Improving practice--the Hospital Pharmacy Initiative revisited

The Hospital Pharmacy Initiative was a 12 million pounds sterling scheme introduced in England in 2003 and aimed at improving antimicrobial prescribing. Although significant successes have been claimed for the scheme, there is evidence which demonstrates that the untargeted and essentially undirected investment where no clear objectives were set has resulted in extremely variable developments with arguably minimal gains attributable to the programme. This contrasts strongly with the Scottish approach where form and function has been detailed with a focus on service sustainability in the ongoing challenge of improving prudent antimicrobial prescribing.