Medicines optimisation dashboard

Patients depend on medicines to help maintain health, prevent illness, manage chronic conditions and treat disease. Medicines are such an important part of what the NHS does to help patients and are therefore a very precious resource.

Over the years, much work has been done to ensure medicines-use is evidence based and cost effective. In previous years, there has been a focus on prescribing data (drug cost and volume) relating to drug choice and prescribing. However, until recently, relatively little work has been done outside of the academic setting on how well patients are supported to get the best outcomes from their medicines.

Evidence, both national and international, suggests that medicines use is “sub optimal”. That is why we supported and encouraged the development of principles to support medicines optimisation. Led by the Royal Pharmaceutical Society, but developed in collaboration with patients, the medical and nursing professions and the pharmaceutical industry, the principles offer a step change in the way that we think about medicines use in the NHS.

Medicines optimisation is about ensuring that the right patients get the right choice of medicine, at the right time. And by focusing on patients and their experiences, the goal is to help patients to: improve their outcomes; take their medicines correctly; avoid taking unnecessary medicines; reduce wastage of medicines; and improve medicines safety. Ultimately medicines optimisation can help encourage patients to take ownership of their treatment.

NHS England is working with patients, the pharmaceutical industry, royal colleges and others to encourage a range of improvements aimed at ensuring that patients get the support they need to get the most from their medicines.

This dashboard is part of the wider PPRS/Medicines Optimisation Programme, a joint programme of action by NHS England and the ABPI with the full support of Government through the Ministerial Industry Strategy Group.  The primary aim of the programme is to improve patient outcomes, quality and value from medicine use, guided by the principles of medicines optimisation, and to create a clinical pull to accelerate the optimal use of innovative, clinical and cost effective medicines which maximises the benefits of the PPRS Agreement.

Recent changes to the medicines optimisation dashboard

Further to the first full revision of the medicines optimisation dashboard in November 2015, following feedback received from users we have refreshed data for metrics where more up to date data is available. We hope this will further help CCGs to understand how well their local populations are being supported, to optimise medicines use and inform local planning. Click on the ‘Changes’ tab within the dashboard to find out which metrics have been updated.

The dashboard is presented to allow local NHS organisations to highlight variation in local practice and provoke discussion on the appropriateness of local care. It is not intended as a performance measurement tool.

In the autumn we will be launching a new look dashboard – see below ‘Evolution and development of the dashboard’.

The data for infliximab has been refreshed. It has been discovered that the data provided for inclusion in the August release was incorrect. This has been raised with the data provider and a new data set has been supplied

Evolution and development of the dashboard

Over its lifetime we have been evaluating and adapting the dashboard to make sure that it meets the needs of the people we want to use it. Over the last 9 months the dashboard metrics have been developed and refined based on the feedback you gave us on the prototype dashboard.

In the coming months we will be considering feedback and recommendations we received from two pieces of work commissioned by NHS England. Firstly, we have again evaluated how you use the dashboard and how you would like to see it develop. Secondly, we have consulted with a wide range of stakeholders to discover how the dashboard can help patients get the best outcomes from their medicines. Both of these reports will be published in the next three months. To hear when these reports are published and be kept up-to-date with any developments, please open the dashboard and click on ‘Subscribe to updates to Medicines Optimisation Dashboard’ on the menu page.

In November we plan to launch a new look dashboard which implements learning from feedback and evaluation and also aligns with the Right Care Atlas of Variation and the Innovation Scorecard. This will make it easier for our users to employ all three tools to help develop plans to ensure that all patients achieve the best possible outcomes from their treatment, wherever they live.

As this is ongoing work, we welcome any feedback. Your comments and suggestions for future iterations can be sent to England.MODashboard@nhs.net

More information

NICE Guidance: The National Institute of Health & Care Excellence (NICE) published guidance on medicines optimisation in March 2015.  This guideline offers best practice advice on the care of all people who are using medicines and also those who are receiving suboptimal benefit from medicines.

Regional Medicines Optimisation Committees

As a first step towards establishing Regional Medicines Optimisation Committees (RMOC), NHS England held a workshop, on 20 April 2016, with a broad range of NHS colleagues, to begin the process of agreeing the principles which will form the foundations of the committees. The main focus of the workshop was for attendees to discuss the following key issues that will underpin the establishment of the Committees:

  • What are the principles under which the RMOCs will operate?
  • What does the governance structure look like?
  • What does the membership of the Committees look like?
  • How will the work plan be allocated?

NHS Clinical Commissioners and NHS England will be working together to take forward the establishment of the Committees. Read a write up of the discussions.

The Accelerated Access Review: Interim Report (October 2015) highlighted the need to reduce unnecessary barriers to patients receiving the medicines they need. A long held concern is how new medicines, or some new indications of existing medicines, which are not evaluated by the National Institute for Health and Care Excellence Technology Appraisals (NICE TA) programme, are instead evaluated many times across the NHS.

NHS England has committed to achieving best value and patient outcomes from all medicines by helping to eliminate unnecessary duplication of effort from area prescribing processes, and refocus scarce resources towards implementation activities, through implementation of medicines optimisation as part of the Right Care programme.

To achieve this goal, NHS England is committed to the establishment of four Regional Medicines Optimisation Committees (RMOCs), operating together as part of a single system to eliminate duplication of activities.

NHS England is committed to establishing the committees through co-production which is why we have published a discussion paper. The purpose of the paper is to test the proposals for the establishment of the four RMOCs which have been developed working with a range of stakeholders.

Dr Keith Ridge quote: “On occasion, the NHS duplicates the process of evaluating medicines, particularly those which are not evaluated by NICE. Whilst it’s important to recognize that CCGs and trusts have clinical and financial duties to deliver, it must be possible to eliminate unnecessary duplication of effort, and instead focus local expertise on optimising outcomes from medicines use. I believe the best way to eliminate duplication of medicines evaluation is to bring those activities to regional level through the establishment of four Regional Medicines Optimisation Committees. This will ensure any evaluation activity is co-ordinated, done once only, and shared across the four NHS regions.

The Committees will also be key influencers on driving improvement and optimisation of medicines use more generally.

It is critical that NHS England and CCGs work closely together to deliver the committees if the potential benefits are to be delivered. Today’s publication of the Regional Medicines Optimisation Committees discussion paper represents an important step in the Committees establishment process. It provides an opportunity to test our current thinking and in the process gather some valuable feedback which will help shape their development going forward.”

You are invited to respond to the proposals generally, and/or on specific aspects, by email to england.RMOC1@nhs.net. The closing date for receipt of comments is 19 September, 2016.

Biosimilars