The study found that the global health workforce nearly tripled between 1990 and 2023, growing from 40.9 million to 122.1 million workers. Women accounted for 71.4% of this growth and represented 68.9% of all health workers in 2023. Despite this progress, substantial shortages persist across many regions, particularly South Asia and sub-Saharan Africa, where health systems continue to face some of the world’s lowest workforce densities.

Based on Global Burden of Disease (GBD) 2023 estimates, this study provides the first global, sex-disaggregated estimates of 20 health worker cadres, or groups of specially trained health personnel such as doctors, nurses, midwives, pharmacists, dentists, and community health workers, across 204 countries and territories from 1990 to 2023, including the first global estimates of community health workers. It also offers the most comprehensive assessment of the global health workforce to date.

Women have driven global health workforce growth but remain underrepresented in many higher-paid professions.  

Between 1990 and 2023, the global health workforce expanded by more than 81 million workers, including 18.9 million nurses and 8.7 million doctors. Most regions saw substantial growth over this period, although the pace of expansion varied across countries and health professions.

In 2023, the global health workforce included 122.1 million health workers, including 33.2 million nurses, 15.1 million doctors, 7.6 million community health workers, 6.8 million pharmacists and pharmaceutical assistants, and 6.1 million dentists and dental assistants. Women represented nearly seven in ten health workers worldwide, comprising 80.7% of nurses, 96.0% of midwives, and 89.5% of community health workers, while less than half of doctors were women. Similar patterns were observed across dentistry and pharmacy, where women were more likely to work as assistants than as dentists or pharmacists.

“Women have transformed the global health workforce over the past three decades, but they continue to be concentrated in professions that generally offer lower pay and fewer opportunities for leadership,” said Megan Knight, lead author of the study and researcher at the Institute for Health Metrics and Evaluation (IHME). “Building stronger health systems will require not only expanding the workforce, but also creating equitable opportunities for career advancement, leadership, and safe, supportive working environments.”

Millions of health workers will be needed to achieve universal health coverage.  

Despite substantial workforce growth, researchers estimate the world would need an additional 34.4 million health workers to achieve a score of 80 out of 100 on the GBD universal health coverage effective coverage index, a benchmark representing moderate levels of universal health coverage. This includes shortages of 23.9 million nurses and midwives, 7.1 million doctors, 1.8 million dentists, and 1.6 million pharmacists.

Workforce shortages were greatest in South Asia, which would require an additional 2.6 million doctors and 10 million nurses and midwives to reach moderate universal health coverage. Sub-Saharan Africa also faced severe shortages across major health professions, with nursing density of 14.5 per 10,000 population compared with 121.8 per 10,000 in high-income countries. At the country level, nurse density was as low as 3.2 per 10,000 in Chad and 3.3 in Madagascar, compared with 171.7 per 10,000 in Belgium and 161.4 in the United States.

“Health workers are the foundation of every health system,” said Dr. Annie Haakenstad, senior author of the study and Assistant Professor of Health Metrics Sciences at IHME. “Although the global workforce has expanded dramatically, millions more doctors, nurses, midwives, dentists, and pharmacists will be needed to ensure people everywhere can access essential health services. These findings provide countries with minimum thresholds for planning the workforce needed to strengthen health systems and move toward universal health coverage.”

Meeting global health goals will require sustained investments in the health workforce.  

The study estimates that achieving moderate universal health coverage is associated with minimum workforce densities of 23.8 doctors and 64.5 nurses and midwives per 10,000 people, along with 5.2 dentists and 5.6 pharmacists per 10,000. These minimum benchmarks can help countries identify workforce gaps and plan the investments needed to meet future health needs.

The estimates also provide a measure of progress toward Sustainable Development Goal (SDG) target 3.c.1, which calls for substantially increasing the recruitment, development, training, and retention of the health workforce, as well as SDG target 3.8 on achieving universal health coverage.

Closing global workforce gaps will require sustained investments in health worker education, recruitment, retention, and working conditions. Gender-responsive policies, including leadership development, workplace protections, paid parental leave, and flexible work arrangements, can also help support the predominantly female health workforce. Building a well-supported health workforce will be essential to expanding access to care and ensuring health systems are equipped to meet future health challenges.

The post Women make up nearly 70% of the global health workforce, even as the world faces a shortage of 34 million health workers appeared first on Pharmacy Update Online.

That may depend on several factors, including your digital literacy, income, age, and experience communicating with doctors and nurses, according to a new study led by researchers at NYU School of Global Public Health. The findings, published in JAMA Network Open, suggest that there is room for improvement in how health information is presented to patients.

The 21st Century Cures Act requires that electronic health information—including test results like labwork and imaging—be released to patients as soon as the results are available. As a result, many see their results before their provider.

“The Cures Act has restructured the traditional pathway between the release of a test result to a patient-clinician discussion,” said Jemar Bather, assistant professor of biostatistics at NYU School of Global Public Health and the study’s lead author. “We wanted to understand whether a patient’s probability of accessing test results—and understanding of them—varies based on sociodemographic characteristics, health status, patient-centered communication, and digital health literacy.”

The researchers analyzed data from the 2024 Health Information National Trends survey, a representative sample of US adults collected by the National Institutes of Health. A total of 4,982 respondents who had access to their electronic medical records and received a test result in the past year were included, which can be generalized to represent nearly 175,000,000 US adults.

More than two-thirds of adults (68.6 percent) reported viewing their test results before hearing from a provider. Those who immediately viewed results were more likely to be older and female, and have a higher income, multiple chronic health conditions, higher digital literacy, and greater use of health-related social media.

In addition, comprehension of test results varied. Among those who immediately viewed results, 6.6 percent said they had a poor understanding, 26.8 percent understood the results fairly well, 31.7 percent understood them well, and 34.9 percent understood the results very well. Those who reported having the lowest understanding of their test results were more likely to be from the Midwest or South and had experienced discrimination in medical care.

In contrast, people with higher digital literacy had a better understanding of their medical test results, as did those who experienced better patient-centered communication—for instance, feeling that health care professionals explain things in a way they can understand and involve them in decision making.

“Health systems give you your data, but that does not mean that they put a lot of effort into making the information easy to understand on your own,” said study author José Pagán, professor and chair of the Department of Public Health Policy and Management at NYU School of Global Public Health. “Health systems and online patient portal developers should look for innovative ways to improve how they communicate—for instance, using AI to summarize test results in plain language and provide easy means for follow-up questions.”

“While the Cures Act’s goal of expanded patient access is being realized, a subset of patients who view their results before being contacted by their health care provider is having difficulty understanding what they see. Improving patient-centered communication may help in closing this comprehension gap,” noted Bather.

In addition to Bather and Pagán, study authors include Melody Goodman of NYU School of Global Public Health, Zoe Lindenfeld of Rutgers University, Karen Fortuna of the Geisel School of Medicine at Dartmouth, and Guilherme Del Fiol and Kimberly Kaphingst of the University of Utah.

The post Most patients view their test results before their doctor, with some reporting low comprehension appeared first on Pharmacy Update Online.

Digital transformation is key to the realisation of the NHS 10 Year Plan for England, “shifting from bricks to clicks,” but compliance with statutory digital clinical safety standards is not routinely monitored or enforced, explain the researchers.

This is despite statutory requirements under the Health and Social Care Act 2012 for digital health technologies to undergo formal clinical risk assessment (DCB0129/160), they point out.

The researchers previously reported compliance rates in a survey of 239 NHS trusts and integrated care boards (ICBs) in England, using freedom of information requests. They found that among the 14,848 digital health technologies in use in these organisations, 70% lacked documented safety assurance; only 17% were fully assured.

To better understand the drivers behind the poor compliance rates, the researchers carried out a secondary analysis of qualitative data from the original survey responses and additionally drew on previously unpublished quantitative data on Clinical Safety Officer (CSO) capacity.

CSOs are clinicians who are responsible for overseeing the clinical risk management of digital technologies used in the delivery of patient care.

On average, one full time CSO was deployed at each of the 211 organisations that responded to the original survey (February to March 2025). In all, 163 organisations (77%) provided data on hours worked

NHS trusts reported slightly higher capacity (average of 1.3 full time equivalent staff) than ICBs who reported an average of less than half (0.4).

Free text responses suggested the figures overstated actual capacity, with CSO duties typically performed alongside other substantive duties.

Twenty two organisations couldn’t quantify time spent on DCB implementation. And 11 identified the CSO function as part of a senior leader’s role, which included associate medical director, chief clinical information officer, and chief nurse.

“While embedding safety within senior clinical leadership may provide strategic visibility, it also means the individuals responsible for safety oversight are those with the least available time to undertake it; reducing effective capacity and impairing the development of experiential expertise,” point out the researchers.

Thirty-seven organisations invoked statutory exemptions to the original FOI request, with the most common being cost and time required to meet it, with inaccessible data and/or the absence of a central register, the most common justifications.

“While we have no reason to suspect the validity of these claims, we would nevertheless highlight that both reasons indicate immature clinical safety governance processes,” write the researchers.

Of particular note were the exemptions claimed under prevention or detection of crime and health and safety, which indicate a fundamental misunderstanding of what is meant by clinical safety, they highlight.

“These responses collectively suggest a workforce model that is structurally incapable of delivering the proactive, continuous risk management that the standards require,” they point out.

Thematic analysis of the free text comments pinpointed four major and mutually reinforcing drivers of non-compliance: poor understanding of the standards; immature governance infrastructure and oversight; ineffective assurance processes; and the perception of a CSO not as a dedicated, professionalised post, but as an ancillary responsibility absorbed into existing roles.

“These themes do not operate in isolation,” emphasise the researchers. “The result is a system in which no single component (ie, knowledge, governance, process or workforce) functions adequately, and the failure of each compounds the others.”

This matters, say the researchers, because:

• The Plan’s ambition to rapidly adopt frontier technologies, including AI, genomics and robotics, demands a highly skilled CSO workforce with dedicated time to undertake risk assessments of increasing complexity
• Despite the recognition (Topol Review) that preparing healthcare workers for a digital NHS requires embedding digital safety knowledge at undergraduate and postgraduate level, this study’s findings suggest that this hasn’t happened
• The shift from hospital to community will also likely require concomitant expansion of the community digital footprint, especially in primary care, which is likely to be smaller and less well resourced than trusts and ICBs, with less access to specialist CSO capacity
• The commissioning of services from diverse providers means extending digital safety obligations across a wider, heterogeneous provider landscape, which risks creating accountability gaps where ultimate responsibility for patient safety is unclear
• The Medium Term Planning Framework mandates a 2% year-on-year improvement in productivity, creating tension between the speed of deployment and the rigour of assurance

To tackle these issues, the researchers suggest:

• the need for regulation, with the Care Quality Commission uniquely placed to do this
• adding DCB0160/0129 compliance to the patient safety domain of the NHS Oversight Framework to signal that digital safety governance is core to care quality
• formalising the CSO pathway, introducing a tiered competency based structure for operational delivery to bring the NHS into line with other safety critical industries
• the development of mechanisms for sharing best practice, identifying standard deployment hazards and causes, and raising awareness of clinical incidents

The researchers acknowledge that their data lacked the depth, contextual detail, and opportunities for clarification that would typically be afforded by traditional qualitative methods, such as semi-structured interviews. And their survey excluded primary care and adult social care, so compliance remains unknown in these sectors.

Nevertheless, they conclude: “NHS organisations in England are systematically failing to comply with legislated digital safety standards…Before the UK Government pursues its ambitious digital future for the NHS, a new digital safety architecture must be established.”

They continue: “A model combining centralised assessment with local risk management, a professionalised CSO workforce, empowered regulatory enforcement, and integration of digital safety into national quality frameworks is needed to ensure that innovation and patient safety are pursued as concurrent priorities.

“Without these changes, the digital transformation envisaged in the 10 Year Health Plan risks propagating patient harm at unprecedented scale and speed.”

The NHS 10 year Health Plan “risks propagating patient harm at an unprecedented scale” due to the lack of appropriate safety architecture to support the envisaged digital transformation, warn experts in an analysis published in the online journal BMJ Innovations.

Digital transformation is key to the realisation of the NHS 10 Year Plan for England, “shifting from bricks to clicks,” but compliance with statutory digital clinical safety standards is not routinely monitored or enforced, explain the researchers.

This is despite statutory requirements under the Health and Social Care Act 2012 for digital health technologies to undergo formal clinical risk assessment (DCB0129/160), they point out.

The researchers previously reported compliance rates in a survey of 239 NHS trusts and integrated care boards (ICBs) in England, using freedom of information requests. They found that among the 14,848 digital health technologies in use in these organisations, 70% lacked documented safety assurance; only 17% were fully assured.

To better understand the drivers behind the poor compliance rates, the researchers carried out a secondary analysis of qualitative data from the original survey responses and additionally drew on previously unpublished quantitative data on Clinical Safety Officer (CSO) capacity.

CSOs are clinicians who are responsible for overseeing the clinical risk management of digital technologies used in the delivery of patient care.

On average, one full time CSO was deployed at each of the 211 organisations that responded to the original survey (February to March 2025). In all, 163 organisations (77%) provided data on hours worked

NHS trusts reported slightly higher capacity (average of 1.3 full time equivalent staff) than ICBs who reported an average of less than half (0.4).

Free text responses suggested the figures overstated actual capacity, with CSO duties typically performed alongside other substantive duties.

Twenty two organisations couldn’t quantify time spent on DCB implementation. And 11 identified the CSO function as part of a senior leader’s role, which included associate medical director, chief clinical information officer, and chief nurse.

“While embedding safety within senior clinical leadership may provide strategic visibility, it also means the individuals responsible for safety oversight are those with the least available time to undertake it; reducing effective capacity and impairing the development of experiential expertise,” point out the researchers.

Thirty-seven organisations invoked statutory exemptions to the original FOI request, with the most common being cost and time required to meet it, with inaccessible data and/or the absence of a central register, the most common justifications.

“While we have no reason to suspect the validity of these claims, we would nevertheless highlight that both reasons indicate immature clinical safety governance processes,” write the researchers.

Of particular note were the exemptions claimed under prevention or detection of crime and health and safety, which indicate a fundamental misunderstanding of what is meant by clinical safety, they highlight.

“These responses collectively suggest a workforce model that is structurally incapable of delivering the proactive, continuous risk management that the standards require,” they point out.

Thematic analysis of the free text comments pinpointed four major and mutually reinforcing drivers of non-compliance: poor understanding of the standards; immature governance infrastructure and oversight; ineffective assurance processes; and the perception of a CSO not as a dedicated, professionalised post, but as an ancillary responsibility absorbed into existing roles.

“These themes do not operate in isolation,” emphasise the researchers. “The result is a system in which no single component (ie, knowledge, governance, process or workforce) functions adequately, and the failure of each compounds the others.”

This matters, say the researchers, because:

• The Plan’s ambition to rapidly adopt frontier technologies, including AI, genomics and robotics, demands a highly skilled CSO workforce with dedicated time to undertake risk assessments of increasing complexity
• Despite the recognition (Topol Review) that preparing healthcare workers for a digital NHS requires embedding digital safety knowledge at undergraduate and postgraduate level, this study’s findings suggest that this hasn’t happened
• The shift from hospital to community will also likely require concomitant expansion of the community digital footprint, especially in primary care, which is likely to be smaller and less well resourced than trusts and ICBs, with less access to specialist CSO capacity
• The commissioning of services from diverse providers means extending digital safety obligations across a wider, heterogeneous provider landscape, which risks creating accountability gaps where ultimate responsibility for patient safety is unclear
• The Medium Term Planning Framework mandates a 2% year-on-year improvement in productivity, creating tension between the speed of deployment and the rigour of assurance

To tackle these issues, the researchers suggest:

• the need for regulation, with the Care Quality Commission uniquely placed to do this
• adding DCB0160/0129 compliance to the patient safety domain of the NHS Oversight Framework to signal that digital safety governance is core to care quality
• formalising the CSO pathway, introducing a tiered competency based structure for operational delivery to bring the NHS into line with other safety critical industries
• the development of mechanisms for sharing best practice, identifying standard deployment hazards and causes, and raising awareness of clinical incidents

The researchers acknowledge that their data lacked the depth, contextual detail, and opportunities for clarification that would typically be afforded by traditional qualitative methods, such as semi-structured interviews. And their survey excluded primary care and adult social care, so compliance remains unknown in these sectors.

Nevertheless, they conclude: “NHS organisations in England are systematically failing to comply with legislated digital safety standards…Before the UK Government pursues its ambitious digital future for the NHS, a new digital safety architecture must be established.”

They continue: “A model combining centralised assessment with local risk management, a professionalised CSO workforce, empowered regulatory enforcement, and integration of digital safety into national quality frameworks is needed to ensure that innovation and patient safety are pursued as concurrent priorities.

“Without these changes, the digital transformation envisaged in the 10 Year Health Plan risks propagating patient harm at unprecedented scale and speed.”

The post NHS 10 Year Health Plan “risks propagating patient harm at an unprecedented scale” appeared first on Pharmacy Update Online.

RTPB tools sit within the electronic prescribing workflow and show clinicians a patient’s expected out-of-pocket cost for a selected medication, alongside lower-cost alternatives where these are available. The intention is to allow cost to be factored into prescribing decisions at the point of ordering rather than at the pharmacy counter, where an unexpected price can lead to a prescription going unfilled.

The analysis found no difference in fill rates across all prescriptions written. When the researchers looked specifically at high-cost drugs, however, prescriptions were more likely to be filled when the tool was in use. The effect was most pronounced among patients from low-income communities, the group for whom out-of-pocket costs are most likely to act as a barrier to starting treatment.

The authors note an important limitation. The RTPB tool generated recommendations for only a small proportion of prescription orders, which means the findings apply to a narrow segment of the randomised population rather than to prescribing as a whole.

The corresponding author is Sunita M. Desai, PhD, of the Department of Population Health at NYU Grossman School of Medicine.

Read the full study: Real-Time Prescription Benefit Tool Availability and Prescription Medication Fill Rates

The post Real-time prescription benefit tool lifts fill rates for high-cost drugs, study finds appeared first on Pharmacy Update Online.

Their readability is mostly college level, the analysis—the first of its kind–shows. This isn’t recommended for content designed to be read by patients, say the researchers, who add that while communication quality may influence clinical outcomes, the dual purpose clinical letters serve makes improvement challenging.

Unlike many other health systems, there is a well established practice in the UK of sending letters to patients following an outpatient clinic appointment. These letters used to be copies of those sent to the patient’s family doctor (GP), but the emphasis has shifted to making them clearer and more patient centred, note the researchers.

Academy of Medical Royal Colleges (AoMRC) guidance in 2018 encouraged clinicians to write directly to patients rather than about them, and NHS England has since reinforced the importance of clear and timely communication with patients as essential for efficient and effective outpatient services, they add.

But it’s not clear to what extent clinical letters meet recommended readability standards. To find out and set a quality benchmark, the researchers focused on the highest volume outpatient specialty in UK healthcare—-ophthalmology.

They measured the readability and linguistic complexity of over 4.6 million outpatient clinic letters sent to 804,986 patients between 2013 and 2025 attending 17 subspecialty services at a UK hospital trust, specialising in various aspects of eye health.

Their analysis shows that the average readability score (Flesch Reading Ease) of the letters was 51.1, indicating college-level understanding. This means the correspondence was more complex and less accessible than recommended for content designed to be read by patients. Overall, 95% of the letters were less readable than recommended.

Readability varied across the 17 subspecialties, however, suggesting that communication quality may reflect service-level culture and documentation requirements, say the researchers.

The highest readability was observed for letters from paediatrics, optometry, and orthoptics services.

In children’s eye services, correspondence was often directed to parents or caregivers, which may encourage use of simpler language, suggest the researchers. And in optometry and orthoptics structured templates were often used, likely facilitating more consistent readability, they add.

There was a slight upward trend over the study period in the likelihood of letters being addressed directly to patients over the study period, but the proportion doing so remained very low, overall, at just over 2%, while use of the personal pronoun ‘you’ was also very low.

The researchers highlight several limitations to their findings, including the inability to assess variations in the readability of individual clinicians’ letters. The analysis also focused on readability and linguistic complexity rather than measuring which aspects of communication matter most to patients or had the greatest impact on healthcare outcomes.

The methods used to classify the intended audience may not fully reflect how correspondence is ultimately used or interpreted, while shifts in clinical practice, record keeping, or institutional policies may also have introduced effects not accounted for in the analysis, the researchers add.

But the study is the first long term population-scale evaluation of outpatient clinic letter readability over more than a decade, and exposes a gap between policy recommendations and routine practice, they point out.

“It demonstrates that poor readability is pervasive, has worsened over time, and varies
substantially between services, revealing system-level patterns that were previously unquantified,” they write.

Clinician letters must simultaneously work as a medical record and provide key information for other healthcare professionals as well as for patients, making it hard to simplify the linguistic content—a challenge that is further compounded by time pressures—they explain.

But they conclude: “These findings highlight a persistent gap between national recommendations and real-world practice, which underscores the need for targeted interventions and innovative approaches to support clear and patient-centred communication.”

The post Patient letters from UK hospital eye health services likely too difficult to understand appeared first on Pharmacy Update Online.

The retrospective cohort study linked deidentified electronic health records with administrative claims from the Optum Labs Data Warehouse, identifying 1,428 adults with commercial or Medicare Advantage cover who received a first buprenorphine prescription for opioid use disorder (OUD) between 1 January 2020 and 25 September 2024. Abandonment was defined as no dispensing record within 30 days of the prescribing date.

Overall, 369 patients (25.8%) abandoned their first prescription, with the annual proportion rising from 19% in 2020 to 37% in 2024 (*P* for trend = .02).

Patients whose prescriptions went unfilled were younger (mean 54.3 vs 57.4 years), more frequently Hispanic (10.6% vs 4.8%), more likely to hold commercial rather than Medicare Advantage cover (51.8% vs 29.4%), and faced higher pharmacy deductibles (mean $483.80 vs $296.40). Those who collected their medication were more likely to have a recorded diagnosis of OUD or overdose in the previous 180 days (54.4% vs 40.1%) or a mental health diagnosis (52.5% vs 38.5%).

The authors, led by Xinyi Jiang, PhD, MS, of the CDC’s Division of Overdose Prevention, suggest pharmacy plan deductibles may be an important factor in abandonment, and point to dispensing buprenorphine directly during clinical encounters, strengthening linkage to care, and improving pharmacy availability as ways to reduce barriers to treatment.

**Source:** Jiang X, Zhang K, Chen Y, et al. Abandonment of Prescribed Buprenorphine for Opioid Use Disorder, 2020-2024. *JAMA Netw Open.* 2026;9(8):e2627142. doi:10.1001/jamanetworkopen.2026.27142

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2026.27142?guestAccessKey=1db66b39-91d4-4a88-b5b1-334a938dd52d&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_term=080426

The post Abandonment of prescribed buprenorphine for opioid use disorder, 2020-2024 appeared first on Pharmacy Update Online.

Why discharge summaries matter

A discharge summary is the primary method of communicating what happened during a hospital stay to GPs, community teams, community pharmacists, and sometimes patients’ carers. When this transfer of information is delayed or incomplete, the consequences can be serious: GPs may fail to follow up appropriately, or may unknowingly re-prescribe medication that caused harm in the first place. Patients themselves are often unclear about their own medication changes, increasing the risk of errors after discharge. The project’s goal, says Mr Chan, was to “improve both the quality and the timeliness of discharge information while reducing the administrative burden on clinicians.”

A process under strain

Before the redesign, the discharge process was slow and highly variable. Clinicians often had to review hundreds of pages of notes before compiling a summary — a particular challenge on mental health wards, where admissions can range from 30 to 120 days. Completion rates within 24 hours of discharge varied considerably between wards, from around 70% down to just 30%. Ownership of the task was also unclear, with doctors and pharmacists sometimes each assuming the other was responsible, while junior doctors juggled competing priorities. The result was delay, and community clinicians left without timely information on diagnosis, treatment, and medication changes.

Redesigning the pathway before adding AI

Recognising that the problem could not be solved by one professional group alone, the trust convened a multidisciplinary co-production group, chaired by a consultant psychiatrist. The team used performance data and direct feedback from GPs to clarify responsibilities and standardise workflows before considering any technology. This groundwork alone raised the overall proportion of discharge summaries reaching GPs within 24 hours to around 60% — but progress then plateaued.

Introducing AI

The trust had already been using an AI platform, Anathem, for about two years to support ambient voice transcription of outpatient consultations. Extending this technology to discharge summaries was, “a natural progression” says Mr Chan. The AI reviews up to 300 pages of clinical notes and drafts the two-part discharge document: a clinical summary and a medication summary, including the reason for admission, diagnosis, interventions, medication changes and reasons for stopping drugs, and follow-up requirements. Feedback from GPs showed they rarely read beyond two pages, so the AI-generated document was deliberately condensed to that length.

The impact on efficiency has been substantial. Producing a discharge summary manually took a junior doctor 45 minutes to an hour; with AI support, this has fallen to around 20 minutes. Timeliness has also improved sharply, with 24-hour completion rates rising from 60% to around 90%.

Safeguards and accountability

Crucially, the AI does not send documents automatically. The resident doctor must review, edit, and formally sign off the summary using a smart card before it is transmitted electronically to the GP, retaining full professional accountability. This reflects lessons learned from early problems, including “hallucinations or confabulations”; in one case, the AI mistakenly recorded a patient’s suicidal ideation as an intent toward strangulation. Such incidents reinforced the trust’s view that AI can support clinicians but cannot replace their judgement.

Access to the tool is similarly staged. Foundation-level doctors (F1 and F2) are excluded. Specialty Trainee (ST) level doctors must first demonstrate they can produce a discharge summary manually before AI access is granted — an approach Mr Chan compares to a pilot needing to be able to fly a plane manually before using autopilot.

What’s next

Having piloted the approach on three wards, the trust now plans to scale it across the wider hospital and into community services, while continuing to gather feedback from clinicians, GPs, and patients. Mr Chan believes the model is transferable across the NHS, since safe information transfer between care settings is a universal challenge, even if local workflows differ.

Looking ahead, he is clear that AI will not replace healthcare professionals. “The future is not about replacing healthcare professionals with machines,” he says. “It is about augmenting them… The combination of human judgment, compassion and professional accountability, supported by well-governed technology, will deliver the safest care to the patient.”

Poster presented at the Clinical Pharmacy Congress. London 8-9th May 2026

The post Smarter, faster, safer: automating discharge summaries with Anathem AI appeared first on Pharmacy Update Online.

With the massive potential of artificial intelligence to transform healthcare in the coming years, UVA’s R. Andrew Taylor, MD, MHS, and Clemson’s Arwen B.L. Declan, MD, PhD, created the new framework to ensure healthcare remains “rooted in its ethical obligations” to serve patients, communities and local workforces, they say in a new paper outlining their creation. Their Total Mission Value framework arrives as hospitals face mounting pressure to adopt AI quickly, often with little practical guidance on how to weigh a tool’s worth beyond its price.

Declan and Taylor’s framework puts patient care and the patient experience at the top of a pyramid built on a foundation of ethics and supported by a base of economic sustainability. It emphasizes that AI should support care providers in their mission rather than replace them or simply create more work for them.

“AI is being adopted in medicine at a scope and velocity we have never seen before, but hospitals haven’t had a good way to weigh these decisions as a whole,” said Taylor, vice chair of research and innovation for the University of Virginia School of Medicine’s Department of Emergency Medicine. “Typical approaches tend to measure cost, because cost is the easiest thing to measure. We built this framework to give organizations a structured way to also weigh what an AI tool does for patients, for staff and for the quality of care.”

The Future of AI in Healthcare

Declan and Taylor are candid that AI’s promise cuts both ways. “AI tools could enhance care speed, diagnostic accuracy and costs efficiency while supporting population health, scientific inquiry and operational management,” they note in their paper. “However, they also introduce risks of bias, opacity, workforce displacement and erosion of the patient-clinician relationship that are invisible to cost-focused analyses.”

Declan and Taylor note that hospitals have lacked a structured way to weigh these choices as a whole—the standard approaches for evaluating a new technology tend to center on cost. Their framework is built to fill that gap, integrating five “ethically grounded” priorities: patient care, staff experience, hospital operations, economic impact, and education and research.

Patient care, which the authors place at the top of the framework, emphasizes the importance of “patient-centered” care and traits such as integrity, honesty, trust, compassion and respect. The staff-experience category, meanwhile, calls for hospitals to use AI to drive workforce development, teamwork and collaboration across disciplines.

Declan emphasizes that realizing AI’s full potential means resisting the urge to evaluate it narrowly. “Hospitals are seeing a huge number of new AI tools marketed to improve healthcare. The challenge is to figure out which ones actually will,” said Declan, clinical assistant professor in Clemson University’s School of Health Research. “That requires weighing an AI tool’s impact across clinical, operational and financial dimensions, while keeping patient care at the center of every decision.”

Ultimately, it is vital that hospitals remember that patient care is their “central, defining mission,” Declan and Taylor write.

“Our hope is that keeping the mission front and center actually speeds good AI adoption rather than slowing it down, because it builds the trust that patients and clinicians need,” Taylor said. “Technology should help us take better care of people. If we keep that as the goal, the efficiency and the savings tend to follow.”

Framework Published

Taylor and Declan have unveiled their framework in the scientific journal npj Digital Medicine. The article is open access and free to read.

Taylor noted that he has received a grant from Beckman Coulter to support evaluation of a clinical decision-making algorithm called TriageGo and that he is an adviser for VeraHealth.

To keep up with the latest medical research news from UVA and UVA’s new Paul and Diane Manning Institute of Biotechnology, bookmark the Making of Medicine blog at https://www.uvahealth.com/making-of-medicine.

The post Doctors develop guiding principles for future of AI in healthcare appeared first on Pharmacy Update Online.

A privileged but pressured role

GPs sit “at the forefront” of the NHS, seeing large numbers of patients each day, often within 10 or 15-minute consultations, says Dr Vautrey. The role spans the full spectrum of life, from young children to elderly patients living with long-term conditions or reaching the end of life. Much of the challenge lies in the unpredictability of each consultation: clinicians frequently do not know in advance what a patient will bring to them, making it a “real privilege” but also a demanding job, particularly when trying to spot emerging conditions among the many patients whose long-term conditions are already well understood.

What “seamless” means for patients

Patients simply expect their GP and pharmacist to be working from the same information, says Dr Vautrey. Electronic prescribing has already transformed this relationship, replacing handwritten and printed prescriptions with direct electronic transfer to the pharmacy. Where practices and pharmacies have a good working relationship, patients experience this as a single, joined-up local health service, with consistent messaging from both sides. Co-located or closely-linked pharmacies and surgeries tend to achieve this most effectively, he notes.

The 10-year plan: promising rhetoric, uncertain delivery

Asked about the NHS 10-year health plan, Dr Vautrey is cautiously optimistic but wary of a familiar pattern. The ambition to move care into the community and build up neighbourhood health services is “long overdue”, he says, but it must be matched by sustained investment, since community services – including community nursing – have been “overstretched and underfunded” for years. Real investment is needed not only in workforce but in premises, many of which are currently too small to expand services such as community cardiology, dermatology, ENT or gynaecology clinics that could otherwise be delivered locally.

Digital records and data confidence

General practice has led the NHS on digital records for years, says Dr Vautrey, citing electronic prescribing as a case in point: patients can now receive a prescription within minutes wherever they are in England, rather than having to track down a local GP while travelling. Increasing use of the NHS app and shared access to patient information is welcome, but any new digital systems must preserve patients’ confidence that their data will remain confidential and properly safeguarded, he emphasises.

Prevention: good intentions, but funding gaps remain

On the plan’s emphasis on tackling obesity and smoking, Dr Vautrey highlights the frustration many GPs feel at being unable to prescribe newer, highly effective weight-management medications more widely because of cost. He also points to years of cuts to locally commissioned preventive services – weight management, smoking cessation, drugs and alcohol and sexual health services – as local authority budgets have come under pressure, warning that a long-term, wholesale commitment to prevention funding is needed to reduce future NHS costs.

Wearables and shifting expectations

It is “too early to know for sure” how useful wearable technology will prove, says Dr Vautrey. Home blood pressure monitoring is already valuable, partly because it avoids the anxiety some patients feel in clinical settings, but other wearables can sometimes generate anxiety rather than reassurance. Simple tools such as phone step-counters, however, can meaningfully encourage physical activity. More broadly, patient expectations of living longer with long-term conditions are rising, and society will need honest conversations about what the NHS can sustainably provide versus what may need to be funded differently, particularly as highly specialised, expensive medicines become available.

Drug shortages: a persistent, largely economic problem

Medicine shortages remain a daily frustration for GPs, pharmacists and patients, says Dr Vautrey. The causes range from global manufacturing issues to manufacturers choosing to sell more profitably elsewhere rather than into the UK market. He believes government has yet to grapple seriously with the issue, including the case for greater domestic medicine production. At present, all too often, pharmacists bear the brunt of patients’ frustration when common medicines become hard to source.

A closing message

Reflecting on his years representing GPs nationally, Dr Vautrey’s message to government is unambiguous: practice teams, community pharmacists and other primary care professionals are already working closely together on patients’ behalf, but they need long-term, sustained investment. Strengthening these foundations, he argues, would improve care quality, ease pressure on secondary care, and ultimately leave both patients and the NHS as a whole better off.

About Dr Richard Vautrey

Dr Richard Vautrey is a GP partner, Meanwood Group Practice, Leeds and Clinical Director, Leeds Central North PCN.

The post Making primary care seamless in a digitally-led NHS appeared first on Pharmacy Update Online.

Researchers found that many online GLP-1 RA prescription vendors did not require any interaction with a clinician, instead relying largely on patient-reported questionnaires. According to the study, these questionnaires may fail to capture important elements of a patient’s clinical and social history.

Several findings pointed to limited safety oversight. Investigators observed multiple GLP-1 RA prescriptions being issued by the same clinicians, prescriptions granted even when required photos were missing, and prescriptions completed in five minutes or less.

The findings add to growing scrutiny of the direct-to-consumer telehealth market, which has expanded rapidly alongside surging demand for weight-loss and diabetes medications.

The study’s corresponding author is Reshma Ramachandran, MD, MPP, MHS, of Yale University. The full study is available in JAMA (doi:10.1001/jama.2026.9131).

The post Online GLP-1 prescribing often skips clinician interaction, study finds appeared first on Pharmacy Update Online.

Reduced NHS spending on other health interventions would have an adverse impact on public health which could increase excess preventable deaths by 229,000 by 2036 – more than the covid-19 pandemic between March 2020 and June 2022 (137,000). If the indirect effect on adult social care is also included, excess deaths increase to 291,000, argue the authors. Most of these deaths are expected to be people with cardiovascular, respiratory, and gastrointestinal disease and cancer.

The UK-US pharmaceuticals deal was announced by the UK government on 1 December 2025 and described as a “landmark” deal that would “safeguard medicines access and drive vital investment for UK patients and businesses” through strengthening UK-US cooperation in sectors like life sciences and pharmaceuticals.

The agreement secured a 0% tariff on UK pharmaceutical and medical device exports to the US for three years, but also committed the NHS to substantially higher expenditure on new branded medicines over the next decade through changes to drug pricing arrangements and health technology assessment.

From April 2026 the government instructed the National Institute for Health and Care Excellence (NICE) to increase its cost-effectiveness threshold for new medicines from £20,000-£30,000 per quality adjusted life year (QALY) to £25,000-£35,000 per QALY for the same health benefits.

Changes in the way health benefits are measured by NICE’s assessments will also give more weight to benefits offered by new medicines. QALYs combine gains in survival and quality of life into a single measure and NICE has generally required a cost-effectiveness threshold of £20,000-£30,000 per QALY to balance the health gains offered by new medicines against the detrimental impact on health if NHS resources were displaced from other services.

An agreement between the pharmaceutical industry and the UK government (the voluntary scheme for branded medicines pricing, access, and growth; VPAG) designed to limit growth in NHS expenditure on branded medicines through industry rebate payments has also been watered down. In 2025 the rebate rate was 23% but under the new agreement this has been cut to 14.5%.

Overall, under the deal, the government has committed to more than double spending on new medicines from 0.3% of gross domestic profit (GDP) to at least 0.6% by 2036, with interim targets of 0.35% of GDP in 2028 and 0.4% of GDP in 2030.

The Department of Health and Social Care has undertaken an impact assessment on the wider costs of this trade deal, but this document has not been made publicly available.

The authors are calling for the full details of the deal and its impact assessment to be made public so the deal can receive parliamentary scrutiny. They also emphasise that many of the suggested benefits of the deal, such as claims that higher UK medicine prices will stimulate pharmaceutical innovation and investment in the UK, are uncertain.

Assuming these GDP targets are met and GDP rises by 1.5% annually, as predicted by the Office for Budgetary Responsibility (OBR), the additional annual costs to the English NHS will be at least £1.3bn in 2028 (£25m per week), and £8.8bn in 2036 (£170m per week). The cumulative additional cost will be £2.6bn by the end of 2028 and £44.7bn by the end of 2036.

Modelling of English local authority data suggests that every £1bn the NHS must find to fund this deal will increase the costs of publicly funded adult social care by £118m because of increases in morbidity and mortality.

NICE estimates that increasing cost effectiveness thresholds will result in only two to five additional medicines being approved annually. NICE already approves more than 90% of medicines it evaluates, suggesting that the agreement is more likely to increase the prices paid for medicines already entering the NHS rather than substantially expand access.

While the agreement establishes zero tariffs on UK pharmaceutical and medical device exports to the US for three years, the UK remains a net importer of medicines. The economic benefits of securing zero tariffs for UK pharmaceutical exports has also been substantially diminished since a US Supreme Court ruling reduced the proposed tariffs from 100% to 10%. The projected costs of the agreement are expected to exceed the total annual value of UK medical exports to the United States (£5bn) before 2031.

The authors say, “The government’s willingness to accommodate industry pressure while the NHS absorbs the resulting costs raises important questions about transparency and accountability.”

They add, “More importantly, it emphasises a broader structural problem at the heart of a health system conceived with the intention of delivering equitable, patient centred care, now reduced to underwriting risk in global pharmaceutical markets.”

The post UK-US trade deal will mean the NHS has to divert billions from other NHS services to pay more for new medicines appeared first on Pharmacy Update Online.

Heart failure affects approximately 860,000 Canadians, is associated with reduced survival and quality of life, and is the third leading cause of hospitalization in the country. Heart failure with reduced ejection fraction (HFrEF) accounts for approximately half of these cases.

Despite high-quality evidence supporting the benefits of guideline-directed medical therapy (GDMT) for patients with HFrEF, which entails the rapid initiation of four distinct classes of medication collectively known as quadruple therapy, use of these medications remains suboptimal. This is in part due to inadequate access to heart failure specialists and clinics for many Canadian patients living with HFrEF. This high unmet need underscores the importance of alternative models that expand beyond physician-led GDMT management.

“Heart failure is a serious medical condition that has several effective medications that are underused across Canada,” says lead investigator Ricky Turgeon, BSc(Pharm), ACPR, PharmD, Faculty of Pharmaceutical Sciences, University of British Columbia. “Pharmacists and nurse practitioners are important members of the healthcare team who can help to improve medication use for heart failure.”

The researchers evaluated whether getting pharmacists and nurse practitioners to initiate and manage heart failure medications would be good value for money for the healthcare system by comparing two different scenarios using an economic model.

In the first scenario, patients with heart failure received the usual care currently experienced by most British Columbians with heart failure. In the second scenario, patients with heart failure received the usual care plus additional medication management from pharmacists and nurse practitioners. The investigators then modelled what would happen to these patients over time and tracked how long they would live, how often they would be hospitalized, and how much healthcare resources they would need.

It was estimated that within the first year of implementation, this added service would save approximately 10 lives and prevent 25 hospitalizations per every 1,000 patients who received the pharmacist- or nurse practitioner-led intervention.

“While this service would require additional funding, we demonstrated that this investment would be well justified given what the Canadian healthcare system is generally willing to pay,” notes Dr. Turgeon. “The size of this benefit was far beyond what was anticipated. As a pharmacist caring for people with heart failure, I find these results genuinely empowering. They show that we play an important role in improving patients’ lives while also easing pressure on the healthcare system. We have the evidence; now we need to implement this approach.”

By quantifying the clinical and economic impacts of these additional medication management services, this study provides healthcare system planners with the insights needed to effectively address persistent gaps in care for heart failure patients.

Co-lead investigator Kelly Mackay, MA, Cardiac Services BC, Provincial Health Services Authority, comments, “Our research offers a roadmap to improving patient outcomes while strengthening the sustainability of our health system. The research also provides Cardiac Services BC with the evidence and innovation needed to drive meaningful system change.”

“Expedited and increased access to quadruple therapy has the potential to save lives and reduce some of the pressures in British Columbia’s hospitals. We believe this model could also be successful in other Canadian provinces. We’re thrilled that this research presents such an effective—and feasible—way for more heart failure patients to receive this gold-standard treatment,” concludes co-investigator Nathaniel Hawkins, MBChB, MD, MPH, Cardiac Services BC, Provincial Health Services Authority, and Division of Cardiology, University of British Columbia.

The post Enlisting pharmacists and nurse practitioners in medication management can fill critical gaps in heart failure care, save lives, and reduce hospital stays appeared first on Pharmacy Update Online.