Improving Prescribing Safety & Reducing Patient Risk
07 April 2026
The National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (PSRC) is a leading research partnership dedicated to improving patient safety across health and care systems. Bringing together academics, clinicians, patients, and industry partners, the collaboration focuses on generating evidence-driven insights to reduce harm and
enhance the quality of care.
Healthcare problem
Medication errors are common in primary care and cause significant patient harm, with over a billion prescriptions issued annually in England and errors contributing to more than seven times more avoidable deaths than in secondary care. Around 5% of UK general practice patients are exposed to potentially hazardous prescribing and about 12% lack appropriate monitoring, underscoring the need for continuous systems to identify and prevent medication safety risks.
Innovation
In partnership with Graphnet, NIHR PSRC developed the Safety Medication dASHboard (SMASH) - a digital tool that helps pharmacists and GPs reduce hazardous prescribing by flagging patients who may be at risk from the medicines they are prescribed in general practice.
The groups of patients identified by the application are based on a set of evidence based prescribing safety indicators, agreed by experts, which describe potentially hazardous prescribing situations. Once identified, the healthcare professional can open the patient’s medical record in their own system to determine how best to address and correct the issue.
NIHR Support
This project was a collaboration between the NHS (Greater Manchester Integrated Care Partnership), academia (The University of Manchester), and industry (Graphnet). Support and funding from the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC) were crucial to its success. The NIHR GM PSRC contributed essential research capacity and expertise, led by their Improving Medication Safety research theme.
Outcomes
SMASH was evaluated in 43 general practices covering a population of 235,595 people in Salford. It has now been rolled out regionally via the Greater Manchester Care Record (GMCR), covering 3 million people.
- 65% of prescribers agree or strongly agree that patients are at less risk of admission from unsafe prescribing using SMASH (User survey, 2024)
- 40% reduction in hazardous prescribing within 12 months of implementation during the Salford evaluation.
- Since launch on the GMCR in April 2023, there has been a further 7% reduction in patients at risk of harm by the end of 2023 (Source: ePACT2).
For relevant publications, click here.
