Agenda item

The Board had before it a report by Judith Proctor (Chief Officer, ACHSCP) and David Pfleger (Director of Pharmacy and Medicines Management, NHS Grampian) which provided information in relation to actions being taken, or planned by the Executive Team to address the identified risks.

The report recommended:-

that the Board –

(a)       Note the IJB would be following an assertive approach in pursuing medicines efficiencies including maximising the use of generic medication;

(b)       Note the level of financial risk associated with the assumptions of achieving the maximal savings used in the budget assessment, especially relating to Pregabalin for the 2017-18 financial year which presented the biggest savings opportunity and therefore risk to the Aberdeen City IJB prescribing budget; and

(c)       Endorse the approach set out in relation to local measures being put in place to maximise efficiency and local control on the prescribing budget.

David Pfleger spoke to the report and highlighted the issues that would impact on the prescribing budget such as the volume and cost of drugs; and the level of transactions. Mr Pfleger set out the complexity of prescribing which was influenced by a range of factors such as population demographics; compliance with GP contracts and clinical guidance; in addition to legal issues associated with prescribing branded and generic medicines. Further to this, he outlined the controls available to the Board to manage prescribing costs as well as risks linked to these options and oversight arrangements NHS Grampian had put in place to monitor prescribing throughout Aberdeen City.

The Chair advised that he attended an IJB Chairs meeting on 6 March 2017 in which members had discussed local and national issues that impacted on prescribing budgets. He noted that today’s budget agreement was a strong statement of intent on how the Aberdeen City IJB would approach the challenges associated with prescribing. The Chair asked if the IJB would be required to make any adjustments to the level of savings related to generic medicines, particularly Pregabalin. Alex Stephen explained that it was unclear at this point how the balance of risk between Pregabalin and generic medicines would fall and highlighted that the IJB’s reserves fund was in place as a contingency.

Thereafter there were questions on workload challenges for GPs who would have additional responsibilities to achieve cost efficiencies and how Community Pharmacists could support GPs in this regard; and what measures the Partnership had adopted at both locality and Pan-Grampian level to engage the public in order to increase efficiencies related to prescribing.

The Board resolved:-

(i)           to note the IJB would be following an assertive approach in pursuing medicines efficiencies including maximising the use of generic medication;

(ii)          to note the level of financial risk associated with the assumptions of achieving the maximal savings used in the budget assessment, especially relating to Pregabalin for the 2017-18 financial year which presented the biggest savings opportunity and therefore risk to the Aberdeen City IJB prescribing budget; and

(iii)         to endorse the approach set out in relation to local measures being put in place to maximise efficiency and local control on the prescribing budget.

JONATHAN PASSMORE MBE, Chairperson.