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Bevan Exemplar Cohort 8 Projects

Using One Health Approaches to reduce Pharmaceutical and Healthcare Waste

Sarah Thorne

Hywel Dda University Health Board

This project aims to provide a viable solution for the issue of medicine and dressings waste created in the NHS by defining a common formulary between human and small/companion animal veterinary practice and modelling a supply chain to divert these streams to animal sector usage.

By establishing a ‘buddy’ network involving care facilities, pharmacies, and veterinary practices, we can create an enclosed circular supply route to give an alternative outlet for products that would otherwise be considered waste. We propose that medicines supplied to a care facility where safe storage of medicines protocols are in place would allow reassurance on quality standards. Once returned to a community pharmacy, suitably qualified staff could follow an SOP (Standard Operating Procedure) to grade and segregate items against a pre-defined common formulary. Appropriate products could then be supplied to local vet practices to reissue to their animal patients. To avoid any financial loss/gain, to overcome the perception of ‘second-hand’ medication and to provide an incentive to the end consumer (pet owner), financial offsetting of antibiotic sensitivity testing could be offered. This would help ensure prudent prescribing, by increasing the uptake of sensitivity testing thereby reducing antimicrobial resistance and the risk of zoonotic diseases.

Commonly sensitivity testing is not offered to small and companion animal owners due to the financial burden however, increased uptake of this service would improve appropriate antibiotic prescribing choices. Similarly, by ensuring more waste is returned to pharmacies and not sent to landfill, the issue of pharmaceutical pollution and negative environment impact of inappropriate disposal routes can begin to be tackled, benefitting water courses and ecosystems over a wide geographic area.

Due to the unique nature of this proposal, the project will be tackled in a stepwise approach to address each potential barrier to success.