Medicines Management · Prescribing Optimisation
BOOMERANG
Bringing Objective Optimisation of Medicines for Equality,
Reduced Admissions & NHS Gains
BOOMERANG is Eclipse's medicines optimisation programme: a structured, population-level approach that helps your system find the patients most likely to benefit from a medicines change, while making sure any monitoring or safety need is flagged at the same time. The aim is better outcomes, fewer avoidable admissions and better value from the medicines budget. Eclipse flags and supports; the decision to start, change, stop or refer always sits with the patient's NHS GP practice and commissioner.
Works alongside EMIS & SystmOne
Prescribing savings validated via ePACT2
Supports over 28 million NHS patients
Built for the NHS since 2006
The Challenge
The Medicines Challenge Facing Every ICB
Medicines are the most common healthcare intervention in the NHS and, after staff, the second largest area of spend. The cost to NHS commissioners for medicines, appliances and devices in England reached around £20.9 billion in 2024/25, with roughly half spent on medicines dispensed in the community. More than a billion prescription items are wasted each year, costing the NHS over £300 million in unused medicines alone.
At the same time, the 2021 national overprescribing review, Good for you, good for us, good for everybody, found that at least 10% of items dispensed in primary care are not needed or could be better managed without a medicine. Prescribing quality varies widely between practices and PCNs, eligible patients miss out on high-value medicines, others remain on treatments that should be reviewed, and monitoring for higher-risk medicines can fall behind safe intervals. BOOMERANG turns that variation into a prioritised, patient-by-patient action list, so the right patients are reviewed first.
How it works
Powered by SMART Triage
At the heart of BOOMERANG is SMART, our Structured Medication Automated Review Triage. SMART reports automatically surface the patients who need an enhanced review, so clinical time is focused where it adds most value. For each patient, SMART:
01
Identifies Suitability
Finds patients who may be suitable for the proposed optimisation, taking account of their conditions, current medicines and recorded results.
02
Flags Monitoring Needs
Highlights any additional monitoring or safety checks a patient would need before or after a change, so safety is built in from the start.
03
Supports Engagement
Enables your team to engage directly with the patient, supporting shared decisions and self-management.
Every recommendation is presented to the practice for clinical decision. Eclipse provides the analysis and the worklist, not the prescription.
Optimisation Programmes
Targeted Optimisation Across High-value Areas
Each workstream identifies a defined cohort, applies the relevant national guidance, and flags both opportunity and monitoring need. Programmes can be activated individually or as a coordinated regional set.
Patient Safety
DOAC Optimisation
Reviews anticoagulant dose against current renal function and indication, flagging potential under or over-dosing in atrial fibrillation.
Condition Optimisation
Statin Optimisation
Highlights higher-risk patients without established CVD who are not yet on lipid-lowering treatment, supporting NICE-aligned prevention.
Patient Safety
DMARD Safety
Identifies patients on drugs such as methotrexate whose shared-care blood monitoring is due or overdue.
Condition Optimisation
DPP-4 Optimisation
Reviews patients on DPP-4 inhibitors for right-drug, right-dose including renal dosing, and higher-value alternatives where indicated.
Condition optimisation
SGLT2i Optimisation
Identifies patients with diabetes, heart failure or CKD who may benefit from an SGLT2 inhibitor in line with NICE guidance.
Structured Reviews
Deprescribing
Identifies problematic polypharmacy where review may allow medicines to be safely reduced or stopped, in line with NICE NG5.
Condition Optimisation
GLP-1 Optimisation
Finds patients with type 2 diabetes who may be suitable for a GLP-1 receptor agonist for glycaemic and cardiovascular benefit.
Carbon Optimisation
Inhaler Optimisation
RIdentifies patients where a clinically appropriate switch to a lower-carbon inhaler is possible, supporting the Greener NHS agenda.
ONS Optimisation (oral nutritional supplements, food-first), Cost-effective Prescribing and Safety & Monitoring Updates run across all programmes.
In Depth
Structured Reviews, Shared-care Safety & Greener Prescribing
Structured medication reviews. BOOMERANG supports the Structured Medication Review requirements of the PCN Network Contract DES by helping your clinical pharmacists find and prioritise the patients who benefit most: those with problematic polypharmacy, severe frailty, recent admissions or falls, or on higher-risk medicines. It aligns to NICE NG5 and the national overprescribing review, and can incorporate recognised tools such as the NHSBSA polypharmacy comparators.
Shared-care safety monitoring. For shared-care medicines, BOOMERANG keeps safety visible. It flags patients whose monitoring for DMARDs or anticoagulants is due or overdue, so practices and PCN pharmacists can act before a gap becomes a risk. Methotrexate monitoring, for example, is a recognised patient-safety priority.
Greener prescribing. Inhaler propellants account for around 3% of the entire NHS carbon footprint, and about 13% within primary care, and dry powder inhalers can produce roughly 18 times less carbon than metered-dose inhalers. BOOMERANG's Carbon Inhaler Programme identifies patients for whom a clinically appropriate, lower-carbon switch is possible. Switches are only ever proposed where clinically suitable; respiratory control and patient preference come first, and the clinical decision stays with the practice.
Key benefits
Spend Less, Monitor Better, Improve Outcomes
Value
Reduce medicines spend
BOOMERANG identifies regional variation and the patients suitable for optimisation, helping your system release value from the medicines budget and reduce avoidable waste.
Safety
Personalised, safer care
Patients receive appropriate monitoring, review and follow-up in line with best-practice guidance, with safety needs flagged up front.
Outcomes
Improved outcomes
By acting on high-value optimisations and overdue monitoring, BOOMERANG supports better clinical outcomes and fewer avoidable admissions.
Evidence & Impact
Targeting a National-scale Opportunity, Locally
The national overprescribing review estimated that the cost of overprescribing to the NHS in England could be in the region of up to £1 billion a year, based on at least 10% of around 1.1 billion primary care items dispensed being unnecessary or better managed without a medicine. NHS England has separately set a target to save £1 billion on medicines by 2029. Against this national backdrop, BOOMERANG focuses your local effort on the patients where optimisation will have the greatest impact, with all impact measured against your own baseline.
Prescribing savings are validated using NHSBSA ePACT2 data; admissions avoidance is validated using NHS HES / SUS data.
Governance & Clinical Responsibility
Assured, & Clear About Who is Responsible for What
BOOMERANG is delivered by Eclipse in partnership with your ICB, PCNs and GP practices on Eclipse Live, an NHS Digital assured Patient Support Platform. Eclipse acts as a data processor under appropriate data sharing arrangements: NHS number and date of birth are hashed using an approved 256-bit algorithm, only de-personalised data is accessible through the interface, and access is restricted to NHS-email accounts with mandatory two-factor authentication.
Eclipse provides the analytics, the prioritised worklists and the engagement tools. Clinical responsibility, and all prescribing, deprescribing and referral decisions, remain with the patient's NHS GP practice and the commissioning NHS organisation. Eclipse does not prescribe, deprescribe or refer.
Eclipse Live has been built for the NHS since 2006 and gained NHS Digital assurance in 2017. The platform is ISO 27001 certified, holds Cyber Essentials Plus, and is compliant with the Data Security and Protection Toolkit, with EMIS IM1 and SystmOne interoperability. Eclipse's NHS work has been recognised nationally, including the HSJ Awards 2021 Connecting Services and Information Award for Covid Protect, delivered in partnership with Norfolk and Waveney. The full list of awards is on the Eclipse awards page.
Frequently asked questions
Does Eclipse prescribe or change my patients' medicines?
No. Eclipse identifies and prioritises patients and flags monitoring needs. Every prescribing, deprescribing and referral decision is made by the patient's NHS GP practice. Eclipse provides the analysis and the worklist, not the prescription.
What is the basis for the "up to £1 billion" figure?
The 2021 national overprescribing review estimated that overprescribing could cost the NHS in England around £1 billion a year, based on at least 10% of primary care items being unnecessary or better managed without a medicine. BOOMERANG helps your system target that opportunity locally.
How does BOOMERANG support our PCN Structured Medication Review requirements?
It helps your clinical pharmacists find and prioritise the patients who benefit most, in line with the Network Contract DES, NICE NG5 and the overprescribing review, including those with problematic polypharmacy, frailty or recent admissions.
How does it help with the Greener NHS agenda?
The Carbon Inhaler Programme identifies patients for whom a clinically appropriate switch to a lower-carbon inhaler is possible, supporting net-zero goals without compromising respiratory control.
How are savings and impact validated?
Prescribing savings are validated using NHSBSA ePACT2; admissions avoidance is validated using NHS HES / SUS data, always measured against your own baseline.
Can we run just one programme, or do we have to do all of them?
Programmes can be activated individually or as a coordinated regional set, so you can start with your highest-priority workstream and expand over time.