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NHS Priorities
The
priorities and planning guidance for 2003-2006 has been published. Improvement,
Expansion and Reform: the Next Three Years introduces a new system of
three-year planning and allocations. More detail on the key priorities is given
too - cancer, CHD, mental health and older people. NHS Chief Executive Nigel
Crisp has promised PCTs that they will be allowed 'local creativity' in
deciding how to spend their share of the £150bn investment over the next
three years. He said the guidance had been 'streamlined' to ensure PCTs enjoyed
real freedoms during the new planning cycle. There is too much to go over here
and the document is a must-read. See
www.doh.gov.uk/planning2003-2006/index.htm. Connect to the
opportunities!
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Changing NHS funding
arrangements
Also published is a consultation paper on changing
NHS funding arrangements. Reforming NHS Financial Flows: Introducing Payment by
Results sets out the next steps on the financial reforms announced in
Delivering the NHS Plan. The intention is to bring in Healthcare Resource
Groups (HRGs) by 2005/6. The NHS Confederation has described these proposals as
being as significant as the internal market reforms of the early 1990s. See
www.doh.gov.uk/nhsfinancialreforms/financialflowsoct02.htm.
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Older People's NSF -
toolkit
A toolkit for the Older People's NSF Champions has been
produced. See
www.doh.gov.uk/nsf/olderpeopletoolkit.htm. Loads of useful
stuff in here for companies. The ABPI have been involved in all of this and in
Part 1, Section 5 of the document, you will find a list of companies, contacts,
disease areas and the standards where they might be of assistance to NHS
folk.
NICE
Last month we reported on the response
by NICE to the Commons Health Select Committee (HSC) NICE Inquiry report. The
Government's response has now been published. See
www.doh.gov.uk/nice/govresp.htm.
On the timing of
NICE guidance, Government agrees with the HSC that appraisal should normally be
undertaken at, or shortly after launch. Ministers also say that scarce
resources are not a good reason for failure to implement. And on implementation
something new: "The Modernisation Agency has already begun work to design and
test a process for implementing NICE guidelines. The Agency will work with the
NHS bodies to develop a mechanism to support the incorporation of NICE's
recommendations in daily practice." A new Industry National Influencing Centre
(NIC) then in addition to CHI and its successor CHIA!
Also note, "The
Government and NICE agree with the Committee on the need to encourage
pharmaceutical companies routinely to collect cost-effectiveness evidence. The
establishment of NICE has in itself encouraged the collection of this
information, but the Government will use future opportunities to further the
cause."
Prescribing Issues
Prescribing issues
continue to be exposed in the Health Service Journal. Andrew Curl, the still
relatively new Deputy Director General at the ABPI, had a letter published
(3/10/02) following earlier comments about NHS growth money 'disappearing' into
increased drug spending. Using the 'usual' facts, he commented, "There is
strong evidence that spending on medicines reduces the overall cost of NHS
treatments, speeds up the delivery of healthcare and reduces or eliminates the
burden in other sectors of state expenditure, particularly social services.
More money should indeed 'disappear' into increased medicines spending." Useful
quotes!
Fine but then the HSJ follows that by a big feature on medicines
management in a later issue (10/10/02, pps 24- 29). The MM article is all about
how the 'soaring' drug bill should be tackled. It is generally negative and a
bit of a 'scare story' - stuff about the need for PCTs and hospitals to
establish joint formularies, make more use of independent advisers and docs
should stop seeing reps now that pharmaceutical adviser support is there in
PCTs…. "The rate of growth in the cost of medicines is clearly well in
excess of general inflation and the rate of increase in NHS funding….
Concerted and robust action is required to constrain the rate of
growth.
All NHS organisations need to consider their relationships with
the pharmaceutical industry and the access the industry has to overworked
prescribers…the continuing rising cost of treatment involving medicine is
a threat to the implementation of new developments." Shades of wonderful
secondary care, naughty bad primary care…. and GPs are idiots and need
protecting from nasty medical representatives.
Pharmacists -
increasing influence
The same issue also has an editorial on this,
"A staggering 1 per cent of UK gross domestic product now cascades down the
nation's throat each year in the form of medicines. There is every sign that
this flow will increase, thanks to an ageing population, a creative
pharmaceutical industry and the work of NICE. The NHS must do its bit by
getting the most out of its medication budget, which means removing drugs of
limited value, continuing the drive toward generic prescribing and reducing
waste. In both hospitals and primary care settings, pharmacist involvement can
cut costs and improve quality."
Nursing Times - Nurse Prescribing and
Medical Reps
Nursing Times has been running an interesting series of
articles on nurse prescribing. No. 1 of 4 (8/10/02, pps 43-44) was on
'assessing the data' - that's about finding evidence-based stuff and lists a
range of 'independent' sources. It also talks about material from
pharmaceutical representatives. "Research has shown that nurses have used
other, potentially less reliable, sources of information, in particular that
from pharmaceutical representatives, although they did not seem to be aware of
the potential bias in such materials. Nurse prescribers should always be aware
that a drug company's aim is to promote its products. Moreover the company may
have funded its clinical trials." Clever this eh? No. 2 in the series was on
local formularies (15/10/02, p 41). Did you know that the three main criteria
when compiling a formulary are: Efficacy - determined in clinical trials ('can
it work?'), Effectiveness - demonstrated in practice ('does it work?') and
Efficiency - deduced from assessment of costs and benefits ('is it worth
it?').
Wales
The Welsh Medicines Partnership, which
has been established in response to a recommendation from the Prescribing Task
and Finish Group, will support the All-Wales Medicines Strategy Group (AWMSG)
in developing and implementing a prescribing strategy for Wales. The first
meeting of the AWMSG was held last month and very interesting it was too! For
all industry folk in Wales, the minutes and papers are must-reads. Be informed.
The consultation paper Remedies for Success - A Strategy for Pharmacy in Wales
has also been launched.
Scotland
Scottish health
minister Malcolm Chisholm has signaled a radical change to the way health
services are shaped and funded, which seemingly will put power into the hands
of disease-based networks. Mr. Chisholm says he is committed to driving forward
the managed clinical network (MCN) model, which will move decision-making away
from organisations such as Health Boards. The changes likely to be a key part
of the health white paper, expected early in 2003. See
www.scotland.gov.uk/library5/health/chds-00.asp. Capitalise
on the new!
About the author
Therapy
specific - corporate newsletters, written by
Alan Jones of AJC Healthcare, are used by Sales Teams
throughout the UK Pharmaceutical Industry, as a source of crucial NHS
intelligence.
To discuss how your team could benefit from regular
up-to-date analysis of the NHS changes and issues that directly impact on your
business, please contact
Alan Jones of ajc healthcare (alan.jones28@virgin.net)
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