Programme 02
Polypharmacy & Frailty — less burden, more safety.
Structured medication reviews for elderly and frail patients — designed to deprescribe safely, reduce falls risk, and improve quality of life.
Cohort
Who's in scope.
- Patients aged 65+ on 8 or more regular medications
- eFI moderate/severe frailty cohorts
- Care home residents
- Patients with recent falls or admissions
Interventions
What we do.
- Structured deprescribing reviews using STOPP/START
- Anticholinergic burden assessment
- Falls medicines review
- Care planning and patient/carer engagement
Typical first-year outcomes
Measured monthly in the BCS Impact Dashboard.
−2.4
Medicines stopped per patient on average
↓
Anticholinergic burden score
↓
Falls-risk medicines exposure
100%
Reviews with GP sign-off
How the review runs
A consistent, safe process — every time.
- Pre-review prep: notes, bloods, latest discharge summaries
- Structured 7-step review (NHS England framework)
- Shared decision-making with patient or carer
- GP sign-off on every change
- Follow-up review scheduled and tracked
DES 26/27 alignment
Tied to the Network Contract DES.
This programme directly delivers against the structured medication review (SMR) requirements of the Network Contract DES, with a defined cohort approach that satisfies QOF medication review indicators and ICB polypharmacy priorities.
Related BCS work.
Structured Medication Reviews
The clinical SMR service that underpins this programme.
Read about structured medication reviews
High-Risk Medicines Programme
Sibling programme for DOACs, methotrexate, lithium and opioids.
Read about high-risk medicines programme
Long-Term Conditions
Pharmacist-led LTC reviews integrated with deprescribing.
Read about long-term conditions
Talk to our Service Development team
30-minute discovery call. We'll show you how BCS maps to your PCN's specific priorities.