NHS Arden & GEM’s Medicines Optimisation team was engaged by the NHS England Midlands Region Specialised Commissioning team to provide a nine-month period of temporary embedded pharmacy programme management support.
By deploying an experienced pharmacist with specialised commissioning knowledge and medicines data expertise, the region was supported to continue delivering high quality and timely analysis for providers aligned to regional and national priorities. As well as continuing to deliver key areas of work, new projects were also implemented, including the regional incentive scheme to improve uptake of best value medicines.
The challenge
Regional Specialised Commissioning teams have a responsibility to ensure that the NHS and its patients receive the best value from and equitable access to medicines including specialised commissioned high cost drugs (HCDs).
When an internal secondment within the NHS England Midlands Region Specialised Commissioning team threatened to compromise the vital medicines information and insight provided to trusts, NHS Arden & GEM was engaged to backfill the role of Pharmacy Programme Manager. With a large Medicines Optimisation team comprising experienced pharmacists with specialist expertise in medicines data and analysis, Arden & GEM was able to put in place a nine month package of support beginning in December 2023.
Our approach
The Arden & GEM pharmacist was embedded into the regional team with an agreed list of priorities to support local trusts to meet national targets and get best value from medicines.
Four key areas of delivery, from the agreed priority list, are summarised below.
Analysing trends in medicines spend
A deep dive analysis of spend on chemotherapy and non-chemotherapy drugs was undertaken for the top five largest providers in the region. The analysis compared 2023/24 spend to the previous year and was presented to both providers and regional leads to improve understanding of historic spend and inform future planning.
Identifying uptake and barriers to accessing HCDs
Patients across the region should have equitable access to HCDs commissioned by NHS England. By analysing data within the NCDR and Blueteq, variation in uptake and access could be identified. As well presenting a report on the findings, next steps were also considered which could be factored into the existing monthly dialogue between the regional team and providers.
Supporting the regional 23/24 medicines value scheme
Medicines value incentive schemes are used nationally to save the NHS money by encouraging the safe, rapid uptake of drugs which are off patent. By working with the regional team to put appropriate processes and plans in place, local trusts have now been encouraged to participate in the newly implemented scheme.
This has encouraged quicker uptake of best value medicines.
Supporting providers to improve data
With a national focus on improving the quality of contract monitoring standards, a key regional priority was to work with colleagues to support trusts in improving data completion and quality. With expertise in data collation and manipulation, the Arden & GEM pharmacist was able to:
- support in developing regional parameters for monitoring
- work with team members to set meaningful improvement targets
- produce a slide deck for providers to help them understand the data issues for dispensing route populations
- work alongside colleagues to provide targeted support to trusts informed by a monthly tracker.
Outcomes
A nine month period of embedded support was successfully delivered by NHS Arden & GEM to the NHS Midlands Regional Specialised Commissioning team.
By deploying an experienced pharmacist with specialised commissioning knowledge and medicines data expertise, the region was supported to continue delivering high quality and timely analysis for providers from day one. Once established as a trusted member of the team, new projects could also be taken forward such as supporting the regional medicines value rapid uptake incentive scheme and regional data improvement plan.
At the end of the support period a seamless handover was undertaken to enable the team to utilise what was produced during the placement.
"The CSU made a valuable contribution to the work of the Midlands Specialised Commissioning Pharmacy team and supported the team to deliver our objectives. The CSU was able to deploy a pharmacist with prior experience in the area and they successfully fitted into the team."
Susanna Allen, Regional Head of Pharmacy Commissioning at NHS England Midlands Region
Find out more about our Medicines Management and Optimisation service.