increased by almost 50 per cent, which prompted the NHS to explore opportunities to control drug expenditure without adversely impacting on patient care. In NHS West Midlands a range of proposals were developed for change in primary care trust prescribing activity during 2005/06, and PCT pharmaceutical advisers were subsequently tasked with delivering this change. Although in 2005/06 hospital medicines expenditure represented approximately 20 per cent of the total NHS medicines expenditure, it has been suggested that 16-20 per cent of primary care prescribing is initiated in hospital and a further 40 per cent may also be strongly influenced by hospital prescribing.
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