Prescribing at the interface between primary and secondary care in the UK - Towards joint formularies?

The current divisions in managing prescribing between primary and secondary care in the UK arise from separate budgetary arrangements. These divisions are neither sensible, organisationally efficient nor cost effective. Trans ition of patients across the interface of primary and secondary care has al ways been problematic, hindered by poor communication and coordination. Joi nt formularies would improve overall care and raise awareness of the need t o consider overall costs within a unified National Health Service (NHS). Th ere are, however, few examples of successful working of a joint formulary i n the UK. It is likely that harmonisation of drug use in hospitals and in p rimary care will come about because of contracting and commissioning, and t hat it will largely be led by primary care, through the developing primary care groups (PCGs). Local decisions around availability and use of drug the rapies will increasingly be superseded by the national decisions emanating from the newly formed National Institute for Clinical Effectiveness.