TY - JOUR T1 - Structured medication reviews: origins, implementation, evidence, and prospects JF - British Journal of General Practice JO - Br J Gen Pract SP - 340 LP - 341 DO - 10.3399/bjgp21X716465 VL - 71 IS - 709 AU - Duncan Stewart AU - Mary Madden AU - Paul Davies AU - Cate Whittlesea AU - Jim McCambridge Y1 - 2021/08/01 UR - http://bjgp.org/content/71/709/340.abstract N2 - Pharmacists have been employed in UK general practice for many years. Their numbers are now expanding and their roles developing. Clinical pharmacists are expected to alleviate workload pressures on GPs. Notwithstanding the COVID-19 vaccination programme, a new Structured Medication Review (SMR) service has been introduced in Primary Care Networks (PCNs). The long term drivers are clear: addressing problematic polypharmacy in the NHS, reducing avoidable hospitalisations, and delivering better value from medicines spending.1 SMRs are intended to improve the quality of prescribing, delivering improvements to patient care and outcomes.The roll-out of PCNs and the development of the SMR specification were both done at speed. Collaboration between GP practices to form PCNs under the Network Contract Directed Enhanced Service (DES) requires time and goodwill to build the relationships needed to manage clinical, organisational, and business interests collectively.2 Short timescales between policy statements, guidance, and expected implementation have jeopardised effective planning, adding to pressures on clinicians and services during the COVID-19 pandemic.SMRs were one of the first five DES specifications proposed, originally to be delivered to a range of patient priority groups from April 2020. In response to initial consultation, additional new PCN roles were added, including pharmacy technicians. The proposed SMR service was also simplified by reducing the number of target populations and allowing the volume of SMRs to be determined locally.3 COVID-19 planning then took centre stage and has interrupted implementation profoundly. Guidance issued in March 2020 stressed prioritising responses to the pandemic, thus delaying introduction of the SMR. Vaccination was identified … ER -