Medication needs to move back to positivity, and the challenge of achieving this represents huge opportunities for the pharmaceutical industry, a recent meeting of the PharmaTimes Directors Club (PDC) has heard.

The new clinical commissioning groups (CCGs) are looking anew at patient care pathways, and this offers huge potential benefits for the industry in terms of helping tackle challenges relating to medicines optimisation, responsible prescribing and access issues for patients, according to Dr Caron Morton, chair of Shropshire CCG.

"We have an enormous number of patients who require care pathways because they need someone to give them their medicines," she told the PDC. A major contributor here is the way the drugs are packaged and delivered - yet the importance of these factors has been constantly underestimated, as has the need for patient choice and the support mechanisms which help them make the right choices. The "bereavement factor" that has occurred for patients when, for example, telephone support services are removed should not be underestimated, she stressed.

Yet, she told the pharmaceutical industry audience, "we never have you at the table for our discussions."

There is a "huge amount" to be done here, she said. "We need to be commissioning pathways that are beyond organisational boundaries, subcontracting and working in parallel with other organisations." In the past, the development of pathways did not look at crossing these organisational boundaries - "and that's where they fell down and patient harm occurred," she said.

Also, patients and public did not feel that they had a role in co-designing pathways - yet this is all about the patient's spell of care, she noted.

Dr Morton also looked at how manufacturers can help to eradicate medication-related harm. She pointed out that very few of these problems are to do with medicines interactions - it's more about medications being mixed up, given at the wrong time, etc. Very often, we cannot discuss these issues with pharma, she said. The issue now is how to address quality and safety matters with clinicians.

As demands on the NHS continue to grow, driven by the ever-increasing expectations of patients and the public, government ministers have called for the culture within the Service to change, and for this to force the development of stronger relations with academia and industry. Dr Morton was optimistic that these changes will occur. There are now 20-30 CCGs which are interested in doing pilot work with pharmaceutical companies  - conflict-of-interest concerns have been addressed, she said.  

She also advised pharmaceutical companies that their points of contact within CCGs should be at governing body level. CCGs are membership organisations - they are not just about general practitioners (GPs), and they are very different from Primary Care Trusts (PCTs). Also, with increasing transparency, their relationships with patients are improving fast, she told the PDC.