Scope and service

The Specialised Commissioning Medicines Optimisation Clinical Reference Group (CRG) works with experts from around the country to ensure that the NHS can achieve the best value for money when procuring high cost medicines. The CRG also finds ways to ensure patients take their medicines as directed to improve their health and outcomes.

More people are developing long-term, sometimes complex conditions, because they are generally living longer, resulting in further demands on NHS funding.

Against this background it is known that:

• Up to 50% of patients do not take their medicines as prescribed.
• Between 5% and 8% of all unplanned hospital admissions are due to medication issues.
• Medicines waste remains significant.
• According to medication safety data, the NHS could do better at reporting and preventing avoidable harm from medicines.
• Resistance to antimicrobials presents a very real and significant threat to modern health care.

The CRG supports the NHS by providing advice from a national expert forum on high cost medicines.

The CRG’s objectives are:

• To provide a forum for commissioners, providers and procurement pharmacists to share ideas about optimising the use of medicines included in the specialised commissioning ‘high cost drugs list’.
• To engage with clinical commissioning groups (CCGs), procurement, providers and the Commercial Medicines Unit in the development and delivery of a work plan for high cost medicines.
• To work in partnership with national medicines procurement groups, the National Pharmaceutical Supply Group (NPSG) and the Pharmaceutical Market Strategy Group (PMSG).
• To support the on-going roll out of home care reforms.

Our focus is on outcomes:

• Quality of care (efficacy and safety).
• Patient experience – working with patients to meet their needs.
• Value – working with CRGs to promote best value health gains from the use of medicines.
• Financial sustainability – appropriate investment by eliminating wasted resources.

The CRG follows the principles in the NHS Long Term Plan and remains flexible and adaptable as policy develops. It provides patient-centred advice to other clinical reference groups, commissioners, and providers that is focussed on quality, outcomes, safety and value.

Chair and membership

A voluntary Chair is appointed for a three-year term. Members are drawn from the seven NHS England regions and are voluntary appointments. Up to three patient body representatives and up to three representatives from affiliated bodies are eligible to join the CRG membership. There is also one accountable lead commissioner from NHS England

Charlotte Skitterall is the Chair of the Medicines Optimisation CRG. She is also Group Chief Pharmacist for Manchester University NHS Foundation Trust following her appointment to this post in October 2018.

She brings a wealth of experience to the NHS having worked as the Chief Pharmacist and Head of Medicines Management for the Trafford Health Economy and Chief Pharmacist at the University Hospitals of South Manchester.

Charlotte has held a number of roles across Greater Manchester and the North West region including Chair of the Greater Manchester Medicines Management Group, Chair of the Greater Manchester Formulary Group, Professional Secretary and Deputy Chair for the North West Chief Pharmacist Network. She is Chair of the Greater Manchester High Cost Drugs Group and North West Quality Assurance Oversight Committee. Charlotte has a close working relationship with the University of Manchester, overseeing pharmaceutical support at the Clinical Trials Unit, and is also a member of the University’s Advisory Board for the Division of Pharmacy.

CRG membership

Documents

• Commissioning Medicines for Children in Specialised Services