Consortia Board Guide July 2011 v1.1

7/28/2019 Consortia Board Guide July 2011 v1.1

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1 A guide for Commissioning Consortia Boards

An organisationalcompetency framework

to ensure the effectivedelivery of medicines

management functions andresponsibilities

A guide for Commissioning Consortia BoardsJuly 2011 Version 1.1


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Acknowledgements About the National PrescribingCentre (NPC)

About the author

Author Cathy Picton

Project lead Gill HarveyHead o Medicines Management

Production Stephen BeerWeb and Publications O cer

Merissa BellewWeb and Publications Manager

Published by: National Prescribing CentreGround Floor

Building 2000Vortex CourtEnterprise WayWavertree Technology Park LiverpoolL13 1FB

Tel No: 0151 295 8691Fax No. 0151 220 4334

Website: www.npc.nhs.uk

National Institute or Health & Clinical Excellence2011

The NPC is an NHS organisation ormed in 1996 andunded by the Department o Health. In April 2011

the NPC integrated into the National Institute orHealth and Clinical Excellence (NICE). The NPC andNICE already has a history o close working and thisintegration will add urther strength to achieve theNPC aim, which is:

to support the NHS, and those working for it,

to improve quality, safety and value for money, in

the use of medicines for the bene t of patients

and the public.

The NPC work programme is designed to supportthe speci c needs o commissioners, providers andindividuals with an involvement in prescribing andmedicines use. In order to improve the exibility,accessibility and timeliness o its support, theNPC provides key NHS audiences with a rangeo choices or accessing outputs. This includesmaking use o opportunities provided by electroniclearning environments, as well as more traditionalapproaches. Additional materials to complementthis guidance are available through the NPCwebsite: www.npc.nhs.uk

Catherine Picton is a pharmacist with a widerange o experience in healthcare delivery andmanagement. She can be contacted by email [email protected]


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I am pleased to introduce you to this OrganisationalCompetency Framework covering the skills and competenciesneeded by commissioning consortia in order to ul l theBoards responsibilities or medicines management.

Why is medicines management so important?

The prescription o a medicine is the most requent therapeuticintervention in primary care; most sel care is supported bydirect access to a medicine and in hospital settings the use o specialised medicines has trans ormed the treatment o manydiseases. To put it another way, we would not have the healthservices we have today without access to modern medicines.

Great progress has been made in improving the quality andcost efectiveness o prescribing in the 20 years since theImproving Prescribing Scheme was introduced - we havemuch to celebrate but much more to do. We must nowbuild on the successes o the Improving Prescribing Schemeand embrace the idea that getting medicines use right oroptimising the use o medicines has the potential to not just improve outcomes or our patients but, in many cases, tosupport us in redesigning care pathways in ways which reduceoverall system costs. We have no alternative but to seek boththese goals i we are to meet the needs o patients within theresources which will be available to us in the uture.

Alongside these opportunities we must also recognise thenancial risk - around 14% o consortia budgets will pay or

medicines, not just those directly prescribed but also many o the medicines used in hospital.

So the task ahead is much more than just controllingprescribing costs, it is about realising the ull bene ts thatoptimal medicines use can deliver or our patients and or ourHealth Service.

Given this context it must be apparent that everycommissioning consortium will require access to the skills and

competencies needed to optimise the use o medicines andto ensure that the expected patient outcomes and pathwayredesigns are delivered. This Skills and Competency Framework and Sel Assessment Tool, which has been co-produced withcolleagues rom consortia, PCTs, the National PrescribingCentre and DH, is designed to ass ist Consortia Boards to assurethemselves that this is the case.

I hope you will nd it help ul and would welcome eedback [email protected]

Peter RoweNational QIPP Lead or Medicines Use and ProcurementDepartment o HealthRichmond House - Room 20779 WhitehallSW1A 2NS

Email: [email protected]

PA: [email protected]

Foreword


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ARE THERE ANY OTHER SUPPORTING RESOURCES?

Appendix 1 contains a quick diagnostic tool based on the

competency ramework. Boards can use the diagnostic todetermine where they are currently.

A comprehensive list o key medicines management

unctions which underpinned the development o thisramework is downloadable as a Word le. Boards can

use this to give them a detailed overview o the unctionscurrently delivered in the NHS.

HOW CAN THIS DOCUMENT HELP CONSORTIA BOARDS?

Commissioning Consortia must have medicines

management expertise to optimise medicines usage andimprove patient outcomes in all the services that theycommission on behal o their patients.

This resource provides Commissioning Consortia Boards

with a ramework o competencies that a Consortiumneeds to have, or have access to, to ensure the efectivedelivery o medicines management unctions. The

ramework is based on a comprehensive resource 2 alreadyused by PCTs and SHAs in transition planning.

Although Consortium structures will vary across England,

all Consortia Boards must have a thorough understandingo these competencies when they orm their organisations.

Consortia Boards should use this ramework, initially in

conjunction with an experienced PCT Head o MedicinesManagement or SHA pharmacy lead to:

help de ne medicines management needs in anyemerging Consortium and, where appropriate, ederationso Consortia

assist with recruitment and the development o servicespeci cations or medicines management services (orthe recruitment o individuals) with the appropriatecompetencies

identi y gaps in Consortium knowledge and sk ills, andhighlight training and development requirements

Over time the ramework can then be used to reviewConsortium per ormance in delivering management

unctions and responsibilities.

In secondary care,

about 60% of medicines

expenditure is on

high cost medicines

excluded from the

national payment by

results (PbR) tariff.3

These medicines require

active management to

ensure best value for

patients and the NHS.

Recent researchshows that 3-4%

of UK hospitaladmissions are a result

of avoidable medicinerelated illness.And

between eleven and thirty percent of theseadmissions result from

patients not using

their medicines asrecommended by theprescriber. 1


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This ramework de nes thecompetencies necessary todeliver efective medicinesmanagement services andoutcomes or patients. The ramework containssix competencies thatConsortia need to develop(illustrated in gure 1).

Each competency has anoverarching statement,which gives an overviewo what the competencyis about, and numbered

supporting statements. Thestatements are indicatorswhich would demonstratethat a Consortium isdemonstrating thatcompetency. The sixcompetencies and theirindicators can be ound inthe table on pages 6-7.

All the competencies andindicators in this ramework

relate speci cally to thedelivery o medicinesmanagement unctions.

COMPETENCY FRAMEWORK FORCOMMISSIONING CONSORTIA 1

Has astrategic

overview

2Establishes

effectivepartnerships

4Provides

medicinesoversight

6Supports

and developspeople

5Has

medicinesexpertise

A Commissioning

Consortiumdelivering effectivemedicines

management3

Commissionsservices that

optimise the useof medicines

Figure 1: Overview of the sixorganisational competencies


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1. HAS A STRATEGIC OVERVIEW

The Consortium has leadership and a clearly communicated strategy for optimising the use and

management of medicines in a health economy

1. Has a clear leadership role for medicinesmanagement linked to senior colleagues in allpartner organisations and provider services

2. Ful ls the requirements of the NHS Constitutionwith regard to patients access to medicines

3. Has clear and accessible processes forprioritising investment in healthcare interventionsand services that involve medicines

4. Gives the public and patients the opportunityto help shape services and local systems thatuse medicines, in the context of using NHSresources most effectively

5. Effectively manages the entry of new medicines,or new indications for existing medicines, intothe health and social care economy

6. Has systems that comply with statutoryregulations, and can stand up to legal challenge

7. Delivers the Quality, Innovation, Productivityand Prevention (QIPP) agenda in relation toprescribing, medicines usage and procurement

8. Has robust mechanisms for managing therisks associated with medicines (clinical, safety,

nancial, and reputational)

9. Has a consistent approach to medicines acrossservices, whether commissioned directly by GPConsortia or by other organisations supportingGP Consortia

10. Knows how medicines are priced, fundingallocated, how the nancial ows through theNHS are structured, and how this impactson budgets across the health and social careeconomy

11. Supports national policy development andimplementation regarding medicines, andunplanned emerging issues

2. ESTABLISHES EFFECTIVEPARTNERSHIPS

The Consortium links with local, regional and national partner organisations to ensure a co-ordinated approach to medicines usage across

health and social care

12. Partners and plans effectively with Local Authorities, other GP Consortia and the NHSCommissioning Board

13. Engages fully with local Health and WellBeing Boards, Healthwatch bodies, patientparticipation groups and community partners

14. Understands the structure and functions of all agencies/services contributing to healthimprovement, and the impact on patients andtheir medicines as they move through careinterfaces

15. With partner organisations, uses local decision-

making groups to make evidence-informeddecisions about the effective use of medicines

16. Works with other Consortia to identify wherecollaboration and decision-making on a widerfootprint may be appropriate

17. Works with all stakeholders to ensure the safetransfer of medicines and information whenpatients cross interfaces of care

18. Understands, develops and works withlocal contractor services to optimisemedicines usage, for example, dispensingpractices, community pharmacy, dentistryand ophthalmology services, and appliancecontractors

19. Has governance processes in place, andcodes of conduct that set out how consortiacommission or interact with commercial bodies(in relation to medicines), and monitors them

20. Gives proper consideration to working inpartnership with commercial organisations(such as pharmaceutical companies) to improveoutcomes for patients

3. COMMISSIONS SERVICES THATOPTIMISE THE USE OF MEDICINES

When commissioning services or redesigning pathways, the Consortium recognises the potential that optimising medicines usage hasto improve patient outcomes and increase

productivity 21. Establishes and maintains a full understanding

of current and future health needs, and servicerequirements involving medicines

22 . Where there is discretion to commission locallyenhanced services involving medicines, doesthis equitably based on patient need

23. Understands what patients want, and need,from services involving/using medicines

24. Involves medicines management expertise atthe start of, and throughout, the development

of commissioning speci cations and services(or changes to existing services)

25. Ensures that the Commissioning OutcomesFramework, indicators and commissioningguidelines (developed by NICE for theNational Commissioning Board) inform thecommissioning, and management of servicesusing medicines

26. Ensures that service speci cations supportproviders to engage with patients to help themobtain the most bene t from their medicines,minimise the risk of harm and minimisemedicines wastage


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5. HAS MEDICINES EXPERTISE

The consortium has access to the full rangeof skills, expertise and knowledge necessary to deliver the safe, legal and effective use of

medicines across the healthcare economy in order to improve patients outcomes

35. Understands the legislation and systemsgoverning the purchasing, prescribing,administration, supply and disposal of medicines, and their impact on how servicescan be developed and delivered

36. Accesses and interprets horizon scanninginformation for new medicines to identify futuretrends in medicines usage; for example, toforecast budget expenditure, redesign servicesor develop commissioning agreements

37. Has the skills necessary to access and utilisequality summaries of evidence to help shapeand inform local decision-making processes

38. Knows how to interpret, and where appropriatechallenge, the evidence-base underpinning theuse of medicines

39. Recognises the need to access clinicalknowledge and skills, where it is needed

40. Has appropriate pharmaceutical knowledge,knows how to assess pharmaceutical need,and understands pharmaceutical public health

41. Has an overview of the implications of IT developments on service delivery relating tomedicines through, for example, electronicprescription services , electronic transmission of prescriptions and GP clinical systems

42. Understands the structure and functions of the NHS, how they are evolving and theirimplications for service delivery

43. Understands the role and functions of NICE,the NHS Commissioning Board, Monitor andthe Care Quality Commission (CQC) in relationto GP Consortia and the cost effective use ofresources, with a focus on medicines

4. PROVIDES MEDICINESOVERSIGHT

The Consortium Board provides oversight, governance and assurance of safe, effective and affordable medicines usage in provider services

27. Identi es and accesses prescribing data andinterprets it in order to plan for, monitor, audit

and manage medicines usage and expenditure

28. Challenges inappropriate variation in practice inmedicines use and shares and promotes goodpractice

29. Has integrated clinical and corporategovernance, providing assurance of controland safety in the use of medicines (for examplethrough policies, training and audit)

30. Encourages and supports reporting of, andshared learning from, serious incidents andnear misses

31 . Ensures the safe management of controlleddrugs in line with regulations

32. Identi es, and has mechanisms for themanagement of, unsafe or poor practice, andshares the learning from any investigations

33. Monitors medicines usage, using qualitymarkers and key performance indicators andfeeds back to providers

34 . Shares and routinely benchmarks medicines-related performance against othercommissioners or service providers

6. SUPPORTS AND DEVELOPSPEOPLE

The Consortium ensures that people working in medicines management roles are competent, and supports and develops individuals working for theConsortium

44. Ensures clear professional and managerialaccountability within the organisationfor all medicines management roles andresponsibilities

45. Recruits and retains, or accesses, theappropriate skill mix which takes account of emerging roles and organisations

46. Understands how health and social careprofessionals working with medicinesare trained, their skill base and how theircompetence is maintained and developed

47. Contributes to future workforce planning anddevelopment initiatives

48. Supports and helps develop clinical andprofessional leadership networks for medicinesmanagement

Care Quality Commission investigationsinto failing services continue to highlightpoor medicines management services as

a contributory factor in some cases. 4, 5


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Accountable Of cer for Controlled Drugs: Under the Departmentof Healths legislation governing controlled drugs, all NHS trusts andindependent (private or voluntary) hospitals that are designated bodiesmust appoint an accountable of cer to be responsible for the safe

management and use of controlled drugs in their organisation. (CareQuality Commission: www.cqc.org.uk )

Area Prescribing Committees (APC): An area prescribing andmedicines management committee (APC) is a strategic local groupwhose members are clinicians, providers and commissioners workingtogether to ensure that patients have safe and consistent accessto medicines in the context of care pathways which cross multipleproviders. See Managing medicines across a health community: A ftness for purpose framework for area prescribing and medicines management committees (NPC 2009)

Better Care Better Value (BCBV) indicators: Aimed primarily atcommissioners and acute hospital providers, BCBV indicators reveal thepotential to make signi cant cash or resource savings whilst improvingquality

Care Quality Commission (CQC): the independent regulator of healthand social care in England www.cqc.org.uk

CfWI (Centre for Workforce Intelligence): The CfWI is the newnational authority on workforce planning and development providingadvice and information to the NHS and social care system

Commissioning Outcomes Framework: A set of overarchingindicators that will frame the NHS Commissioning Boards responsibilities(see below for NHS Commissioning Board)

CQUIN: the Commissioning for Quality and Innovation (CQUIN) payment framework , which makes a proportion of providers income conditionalon quality and innovation

ePACT: ePACT is a service for pharmaceutical and prescribing advisorswhich allows on-line analysis of the previous sixty months prescribingdata held on NHS Prescription Services Prescribing Database

Framework for Joint Working with the PharmaceuticalIndustry Beyond Sponsorship : A toolkit designed to help the NHSmeet the challenges of a rapidly evolving health service by providingpractical advice and tools that support joint working projects with the

pharmaceutical industry

GMS QOF: General Medical Services Quality & Outcomes Framework

GP Commissioning Consortia: as de ned in the Department of HealthWhite Paper Equity and excellence: liberating the NHS , these are consortiaof GP practices, working with other health and care professionals, and inpartnership with local communities and local authorities, to commission thegreat majority of NHS services for their patients

HealthWatch England: an independent consumer champion within theCare Quality Commission

Individual Funding Request (IFR): An IFR is a request to a PCT tofund healthcare for an individual who falls outside the range of servicesand treatments that the PCT has agreed to commission. Supporting

rational local decision-making about medicines (and treatments). A handbook of good practice guidance (NPC, 2009)

Joint Strategic Needs Assessment ( JSNA ): a process that identi escurrent and future health and wellbeing needs in light of existing services,and informs future service planning taking into account evidence of effectiveness

Local decision-making (LDM) programme: NPCs programme ofongoing support for local NHS organisations ( http://www.npc.nhs.uk/

local_decision_making ) linked to the NHS Constitution

Medicines Management: A system of processes and behavioursthat determines how medicines are used by patients and by the NHS.(Modernising Medicines Management, NPC 2002 )

Medical Education England (MEE): MEE is an Independent AdvisoryNon-Departmental Public Body with a remit for medicine, dentistry,pharmacy and healthcare science

Monitor: The independent regulator established in January 2004 toauthorise and regulate NHS foundation trusts. www.monitor-nhsft.gov.uk

Useful links
http://www.npc.nhs.uk/local_decision_making/resources/apc_guide_2009_complete.pdfhttp://www.npc.nhs.uk/local_decision_making/resources/apc_guide_2009_complete.pdfhttp://www.npc.nhs.uk/local_decision_making/resources/apc_guide_2009_complete.pdfhttp://www.npc.nhs.uk/local_decision_making/resources/apc_guide_2009_complete.pdfhttp://www.institute.nhs.uk/quality_and_value/high_volume_care/better_care_better_value_indicators.htmlhttp://www.npc.co.uk/local_decision_making/resources/handbook_complete.pdfhttp://www.institute.nhs.uk/world_class_commissioning/pct_portal/cquin.htmlhttp://www.institute.nhs.uk/world_class_commissioning/pct_portal/cquin.htmlhttp://www.institute.nhs.uk/world_class_commissioning/pct_portal/cquin.htmlhttp://www.institute.nhs.uk/world_class_commissioning/pct_portal/cquin.htmlhttp://www.institute.nhs.uk/world_class_commissioning/pct_portal/cquin.htmlhttp://www.nhsbsa.nhs.uk/815.aspxhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_119052.pdfhttp://www.nhsemployers.org/PayAndContracts/GeneralMedicalServicescontract/qof/Pages/QualityOutcomesFramework.aspxhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117352.pdfhttp://www.cqc.org.uk/http://www.npc.co.uk/local_decision_making/resources/handbook_complete.pdfhttp://www.npc.co.uk/local_decision_making/resources/handbook_complete.pdfhttp://www.npc.co.uk/local_decision_making/resources/handbook_complete.pdfhttp://www.npc.co.uk/local_decision_making/resources/handbook_complete.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_081267.pdfhttp://www.npc.nhs.uk/developing_systems/intro/resources/library_good_practice_guide_mmmbook2_2002.pdfhttp://www.mee.nhs.uk/what_we_do.aspxhttp://www.mee.nhs.uk/what_we_do.aspxhttp://www.npc.nhs.uk/developing_systems/intro/resources/library_good_practice_guide_mmmbook2_2002.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_081267.pdfhttp://www.npc.co.uk/local_decision_making/resources/handbook_complete.pdfhttp://www.cqc.org.uk/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117352.pdfhttp://www.nhsemployers.org/PayAndContracts/GeneralMedicalServicescontract/qof/Pages/QualityOutcomesFramework.aspxhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_119052.pdfhttp://www.nhsbsa.nhs.uk/815.aspxhttp://www.institute.nhs.uk/world_class_commissioning/pct_portal/cquin.htmlhttp://www.npc.co.uk/local_decision_making/resources/handbook_complete.pdfhttp://www.institute.nhs.uk/quality_and_value/high_volume_care/better_care_better_value_indicators.htmlhttp://www.npc.nhs.uk/local_decision_making/resources/apc_guide_2009_complete.pdf


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1. National Institute for Health and Clinical Excellence (2009) costingstatement: Medicines adherence: involving patients in decisionabout prescribed mecdicines and supporting adherence.

http://guidance.nice.org.uk/CG76/costingstatement/pdf/english

2. National Prescribing Centre (2010). Ensuring the delivery of prescribing, medicines management and pharmacy functionsin primary and community care. An organisational competencyframework and key functions checklist. Working document.

http://www.npc.nhs.uk/qipp/resources/competency_framework. pdf

3. NPC (2008). What you need to know about prescribing, thedrugs bill and medicines management.

http://www.npc.nhs.uk/resources/nhs_guide_for_managers.pdf

4. Healthcare commission. Investigation into Staffordshire Ambulance Service NHS Trust. April 2008.www.jrcalc.org.uk/hcr0408.pdf

5. Care Quality Commission (2010). Investigation into the mentalhealth care for older people provided by Devon Partnership NHS

Trust.www.cqc.org.uk/_db/_documents/20100614_Devon_Partnership_NHS_Trust_investigation_Full_report_Final.pdf

References

NHS Constitution rights: You have the right to drugs and treatments thathave been recommended by NICE for use in the NHS, if your doctor saysthey are clinically appropriate for you.

You have the right to expect local decisions on funding of other drugs andtreatments to be made rationally following a proper consideration of theevidence. If the local NHS decides not to fund a drug or treatment you andyour doctor feel would be right for you, they will explain that decision to you.Implementation of this right is supported by NPCs local decision-making(LDM) programme see earlier. NHS Constitution

NICE: National Institute for Health and Clinical Excellencewww.nice.org.uk

NHS Commissioning Board: as de ned in the Department of Health White Paper Equity and excellence: liberating the NHS , theNHS Commissioning Board is the proposed entity that will have theresponsibility for holding consortia to account and for allocating andaccounting for NHS resources

Payment by Results (PbR): the tariff based hospital payment systemthat has transformed the way funding ows around the NHS in England;see A simple guide to Payment by Results Department of Health,September 2010. (See also, What you need to know about prescribing, the drugs bill and medicines management : A guide for all NHSmanagers. NPC December 2008)

Patient Group Direction (PGD): a written instruction for thesupply and/or administration of a licensed medicine (or medicines)in an identi ed clinical situation, signed by a doctor or dentist and apharmacist. It applies to groups of patients who may not be individuallyidenti ed before presenting for treatment. (NPC, Patient Group Directions , a practical guide and framework of competencies fo r allprofessionals using patient group directions, December 2009)

QIPP agenda for medicines: Part of a broad spectrum of initiativesbeing developed by DH as a rounded package of Quality, Innovation,Productivi ty, and Prevention (QIPP) activities. The supporting document,Key therapeutic topics 2010/11 Medicines management options forlocal implementation (NPC 2010) focuses on medicines use and theirprocurement
http://www.npc.nhs.uk/qipp/resources/competency_framework.pdfhttp://www.npc.nhs.uk/qipp/resources/competency_framework.pdfhttp://www.cqc.org.uk/_db/_documents/20100614_Devon_Partnership_NHS_Trust_investigation_Full_report_Final.pdfhttp://www.cqc.org.uk/_db/_documents/20100614_Devon_Partnership_NHS_Trust_investigation_Full_report_Final.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_113645.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117352.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_120254.pdfhttp://www.npc.nhs.uk/resources/nhs_guide_for_managers.pdfhttp://www.npc.nhs.uk/resources/nhs_guide_for_managers.pdfhttp://www.npc.nhs.uk/resources/nhs_guide_for_managers.pdfhttp://www.npc.nhs.uk/resources/nhs_guide_for_managers.pdfhttp://www.npc.nhs.uk/non_medical/resources/patient_group_directions.pdfhttp://www.npc.nhs.uk/non_medical/resources/patient_group_directions.pdfhttp://www.npc.nhs.uk/non_medical/resources/patient_group_directions.pdfhttp://www.npc.nhs.uk/non_medical/resources/patient_group_directions.pdfhttp://www.npc.nhs.uk/qipp/resources/qipp_document_jan2011_version1.1_march11_final.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_113645.pdfhttp://www.npc.nhs.uk/qipp/resources/qipp_document_jan2011_version1.1_march11_final.pdfhttp://www.npc.nhs.uk/non_medical/resources/patient_group_directions.pdfhttp://www.npc.nhs.uk/resources/nhs_guide_for_managers.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_120254.pdfhttp://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117352.pdfhttp://www.npc.nhs.uk/qipp/resources/competency_framework.pdfhttp://www.cqc.org.uk/_db/_documents/20100614_Devon_Partnership_NHS_Trust_investigation_Full_report_Final.pdf


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1. Has a strategic overview

4. Provides medicines oversight

3 . C o m

m i s s

i o n s

s e r v i c e

s

t h a t

o p t i m

i s e t h e u s

e o f

m e d i c i n

e s

6 . S u p

p o r t s a

n d d e v e

l o p s

p e o

p l e

2 . E s t a b l i s h e s

e e c t i v e p

a r t n e r s h

i p s

5 . H a s m e d i c i n e s e x p e r t i s e

Appendix 1 Diagnostic spider web tool for Consortia Boards

What is this diagnostic exercise for?

This self-assessment exercise is intended to beundertaken by Consortia Boards to help them todiagnose their readiness to deliver the full range of medicines management competencies expected fromthem.

Undertaking this exercise will enable Consortia Boardsto identify the areas that they are already able to deliver,as well as those they need to develop.

How to Complete the Diagnosis Exercise

Listed on the following page is a series of tablescontaining statements about the six medicinesmanagement competencies outlined earlier in this

document. Consider each statement in turn for each of the six

competencies, and circle the one that you think most closely re ects your level of organisationalcompetency.

When you have completed all six competencies, plotthe level (1 5), against the relevant competency onthe spiders web.

From the resulting graph you will easily be able tosee which competencies you need to develop toenable you to deliver your medicines managementresponsibilities.

5: Our Commissioning Consortia Board has the strategies, structures and processes in place to enable it to deliver its medicine management functions fully

4: Our Commissioning Consortia Board has almost developed its strategies, structures and processes to enable it to deliver its medicines management functions

3: Our Commissioning Consortia Board has started to develop its strategies, structures and processes for the delivery of its medicines management functions at a basic level

2: Our Commissioning Consortia Board has met to discuss its responsibility for medicines management functions but as yet has not de ned its strategy, structures or processes

1: Our Commissioning Consortia Board is not yet supporting the delivery of its medicines management functions

Rating Scale:


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1. Has a strategic overview

5. We have designated board level lead for medicinesmanagement, and a clear strategy and action plan foroptimising medicines use across our health economy.We have the medicines management resourcethrough which it can be delivered in place and havestarted work

4. We have a board level lead for medicinesmanagement and are in the process of developing astrategy and action plan. We have some medicinesmanagement resource

3. We have a board level lead for medicinesmanagement and have started to develop a strategybut have not de ned our resource or taken action

2. We have a lead for medicines management but node ned strategy

1. We have no strategy or designated leadership formedicines management

2. Establishes effective partnerships

5. We have identi ed all our partner organisations, madecontact, set up effective communication processesand are working on areas of joint interest

4. We have identi ed all our partner organisations, madecontact, set up communication processes and havestarted joint working in some areas

3. We have identi ed all our partner organisations, madecontact with most, and set up some communicationprocesses but have yet to start signi cant jointworking

2. We have identi ed most of our partner organisations,are making contacts and developing ideas for jointworking

1. We have started to identify all our key partnerorganisations and are planning to make contact

3. Commissions services that optimise the use ofmedicines

5. We have a good understanding of the needs andservice requirements of our patients with regard totheir medicines, all our contract speci cations set outour expectations for optimal use of medicines

4. We have a good understanding of the needs andservice requirements of our patients with regardto their medicines, we are reviewing our contractspeci cations to set out our expectations for theoptimal use of medicines

3. We are developing an understanding of the needsand service requirements of our patients with regardto their medicines and are going to review ourcontract speci cations

2. We understand the importance of considering theneeds and service requirements of our patients withregard to their medicines and the need to reviewcontract speci cations

1. We do not speci cally look at patients needs aroundmedicines and do not routinely include medicines

issues in contracts

4. Provides medicines oversight

5. The Board is aware of its obligations to providegovernance, oversight and assurance of safe effectiveand affordable medicines usage. We routinely reviewall relevant data to monitor performance and ensurethe provision of feedback to provider services

4. The Board is aware of its obligations to providegovernance, oversight and assurance of safe effectiveand affordable medicines usage. We are in theprocess of developing our review and feedback systems

3. The Board is aware of its obligations to providegovernance, oversight and assurance of safe effectiveand affordable medicines usage. We recognise theneed to take action

2. We are aware that there are gaps in ourunderstanding and are taking steps to developprocesses to meet our obligations

1. We are unclear about our obligations aroundgovernance, oversight and assurance of medicinesusage

5. Has medicines expertise

5. We understand the need for and have access to thefull range of skills, expertise and knowledge necessaryto ensure the safe, legal and effective use of medicinesfor our population

4. We understand the need for and have access to mostof the skills, expertise and knowledge necessary toensure the safe, legal and effective use of medicinesfor our population

3. We understand the need for and have limited access

to the skills, expertise and knowledge necessary toensure the safe, legal and effective use of medicinesfor our population

2. We accept the need for speci c expertise but haventyet considered how it can be accessed

1. We are unclear about the full range of expertiserequired and have no provision to access speci cmedicines expertise

6. Supports and develops people

5. We have processes to ensure that people who areworking with, or for us, in medicines management arecompetent, and we support and develops individualsto carry out their roles effectively

4. We have processes to ensure that people who areworking with, or for us, in medicines managementare competent and we are developing our supportsystems

3. We know what competencies are required and are

beginning to develop our systems and processes toensure that people working for us are competent andsupported in their role

2. We need to understand the full range of competencies and develop our processes before wecan develop the necessary support systems

1. We have no processes or support to ensureprofessionals are competent in medicinesmanagement


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Appendix 2:Development process

The organisational competency framework in this documentis based on the framework published in the working resourcedocument: Ensuring the delivery of prescribing, medicines

management and pharmacy functions in primary and community care. An organisational competency framework and key functions checklist .2

This comprehensive document contained a detailed keyfunctions list which underpinned the development of thecompetencies that commissioning organisations in the NHSwould require moving forward.

The document was published in November 2010 as aworking resource for Primary Care Trusts (PCTs) andStrategic Health Authorities (SHAs) to assist with transition

planning as they hand over their responsibilities toCommissioning Consortia and the National CommissioningBoard. Anecdotal evidence suggests that this document hasbeen heavily used by the NHS.

As Commissioning Consortia began to form it wasrecognised that Consortia needed a version of thecompetency framework speci cally aimed at their Boards.

A small steering group was given the task of developingthat resource which was user tested with GPs andmedicines management leads. The framework in thisdocument has been re ned to take account of changes tothe commissioning landscape since November 2010 andhas been designed to be a relatively short, practical tool toengage Consortia Board members in discussions about howbest to deliver on their medicines management functions.
http://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdfhttp://www.npc.co.uk/policy/qipp/resources/competency_framework.pdf


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Appendix 3: Acknowledgements

Steering group

Ryszard Bietzk General Practitioner West Essex PCT

Gill Harvey Head of Medicines Management National Prescribing Centre

Clive Jackson Chief Executive National Prescribing Centre

Jill Loader Associate Director Medicines Management NHS South West

Jonathan Mason National Clinical Director for Primary Care and Community Pharmacy Department of Health

Lelly Oboh Consultant Pharmacist, Care of the Elderly NHS Lambeth

Catherine Picton Commissioned Project Lead For National Prescribing Centre

Steve Pike General Practitioner Coastal West Sussex GP Commissioning Federation

Carol Roberts Pharmacy lead East of England NHS

Janice Steele Deputy Chief Pharmacist, Croydon PCT NHS Croydon

Peter Rowe National QIPP Lead for Medicines Use and Procurement Department of Health

User testing groups

Rachel Ainger Principal Pharmacist NHS North Yorkshire

Rebecca Birchall Pharmacy Adviser NHS Western Cheshire

Helen Burgess GP Prescribing Lead South Manchester South Manchester PBC

John Hickey Lead Pharmacist Medicines Gover nance Wester n Cheshire PCT

Steve Hulme Assistant Director of Medicines Management NHS Derbyshire County

Peter Johnstone General Manager Liverpool Healthcare

Julie Landale Head of Medicines Management Calderdale PCT

Andy Lee General Practitioner NHS Wirral

Andrea Loudon Head of Medicines Management NHS Cumbria

Coastal West Sussex Commissioning Federation tested a draft version of this document in a half day workshop with their medicines management team, consortia chair and GPprescribing lead.

Representation from the three Wirral Commissioning Consortia tested a later draft of the document in a meeting with the NHS Wirral Head of Medicines Management


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National Institute for Health & Clinical Excellence 2011

Consortia Board Guide July 2011 v1.1

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Transcript of Consortia Board Guide July 2011 v1.1