The use of medicines is the most common therapeutic intervention in the NHS. Around 15-20% of a clinical commissioning group’s (CCG) money is spent on medicines.
Medicines management is a term which encompasses all aspects of the supply, use and disposal of medicines.
Medicines optimisation is about ensuring that the right patients get the right choice of medicine at the right time. It aims to help people get the most from their medicines, to take medicines correctly, avoid taking unnecessary medicines, improve medicines safety, and reduce wastage.
Effective medicines management and optimisation contributes towards:
- Improved health of individuals and the population as a whole
- Improved patient care and satisfaction
- Reducing medication-related harm
- Making best use of available resources
- Making better use of professional skills
- Delivering high quality, effective, safe healthcare
A formulary is a locally-developed document which lists the medicines that are deemed suitable for prescribing within the local NHS. It may also include some other products which can be provided on prescription e.g. dressings.
Birmingham and Solihull CCG is part of the Birmingham, Sandwell, Solihull and environs Area Prescribing Committee (BSSE APC). The committee also includes representatives from the local hospitals, the providers of mental health care and from community services.
Medicines that are included on the BSSE APC formulary are assessed by a committee of clinicians and medicines experts for their suitability for local use. The committee will generally consider medicines in terms of safety, clinical effectiveness, and cost effectiveness and patient factors. The CCG will also consider affordability.
All NICE-approved medicines (i.e. those with a positive NICE technology appraisal) are automatically included in the formulary.
Many medicines accepted for use will be prescribable by GPs, hospital doctors and other healthcare professionals who are qualified to prescribe, but some medicines will have local restrictions on their use. Some will be prescribable in limited circumstances, and some will only be prescribable in hospital settings. Some medicines won’t be included on the formulary at all. All prescribers are expected to take into account whether the medicine they intend to prescribe is on the formulary.
Pharmaceutical needs assessment
The Birmingham Health and Wellbeing Board (HWB) is responsible for developing a pharmaceutical needs assessment (PNA) for the city as a result of the Health and Social Care Act 2012. PNAs are a statutory requirement and must be updated at least every three years.
The aim of the PNA is to inform commissioners about the potential need for pharmacy-based services in an area and, where necessary, use this information to develop new services. It forms part of the wider Joint Strategic Needs Assessment (JSNA) that is produced for Birmingham.
The PNA provides an update on Birmingham’s three previous PNAs from its predecessor Primary Care Trusts (Birmingham East and North, Heart of Birmingham, South Birmingham), with some updated data included to address inconsistencies in the previous approaches. It includes data from an in-depth assessment of needs for pharmaceutical services in the Birmingham area. You can find out more here.
In January 2018 Solihull Council asked for comments on its draft Pharmaceutical Needs Assessment (PNA).
Comments have been taken into account and have helped create the recently published PNA 2018-2021, which will help ensure residents have good access to local pharmacy services.
The document looks at the current provision of pharmaceutical services across Solihull and whether they meet the current and future needs of residents, identifying any potential gaps in services.
NHS England will use the PNA when making decisions regarding applications for new or changes to, existing pharmaceutical services. It will also be used by NHS England, NHS Birmingham and Solihull Clinical Commissioning Group and the council to help make decisions about commissioning local pharmaceutical services. You can read the PNA here.