Across the health system | A question to investigate
A long opportunity list is not an investment strategy.
An integrated care board may face several worthwhile medicines initiatives and limited capacity to deliver them. The decision is not simply which opportunity has the largest headline number. It is which programme fits local need, has an accountable owner and can produce evidence of value under real constraints. Our proposed PHARMORIS evaluation concerns preparation of a medicines improvement portfolio for that decision. It would make assumptions, dependencies and resource requirements easier to compare without presenting a modelled benefit as money already saved.
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Establish which opportunities are relevant locally.
NHS England publishes medicines optimisation improvement topics, including earlier-year material that remains available for local initiatives (NHS England, n.d.). These are context, not an automatic current-year instruction or a ready-made local business case. A portfolio review should define the population, service and decision for each candidate programme. Identify whether the problem is observed locally and what information would confirm its importance. This prevents a national opportunity being copied into a board paper without establishing whether the conditions for local delivery exist.
Compare the constraint as well as the ambition.
Two programmes with similar proposed benefits may require very different specialist input, coordination and implementation time. Describe the capacity each needs and whether the same people are expected to deliver several programmes at once. Show dependencies that could delay the work, including agreements with providers and the availability of suitable information. The portfolio should reveal collisions between attractive proposals. Otherwise separate business cases can each look feasible while their combined demand on the system is impossible to meet.
A practical portfolio table can show evidence strength, implementation demand, time to first interpretable finding and the decision owner beside the proposed benefit. Identify programmes competing for the same specialist capacity and which commitments are reversible. There is no need to hide these trade-offs inside an opaque weighted score. A leader should be able to see why a smaller, testable programme might be the stronger next investment than a larger opportunity built on unresolved assumptions.
Use permissions as part of the data plan.
NHSBSA sets access conditions for ePACT2 and does not offer access to commercial organisations or pharmacy contractors (NHSBSA, n.d.). A proposed evaluation must not assume that NEUVIOR can sign into an NHS-only analytical service. Start with public sources and information the participating organisation is permitted to use and share under an agreed arrangement. Identify restricted requirements early. If a portfolio cannot be evaluated without information that is unavailable, that limitation belongs in the decision, rather than being hidden behind an aspiration to connect every dataset.
Test a small portfolio against the current process.
An initial PHARMORIS study could compare the usual preparation of a defined set of programme briefs with a source-linked alternative. Inputs would include agreed questions, approved aggregate information, resource assumptions and decision criteria. Medicines, finance and delivery reviewers would score whether each brief represents the opportunity and uncertainty correctly. The scope would not allocate budgets or rank services automatically. It would test the preparation of material that accountable leaders can use in their existing governance and prioritisation process.
A portfolio is a series of choices.
An investment case gets stronger when it explains the conditions for repetition. Make the next commitment depend on evidence.
An ICB team needs to compare several medicines opportunities competing for finite implementation capacity. Each proposal has a different evidence base, budget owner and dependency on delivery partners.
Supports an investable boundary: suitable now, suitable after a defined dependency, unsuitable under present conditions or still unknown.
What would we need to understand?
- Locally relevant opportunities
- Evidence strength and accountable budget owner
- Delivery capacity and dependencies
- Current prioritisation process and trade-offs
Constructed decision example | No customer results are shown.
Make the trade-offs inspectable.
A useful output should show how a conclusion changes when a key assumption changes, and where candidates cannot yet be compared fairly. Keep evidence strength separate from proposed benefit size. A large but speculative opportunity should not quietly outrank a smaller, well-understood one because the interface gives them identical certainty. Measures for the evaluation could include unsupported assumptions, missed dependencies, reviewer agreement and total preparation plus checking effort. Financial benefits would remain scenarios until realised and reviewed through an appropriate operational evaluation.
Stop if prioritisation becomes a black box.
Stop if a draft invents a local opportunity size, assumes restricted data access or hides the weights that drive a ranking. Reassess if the portfolio view adds administration without changing the quality of the decision. The team should be able to disagree with the model and see why. If the best conclusion is to pursue fewer programmes, the output should say so clearly. A credible commercial product helps leaders allocate attention and resources; it does not need every available initiative to appear urgent.
Bring the next portfolio decision.
An ICB medicines lead, finance colleague and delivery owner can begin with the programmes competing for capacity and the date a decision is needed. We can discuss a focused preparation comparison and what evidence would make it worth pursuing. The incentive is a more coherent investment discussion across medicines work. PHARMORIS remains a development programme; this use case describes a proposed evaluation of decision preparation, not a current commissioning contract or an automated method of distributing NHS resources.
NEUVIOR Data Analysis
A source.
A question.
A clearer decision.
Useful intelligence keeps its evidence attached.
Our public analysis connects a defined question with named sources, reporting periods and methods. Each source below shows the work available today and the access still needed.
Published-data analysis, research hypotheses and evidence studies are distinct kinds of work. Their meaning should remain clear as the programme grows.
NHS Business Services Authority | Annual
Prescription Cost Analysis
How does activity differ from ingredient-cost concentration?
Analysis availableNHS Business Services Authority | Monthly
English Prescribing Dataset with SNOMED Code
Which product and organisational patterns merit a closer investigation?
Metadata retrievedMedicines and Healthcare products Regulatory Agency | Event-driven; monthly roundup also published
Medicines and device safety communications
Which official communication should a responsible team read next?
Snapshot retrievedNHS Business Services Authority and NHS England | Weekly
Dictionary of medicines and devices
Can the same product identity be followed consistently across sources?
Access reviewSources and further reading
NHS England (n.d.) Medicines optimisation improvement topics. Available at: https://www.england.nhs.uk/publication/national-medicines-optimisation-opportunities-2023-24/ (Accessed: 14 October 2026).
NHSBSA (n.d.) Registering for ePACT2. Available at: https://www.nhsbsa.nhs.uk/access-our-data-products/epact2/registering-epact2 (Accessed: 14 October 2026).
Another useful angle.
- Make the review count. Protect the time around it.
A clinical pharmacist's diary can be full while the work around a structured medication review remains fragmented.
- The repeat request should not become repeated work.
A repeat prescription request can pass through several hands before the person receives a clear answer.
- The value of a biosimilar depends on the pathway around it.
A biological medicines opportunity can require coordination across specialist teams, pharmacy, procurement, administration services and patient communication.