Please provide a summary of the project in non-specialist terms, which includes a description of the scientific background to the study (existing knowledge), the scientific questions the project will address and a justification of these. Please note that the description must be sufficient for the committee to take a reasonable view on the likely scientific rigour and value of the project.

Background to the research
Currently there are two General Practice (GP) practices within Slough Clinical Commissioning Group (CCG) that have the second and fourth highest rates of hypnotic prescribing in the area, which are above local and national averages. Pharmacists working within Slough CCG are independent prescribers who have been delivering medication review services to a range of patients within GP settings. One particular service that was delivered with success in 2013/14 involved an audit of hypnotic prescribing followed by an action plan to reduce prescribing and a further re-audit. The service, which could be described as a brief intervention, was reported to reduce the prescribing of hypnotics within the participating GP practice. There is evidence in the literature that brief interventions can address the prescribing of hypnotics. For example, research has shown that a simple letter intervention reduces benzodiazepine use in patients who have been using them long-term. In addition, a literature review pooling GP’s views on hypnotic prescribing has identified a range of barrier. These barriers, which can be thought of as determinants of behaviour change, span the sources of behaviour according to the ‘capability-opportunity-motivation’ model of behaviour change (COM-B). An existing pharmacist-led service model described below is going to be implemented in the two GP practices within Slough as describe above. The service is akin to a brief intervention and usesa template that was successfully delivered in 2013/14 to one GP practice within East Berkshire CCG.This project is a service evaluation of putting into place this existing service within these two practices.
Two GP practices that are currently prescribing hypnotics above the local and national rates have been identified by the CCG Lead Prescribing Support Pharmacist for Slough CCG to take part in this service evaluation. A practice meeting will be arranged with all prescribers within each setting. This would be in order to provide clear information about the rationale for the project as well as the detail relating to the project including the duration, the processes and the evaluation.
The service being implemented involves:
o Dispatch of a letter to patients meeting inclusion criteria:
? Explaining concern over the patient’s long-term use of named hypnotic
? Highlighting potential side effects relating to long-term use of named hypnotic
? Asking the patient to consider a reduction in their use
? Including advice on how to gradually reduce or cease use in a matter that is feasible and will decrease the likelihood of withdrawal symptoms
? Inviting the patient to discuss the issue further by booking into a pharmacist-led clinic or speaking with their own GP
o For patients receiving a letter and responding by seeing a practitioner:
? moving the medication from ‘repeat’ to ‘acute’ on the prescribing system
? limiting the hypnotic prescription to 56 days’ supply
o For patients receiving the letter but not responding:
? sending a short reminder letter three months after the initial letter
? informing the patient that the maximum length of supply was now 30 days in line with CD regulations
o Preparatory work within GP clinics: