Disposal of waste medicines is an essential service within the community pharmacy contractual framework, to be provided by all community pharmacies in England. NHS England is responsible for commissioning National Health Service pharmaceutical services.

Patients are normally advised to return unused medicines to their local community pharmacy for safe disposal. This is the case also for patients and families of deceased patients who no longer require prescribed medicines.

Appliances are normally collected by community nurses. Occasionally there is a local amnesty with appeals to patients to return equipment, for example crutches and wheelchairs to accident and emergency departments.

Pharmacies are an important source of care, providing services such as flu jabs, health checks and of course dispensing vital medicines. We are transforming how pharmacists and their teams operate in the community - making the most of their skills to meet urgent medicine needs, treat minor ailments and ensure patients receive the best care. Healthy Living Pharmacies across the country with qualified health champions are demonstrating innovative models of delivery, reaching out to their local communities and making a real difference to people’s health.

To make even greater use of this important asset, the Murray Review of community pharmacy clinical services recommended that NHS England and its national partners should consider how best to support Sustainability and Transformation Plans in integrating community pharmacy into those plans. Public Health England published a menu of preventative interventions for the Sustainability and Transformation Plans in November 2016, which outlined evidence-based public health and preventative interventions that can help to improve the health of the population and reduce health and care services demand in the short to medium term. That menu specifically identified that pharmacy can make a contribution to:

- Cardiovascular disease secondary prevention;

- Improving the management of patients with blood pressure;

- Delivering effective brief advice on physical activity as part of everyday clinical care;

- Raising public awareness about reducing the risk of dementia;

- Providing support to stop smoking; and

- Reducing alcohol consumption and harm through brief advice.

The General Practice Development programme covers a number of initiatives set out in the General Practice Forward View, including: £6 million for practice manager development, which runs over three years; £45 million for reception and clerical training, which runs over five years; £30 million for a national development programme, which runs over three years; and £45 million for online consultations, which will run over three years from 2017/18.

NHS England is working to spend up to allocation and final outturn figures will be published later in year in the NHS England accounts for 2016/17 with more detail provided in the Investment in General Practice Report for 2016/17 published by NHS Digital.

The General Practice Forward View, published in April 2016, announced that investment in General Practice will increase from £9.6 billion in 2015/16 to over £12 billion by 2020/21, a major financial investment to transform primary care.

Work is underway to increase the primary care workforce and reduce workload, to improve primary care estates and infrastructure, and to redesign care and spread innovation throughout the country.

It is also becoming increasingly normal for general practices to work together at scale in networks or federation of practices, bringing greater opportunities for practices to work collaboratively to strengthen services and their sustainability.

NHS England is meeting with Capita on a weekly basis to oversee the delivery of its plans for the Dental Performers Lists and other key services and to ensure the right improvements are in place to address the backlogs and delays.

My hon. Friend, the Parliamentary Under Secretary of State for Public Health and Innovation (Nicola Blackwood), continues to work directly with Capita and NHS England to ensure that services are restored to an acceptable and sustainable standard.

The General Practice Forward View (GPFV), published in April 2016, includes a commitment to deliver a major international recruitment drive to attract at least 500 appropriately trained and qualified general practitioners from overseas by 2020.

Following publication of the GPFV, NHS England’s general practice workforce team has been engaging with regional and local National Health Service teams, Health Education England, and other stakeholders, including the Royal College of General Practitioners and the British Medical Association, to agree an approach for delivering the commitment. These different stakeholders have agreed that the programme will be locally led and delivered with national oversight, co-ordination and support by the national general practice workforce team.

Each overseas recruitment project will be expected to satisfy a set of national principles; the national principles are set out at the following link:

https://www.england.nhs.uk/gp/gpfv/workforce/international-gp-recruitment/national-principles/

The contracts and support packages for international doctors recruited into general practices will vary across the country, to be tailored to the opportunities and needs of the local health system. A budget of up to £20 million has been identified to support schemes up to 2020.

The General Practice Forward View (GPFV), published in April 2016, sets out that the Government is investing an extra £2.4 billion a year nationally for general practice services by 2020/21, with the set aim to have an extra 5,000 doctors working in general practice in England by 2020.

NHS England’s South West Development Fund is being used to implement the GPFV locally, with a team of change managers – including one in Plymouth – in place to support practices and make them more sustainable and attractive to new doctors. In addition, Health Education England’s south west team has been active in promoting general practice as a career both by working with national incentives and addressing local opportunities.

We remain fully committed to making this change. We have consulted on our proposals to put in place a defence to the criminal sanction for inadvertent dispensing errors and received good support from patients, carers, healthcare professionals, pharmacy organisations and other bodies. We are working through the necessary processes to change the law. We are in the final stages of clearance and hope to lay the Order shortly.

We have consulted on our proposals to put in place a defence to the criminal sanction for inadvertent dispensing errors and received good support from patients, carers, healthcare professionals, pharmacy organisations and other bodies. We are working through the necessary processes to change the law. We are in the final stages of clearance and hope to lay the Order shortly.

This information is not held centrally.

The autism strategy Think Autism published in 2014 and statutory guidance published in 2015 for local authorities and National Health Service organisations encourages the effective development of local autism strategies for meeting the needs of adults with autism in their local population, as identified in their local needs assessments. Local authorities and clinical commissioning groups should work together to commission services for children with special educational needs, including autism. This should include publishing a ‘Local Offer’ of services.

Information is not held centrally on the annual cost or amount of dispensed but unused prescription drugs in the National Health Service.

The Department commissioned the York Health Economics Consortium and the School of Pharmacy at the University of London to carry out research to determine the scale, causes and costs of waste medicines in England. The report, Evaluation of the Scale, Causes and Costs of Waste Medicines, was published on 23 November 2010. This found that the gross cost of unused prescription medicines in primary and community care in the NHS in England in 2009 was £300 million a year and that up to £150 million of this was avoidable. The report is available at:

https://core.ac.uk/download/pdf/111804.pdf?repositoryId=90

NHS England is working with the Department and the NHS Business Services Authority to consider how value can best be obtained from the use of medicines, both in terms of patient outcomes and financial implications. This work, along with the medicines optimisation programme, will help ensure best value for both taxpayers and patients.