1.2.5 Prescribing in the NHS

Question 1

What is the most common patient level interaction in the NHS, covering all sectors of care: primary, hospital, public and community health?

Answer 1

Prescribing.

Question 2

What is the second highest area of spending in the NHS, after staffing costs?

Answer 2

Prescribing.

Question 3

Under the UK law, only appropriate practitioners can prescribe medicine in the UK. A prescriber is a healthcare professional who can write a prescription - this applies to both NHS prescriptions and private prescriptions - what are the two types of appropriate practitioners?

Answer 3

An independent prescriber and a supplementary prescriber.

Question 4

What is someone called who is able to prescribe medicines under their own initiative?

Answer 4

An independent prescriber.

Question 5

What is someone called who is able to prescribe medicines in accordance with a pre-agreed care plan that’s been drawn up between a doctor and their patient?

Answer 5

A supplementary prescriber.

Question 6

Who is responsible for assessing patient health and making clinical decisions about how to manage a condition, including prescribing medication?

Answer 6

Independent prescribers.

Question 7

Who is responsible for:
- Continuing car after an independent prescriber has made an assessment.

• Work with the independent prescriber to fulfil a clinical management plan.
• Can prescribe any medication, including controlled medicines for any condition within there competence under the agreed clinical management plan?

Answer 7

Supplementary prescribers.

Question 8

What are some examples of who can be an independent prescriber?

Answer 8

• Doctors: GPs or hospital doctors.
• Dentists.
• Nurse Independent prescribers.
• Pharmacist independent prescribers.
• Physiotherapists.
• Podiatrists.
• Therapeutic radiologists.
• Optometrists.

Question 9

What are some examples of who can be a supplementary prescriber?

Answer 9

• Nurses/midwives
• Pharmacists
• Optometrists.
• Podiatrists
• Physiotherapists
• Diagnostic and therapeutic radiographers.
• Dietitians.

Question 10

What had two parts:

• First, it sets out a range of measures for England, unless otherwise stated, to support innovation and better patient outcomes through improved access to the most transformative and cost-effective medicines.
• Secondly, it sets out a UK wide affordability mechanism under which Scheme Members make a financial contribution to the department for sales of Branded Health Service Medicines about the agreed allowable growth rate.

Answer 10

The 2019 Voluntary Scheme for Branded medicines Pricing and Access.

Question 11

What is the voluntary agreement to underwrite the cost of branded drugs sold to the NHS?

Answer 11

The 2019 Voluntary Scheme for Branded medicines pricing and Access.

Question 12

What does the 2019 Voluntary Scheme for Branded medicines Pricing and Access aim to improve?

Answer 12

The scheme aims to improve patient access to branded medicines and keep costs affordable for the NHS.

Question 13

What are the two parts of the 2019 Voluntary Scheme for Branded Medicines Pricing and Access taken together intended to do?

Answer 13

Promote innovation and access to cost effective medicines, commensurate to their value to patients and the NHS, while also supporting sustainability of NHS finances.

Question 14

What are taking centre stage in the drive to improve patient outcomes and reduce inappropriate variation in access to medicines, and are a key component in effective medicines optimisation.

Answer 14

Local formularies.

Question 15

What has been produced to help organisations review their own local formulary and ensure that its reflects local needs, reduced inappropriate variation in prescribing and allows uptake of innovative medicines and treatment following positive NICE technology appraisals in accordance with statutory requirements?

Answer 15

The NICE Medicines Practice Guideline (MPG) (formerly Good Practice Guidance) on Developing and updating local formularies.

Question 16

What does The NICE Medicines Practice Guideline (MPG) (formerly Good Practice Guidance) on Developing and updating local formularies sure that local formulary does what?

Answer 16

• Reflects local needs
• Reduced inappropriate variation in prescribing
• Allows uptake of innovative medicines and treatment following positive NICE technology appraisals in accordance with statutory requirements.

Question 17

What do local formularies ensure? (PQ)

Answer 17

Ensure evidence based and cost effective prescribing.

Question 18

What do local formularies across England vary in? (PQ)

Answer 18

The range of medicines included.

Question 19

Benefits of local formularies:

What do local formularies improve?

Answer 19

• Patient outcomes by optimising the use of medicines.
• Local care pathways.
• Collaboration between clinicians and commissioners.
• Quality - by reducing inappropriate variations in clinical care and facilitating access to cost effective medicines.

Question 20

Benefits of local formularies:

What do local formularies support?

Answer 20

• Inclusion of patient factors in decision making about medicines,
• supply arrangements of medicines across a local health economy
• financial management and expenditure on medicines across health communities.

Question 21

What is it that looks at the value which medicines deliver, making sure they are clinically effective and cost effective? It is about ensuring people get the right choice of medicines, at the right time, and are engaged in the process by their clinical team.

Answer 21

Medicines optimisation.

Question 22

The goal of medicines optimisation is to help patients do what?

Answer 22

• Improve their outcomes
• Take their medicines correctly
• Avoid taking unnecessary medicine
• Reduce wastage of medicines
• Improve medicines safety.

Question 23

(PQ) what is about the NHS achieve the best outcomes for patient, making sure medicines are taken correctly and the courses completed and having the right choice of medicines available?

Answer 23

Medicines Optimisation

Question 24

The NH is supportive of this medicines optimisation agenda and has responded to requests for better coordination, collaboration and alignment across health economies and nationally, by joining up this vital activity through the establishment of what?

Answer 24

Regional Medicines Optimisation Committees (RMOCs)

Question 25

Who has co-developed the intended role and function of RMOCs?

Answer 25

NHS England and NHS clinical Commissioners on behalf of CCGs, in partnership with NHS hospital representatives, NICE, NHS Improvement and representative bodies of the branded and generic pharmaceutical industry.

Question 26

What will RMOCs provide for the benefit of patients and the NHS?

Answer 26

Provide advice and make recommendations on the optimal use of medicines for the benefit of patients and the NHS.

Question 27

What Committees will bring together decision makers and clinician across the 4 regions of England to share best practice, understand the evidence base, coordinate action in order to reduce variation and improve outcomes and value?

Answer 27

The Regional Medicines Optimisation Committees.

Question 28

How many Regional Medicines Optimisation Committees are there?

Answer 28

4.