Steve Williams is a senior clinical pharmacist with 35 years of NHS experience, and a co-host of the Aural Apothecary Podcast - a show that takes "an authentic yet light-hearted take on the world of medicines and healthcare in the UK". Steve shares his approach to tackling polypharmacy with us, having moved from acute hospital settings to general practice specifically to address the root causes of medication-related hospital admissions. Working with a 21,000-patient practice, he describes a systematic approach to structured medication reviews - stratifying patients by risk (those on 8+ medications, high-risk combinations, or dependence-forming medicines), allocating pharmacist time to proactive reviews, and combining medication reviews with long-term condition management in single 30-minute appointments.

The discussion explores the scale of the problem in the UK: a thousand pills dispensed per second, a million people on 10 or more repeat medicines, and an estimated million hospital admissions annually due to medication issues. Steve advocates for training and empowering "competent prescribers" - whether GPs, pharmacists, or nurses - to confidently review and deprescribe medications, noting that his Dorset system has successfully incentivised practices to reach targets for reviewing high-polypharmacy patients. The big question is - can AI start to help us tackle and reduce polypharmacy?

Scottish polypharmacy guidance (updated) The latest version 2025 - draft version for consultation, loads of detail, examples of using the 7-step approach

British Geriatrics Society: Pragmatic prescribing to reduce harm for older people with moderate to severe frailty  Excellent clear 2-page guidance

Health Innovation Network: The mechanics of tackling overprescribing and problematic polypharmacy  Steve’s comprehensive guide to tackling polypharmacy in primary care

Health Innovation Wessex: project Polypharmacy Links to Steve’s training resources.

Manage my meds – for patients and carers to help patients prepare for a medicines review.

The Aural Apothecary: Dr Jessica Morley. Will Artificial Intelligence save the NHS?

Talking General Practice: AI and the future of general practice – Prof Brendan Delaney