Structured medication reviews for GP practices and PCNs
Structured medication reviews for GP practices and PCNs
What is a structured
medication review?
A structured review of a patient’s medication, run against national standards and CQC expectations.
Our medication reviews are delivered by experienced pharmacists working to defined SOPs, NHS England guidance, and CQC standards. Each review is shaped to the practice’s local priorities and the patient’s needs, from polypharmacy management to specific long-term conditions. The work supports QOF, IIF, and PCN DES requirements.
How Will This Help My Practice?
Virtual Pharmacist’s clinical medication review service is an adaptable, clinically governed service that documents medicines decisions, agreed actions and follow-up.
For residents in care homes, see our care home medication reviews.
Flexible service shaped to your practice
Supporting both local priority and patient needs to tackle specific issues.
Clinically governed reviews
Help practices meet their QOF and PCN DES requirements.
Supports GP resources
Improving patient safety, reducing medication waste, and releasing GP time.
Backed by documented SOPs
Ensuring consistency, measurable outcomes, and full auditability.
Evidence-based service
Establishes safe, effective, and patient-centred medication decisions.
Optimise practice efficiency
Adding clinical capacity that scales with your list.
“The team is consistently reliable. Phones are always answered and emails come back the same day. It’s made a real difference to how we run our medication reviews.”
“Fast email replies and clinical input whenever we need it. They picked up our medicines work seamlessly and delivered from day one.”
“Excellent service from start to finish. Easy to reach, quick to reply, and they clearly know NHS workflows inside out. We couldn’t recommend the team more highly.”
How Does Virtual Pharmacist Work?
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Frequently Asked Questions
How is a clinical medication review different from a standard practice review?
Our medication reviews are structured, evidence-based, and auditable discussions, with a consistent approach that aligns with NHS England guidance and CQC expectations. A patient-centred structured medication review includes a discussion with the patient about their medicines. The depth and format of other medication reviews depend on their purpose and the patient’s needs.
Why is a medication review important?
Frequent clinical medication reviews matter for both patients and practices.
For patients, they check that prescribed medication is still effective and suitable against the individual’s medical history, important for making sure care stays right for them.
For practices, structured reviews can support safer medicines use, reduce avoidable waste and contribute to relevant quality requirements. Activity must meet the applicable indicator and coding rules; a review does not automatically achieve a QOF or IIF target.
How are patients contacted for their medication review?
How often should a medication review take place?
What happens if a review is outstanding?
Our thorough workflow system allows pharmacists to see any overdue patient medication reviews within your practice, including for long-term conditions and basic blood recalls. In these cases, the pharmacist will call the patient to book in the review.
Can the service be delivered within our existing clinical systems?
Structured medication reviews, run as a managed service
A structured medication review (SMR) is a patient-centred clinical medication review: a conversation with the patient, and their carer where appropriate, about how their medicines are working, their benefits and risks, and what matters to them. It ends in an agreed, documented plan, and continuing appropriate treatment is a valid outcome. Our clinical pharmacists run SMRs for GP practices and PCNs inside your own clinical system, from the first search to the coded record, under our clinical governance.
Who needs a structured medication review
NHS England’s 2026/27 Network Contract DES guidance identifies priority groups for SMRs:
- Care home residents (see care home medication reviews)
- People with learning disabilities
- Complex and problematic polypharmacy, particularly ten or more medicines
- Medicines associated with errors or harm
- Severe frailty with isolation, being housebound, recent admissions or falls
- Medicines associated with dependence or withdrawal
These groups are not exhaustive. We agree the cohort with your clinical lead, using the guidance and your own clinical information, and start with the patients most likely to benefit. Our guide to structured medication reviews in 2026 covers the guidance in more detail.
Polypharmacy reviews
Patients on many medicines are reviewed for indication, benefit, harm, interactions and monitoring, so each medicine is still the right choice for that patient.
Frailty and falls
For patients living with frailty, the review looks at medicines that can add to falls risk, confusion or a recent admission, alongside the patient’s own goals.
Deprescribing, agreed with the patient
Where a medicine is no longer helping, stopping or reducing it is discussed and agreed with the patient, and follow-up is arranged. Continuing treatment can be the right decision too.
How we run structured medication reviews
- We agree the cohort, the protocol, the escalation routes and the reporting with your clinical lead or PCN.
- We run the searches and size the cohort, so you know the scale before reviews start.
- Our pharmacists contact each patient to book the review and hold it remotely, with carers involved where appropriate and accessibility needs considered.
- Changes are made within the agreed protocol. Prescribing follows protocols agreed with the practice: our independent prescribers sign prescriptions within their competence, and anything outside it goes to the patient’s GP.
- Each review is recorded with the SMR code set out in the DES guidance, alongside the agreed plan, who owns each action and when follow-up is due.
- You receive reporting on completed reviews, follow-up, open actions and anything passed to your GPs.
What our SMR work has delivered
- Norfolk and Waveney PCN: 1,000 structured medication reviews delivered between October and March, alongside a technician service, all under one governance.
- Lincolnshire, nine-practice PCN: 315 hours of medication reviews in a first block, delivered to one pathway across all nine practices. The PCN then moved to a full-year contract covering the whole network.
- Somerset PCN: a 287-hour block of medication reviews, followed by an extension.
Reviews are carried out by GPhC-registered pharmacists, 85% of whom are independent prescribers, in EMIS, SystmOne, Vision or Medicus. We have supported 375+ GP practices and 88+ PCNs in 23 ICB areas. Read the full case studies. Related services: high-risk drug monitoring, long-term condition clinics and, for networks, PCN pharmacist services.
