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National Clinical Director for Prescribing Appointment

GP appointed as NHS’s first National Clinical Director for Prescribing

NHS England and NHS Improvement (NHSE&I) has appointed its first National Clinical Director for Prescribing.

Professor Tony Avery OBE, a GP in Nottingham, will lead the ambitions first set out in the National Overprescribing Review report, working with patients, clinicians and teams across healthcare to ensure the culture and systems governing the prescribing of medicines reflect the needs of England’s diverse populations, improve health outcomes, protect the envirnoment and contribute to a sustainable NHS recovery.

The review found listening to patients, better use of technology, reviewing prescriptions more effectively, better handovers between secondary and primary care and offering alternatives can reduce overprescribing, with a reduction in unnecessary or unwanted medicines prescribing helping to improve patient outcomes and reduce hospital admissions, waste and carbon emissions.

It also called for more research to be done to investigate the reasons why the global issue of overprescribing is more likely to affect people from ethnic minority communities and people with disabilities. 

Professor Tony Avery OBE, National Clinical Director for Prescribing, said:

“I’m delighted to be taking on the newly-created role at such an important time for the NHS. Medicines have a vital role in treating illness and helping people to live with long-term conditions, but they are not always the best solution.

“This report is not about taking treatment or services away from people where they are effective: I want to work with NHS colleagues and members of the public to help ensure that we get the balance right as we work towards a sustainable recovery from the pandemic.

Through really understanding how we can reduce unnecessary medicines prescribing, there’s a huge prize to be gained in improving the health and daily lives of millions of people, and protecting our environment.

Prof Steve Powis, National Medical Director, said:

“Overprescribing is a complex issue, involving systems and culture as well as individuals, and tackling it needs a system-wide response, with clinicians and patients both receiving more support to ensure the NHS is getting prescribing and shared decision-making right. “During the review, we heard from hundreds of patients, clinicians and experts who helped us to identify a range of ways in which we can improve prescribing and benefit patients and local communities. “As we look to recover from the pandemic and do things differently, we will continue to work in partnership with all those involved to implement the recommendations and deliver on the improvements so we reduce overprescribing once and for all.”

David Webb, Chief Pharmaceutical Officer for England, said: Generally, one in five hospital admissions in the over 65 age group and around 6.5% of hospital admissions are caused by the adverse effects of medicines. The more medicines a person takes, the higher chance there is of an unwanted or harmful effect. Some medicines can increase the risk of falls amongst the frail and elderly, whilst others can create a risk of dependency or can be difficult to stop taking. With 15% of people taking five or more medicines a day, more needs to be done to listen to patients and help clinical teams to tackle overprescribing, and I look forward to working with Tony and colleagues to deliver on these recommendations.” 


Professor Avery OBE is a GP in Nottingham and Professor of Primary Health Care at the University of Nottingham. He is also a National Institute for Health Research (NIHR) Senior Investigator and member of the NIHR Greater Manchester Patient Safety Translational Research Centre. He was awarded an OBE in the 2022 New Year’s Honours list.

He is passionate about ensuring the safe, effective and appropriate use of medicines and has worked in partnership with the pharmacy professions, other healthcare professionals and patients over 30 years to drive forward research and policy development in prescribing and patient safety.

He has led a number of major studies investigating the frequency, nature and causes of prescribing safety problems in the NHS. He has also developed effective methods for tackling hazardous prescribing, most notably the pharmacist-led, IT-based intervention called PINCER, which has now been rolled out nationally to general practices in England.

Tony’s work recognises the vital role that medicines have in treating illness and helping people live with long-term conditions, while acknowledging that prescribing of a medicine is not always the best solution. He is committed to ensuring health care professionals and patients have the information and support they need for shared decision making about whether a prescription is needed and, if so, how to balance the effectiveness and safety of medicines alongside the costs to the patient, the NHS and the environment.


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