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National Medicines Procurement changes, future direction and how do we add value ?


NHS CMU Pharmacy Non-Executive Board National Pharmaceutical Supply Group SHA Pharmacy Procurement Groups Branded Medicines Therapeutic ... Mark Hackett CEO ... – PowerPoint PPT presentation

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Title: National Medicines Procurement changes, future direction and how do we add value ?

National Medicines Procurement changes, future
direction and how do we add value ?
  • Andrew Alldred
  • Clinical Director / Director of Pharmacy
  • Harrogate NHS FT
  • Chair National Pharmaceutical Supply Group
  • November 2011

  • National Medicines Procurement Structure
  • What are the roles of the groups?
  • Are they effective?
  • How will they impact on the future NHS?

  • Context
  • Some of the opportunities and challenges
  • Where does the agenda sit ?
  • First 12 months of a new NPSG
  • Is the system effective ?
  • Where next .?

The context
Equity and Excellence Liberating the NHS
  • Patients and Public First
  • No decision about me without me
  • Lots about choice
  • Any qualified provider
  • Closer integration with social care
  • Personal budgets
  • Focus on LTCs , Cancer, Stroke etc

Equity and Excellence Liberating the NHS
  • Improving Outcomes
  • Focus on outcome measures not process targets
  • Quality stds NICE continues
  • Value based pricing of medicines
  • Better access to drugs and greater VFM
  • Cancer drug fund
  • Payment according to performance (CQUINS)

Equity and Excellence Liberating the NHS
  • Autonomy / Accountability / Legitimacy
  • Localism
  • Clinical commissioning groups
  • Abolishment of SHAs and PCTs
  • Joint social and health care working
  • NHS Commissioning Board
  • Stronger Regulation (CQC / Monitor)
  • Public Heath protected

Equity and Excellence Liberating the NHS
  • Cutting Bureaucracy and Improving Efficiency
  • 20 billion savings by 2014
  • 45 reduction in management costs
  • Radically delayer and simplify NHS
  • Reduce DoH functions
  • Reduce number of ALBs
  • QIPP staying

The Conundrum
PATIENT CENTRED Greater Demand Greater
Setting out the Opportunities and Challenges (1)
  • Patient / Clinical Focus
  • Absolute Patient Focus
  • Supply chain stability and security
  • Purchasing for Safety
  • Homecare
  • Delivery of the QIPP agenda to deliver efficiency
  • National / SHA / Local
  • Back office functions and procurement role

Setting out the Opportunities and Challenges (2)
  • Profile and building relationships
  • Engagement of Chief Pharmacists in this agenda
  • Continuing to raise the profile of medicines
  • Developing relationships with third parties
  • NPSG and PMSG role development
  • Maintaining strong relationships with Pharma
  • Collaboration and not Competition ?
  • With all stakeholders

Setting out the Opportunities and Challenges (3)
  • Sharing Best Practice and Innovation
  • Being ahead of the game
  • Sharing best practice
  • Innovative procurement programmes
  • Maximise clinical engagement
  • New Cancer Drug Fund
  • PPRS and value based pricing

  • So where does this agenda
  • sit in the NHS ?

Collaborative Clinical Medicines Procurement in
England Organisational Chart from 2010
National Committees/Groups
Specialist Support
Procurement Groups
NHS Trusts PCT Pharmacy Networks Clinicians
Clinical Networks PCT Commissioners Specialised
NHS CMU Pharmacy Non-Executive Board
Commercial Support Units ???
6 x Regional SCEP Groups Generic Medicines
National Pharmaceutical Supply Group
NHS Commercial Medicines Unit
Pharmaceutical Market Support Group
SHA Pharmacy Procurement Groups Branded
Medicines Therapeutic Rationalisation QIPP
National Homecare Medicines Committee Pharmacy
Business Technology Group Generic Medicines
Sub-Group Branded Medicines Sub-Group Transitional
Products Sub-Group Specialist Medicines
NHS Pharmacists (Procurement, QA, Production,
Medicines Information and Clinical)
Core Functions of NPSG
  • To ensure safe and cost effective purchasing and
    use of medicines
  • Support (and challenge) policy development
  • To develop the strategy and support delivery
    through PMSG, Regional Groups and Trusts etc
  • Support the development of strong relationships
  • Ensure Chief Pharmacist engagement
  • NPSG agenda will reflect this backdrop being
    directly influenced by the national NHS policy

Who is on the group
  • Chairman
  • Andrew Alldred
  • Membership
  • PMSG Chairman and two other PMSG members
  • QC Pharmacist representing National
    Pharmaceutical QC Group
  • PCT Pharmaceutical Adviser
  • PCT Commissioning Pharmacist
  • Northern Ireland, Scotland Wales
  • Department of Health representative
  • NHS CMU General Manager, Principal Pharmacist
    Lead Category Managers (2)
  • SHA Commercial Support Unit/CPH representative
  • NHS Trust Chief Pharmacists representing 10 SHA
    pharmacy networks
  • ATHP Representative
  • National Advisory Board for Hospital
    Manufacturing Representative

Chief Pharmacists
  • Philip Dean (North East)
  • Alastair Gibson(North West)
  • Ian Bournes (SE Coast)
  • Ian Cawthorne (Yorks)
  • Martin Shepherd (East Midlands)
  • Bruce McElroy (West Midlands)
  • Carol Farrow (East of England)
  • Sarla Drayan (London)
  • Ian Clacher (S West)
  • Dennis Lauder (South Central)
  • Ann Jacklin (ATHP)
  • Maggie Dolan (Scotland)
  • Mike Scott (Northern Ireland)
  • (Wales) to be confirmed

What have been the Medicines Procurement
Priorities for NPSG?
  • Three Priorities for 2010/11and 2011/12
  • QIPP and Collaborative Procurement
  • Homecare
  • Chief Pharmacist engagement and support

The Financial Environment and QIPP
  • UK Health Economy and Public debt
  • Efficiencies in Trusts around 20-25 over 4-5
  • 15-20 Billion for NHS (front line protection!)
  • Focus on Medicines Spend
  • Focus on Medicines Management Services
  • Medicines Savings Opportunities
  • QIPP Opportunity for savings
  • 15 growth in secondary care
  • Flat growth in primary care

UK Annual Drug Expenditure (m)
Data Source IMS
(No Transcript)
Initial focus around QIPP
  • Maximise the opportunities through collaborative
    medicines procurement
  • Develop therapeutic tendering programmes
  • Share best practice and innovation
  • Reduce variation
  • Savings plus quality plus safety
  • Requires Chief Pharmacist support

National Homecare Review
  • Chair Mark Hackett CEO Southampton NHS
    Foundation Trust
  • Report in 2011
  • Policy development and recommendations to NHS
  • Data / information handling etc
  • Opportunities in relation to QIPP
  • Appropriate models of care
  • Relationship with other supply routes

Chief Pharmacist Engagement
  • Going forward going to be crucial
  • Multiple challenges within the system at all
  • Lots of opportunities through utilising medicines
    procurement functions e.g. branded medicines and
    therapeutic tendering
  • Clinical services and medicines procurement
    delivering quality patient care

Importance of Chief Pharmacist Engagement
  • So - are we effective ?

In many ways Yes ?
  • Patients are getting their medicines
  • Outcomes are improving
  • Safety is improving
  • New medicines are being developed
  • People are living longer
  • We are saving money
  • Evidence of excellent collaboration
  • Good clinician and patient engagement

But are we really getting it right .?
  • Medicines Optimisation
  • Still significant waste in the system
  • Still high numbers of medicines related incidents
  • Still significant admissions caused by medicines
  • Still 50 of patients dont take medicines as
  • Still patients say they dont get enough or the
    right information

The next 12 months ..
  • Adjust in line with the environment
  • Making sense of the NHS reforms / environment
  • Dialogue with CPhO and CMU Board re direction
  • Continue to influence policy makers at DH e.g.
  • Medicines optimisation
  • Branded Medicines Strategy / effective medicines
    contracting (incl national contracting)
  • Value Based Pricing
  • Homecare
  • Engagement with NHS Commissioning Board

The next 12 months..
  • Continued engagement with QIPP Agenda
  • Support Medicines Optimisation Agenda
  • Support Medicines Safety Agenda
  • Continue medicines efficiencies
  • Personalised medicines agenda
  • Pharmaceutical Supply Chain Review ?
  • Supply chain options
  • Distribution models (inc homecare, outsourcing,
    links with community)
  • Shortages
  • Emergency Preparedness
  • E.g. Flu

The next 12 months
  • Access and Affordability of New Medicines
  • Managing shortages
  • Commissioning decisions
  • PPRS Value Based Pricing
  • Cancer Drug Fund
  • Other Providers competition / partnerships

Delivery through.
  • NPSG / PMSG and CMU Board and DoH
  • Continued engagement
  • Policy Makers to NPSG
  • Policy alignment
  • Confirmation of strategic direction
  • Strategic Planning session early 2012
  • Commissioned work
  • Joint programmes of work

What is our general approach?
  • We should continue to expect, be ready for and be
    well prepared for challenges that lie ahead
  • We should be on the top of our game
  • We should not be defensive
  • We should continue to deliver on what we are good
  • VFM
  • Quality
  • Safety
  • We should make the most of the opportunities, if
    we dont others will

  • Broad agenda but well positioned to influence
  • Cohesive strategy developing
  • Requires Chief Pharmacist Leadership
  • NPSG / PMSG to support Chief Pharmacists
  • Shift of emphasis around medicines optimisation
  • Use medicines procurement to deliver key