LPP strapline

Secondary Care

The LPP Medicines Optimisation and Pharmacy Procurement workstream extends and complements the pan-NHS work of the NHS Commercial Medicines Unit and the four London medicines procurement consortia.

Our workplan is guided by horizon scanning and national and local clinical priorities identified from discussion with key stakeholders. Our priorities are reviewed each year with our stakeholders in order to compile a work programme for the following financial year.

Most initiatives consist of two phases. The first aims primarily to identify and exploit evidence-based opportunities to tender and contract for selected medicines as a way to optimise acquisition costs, value for money and quality of care. The second consists of monitoring local uptake of established frameworks or contracts and providing specialist advice to support local change management and implementation by influencing prescribing practice.

Our plan:

    • Mental Health– taking into account the complexity of mental health prescribing and areas of concern identified by medicines management leads, this workstream's initiatives are designed to provide benefit to both secondary and primary care. Performance indicators for mental healthcare initiatives in the secondary care dashboard are agreed during the year. The primary care mental health workstream also has its own dashboards - encompassing both quality and safety initiatives and financial initiatives.
    • Cancer – supported by the secondment of one 0.5 fte specialist pharmacist, and working closely with colleagues in the two new Integrated Cancer Systems in London, the aim is to identify and exploit opportunities to optimise value for money from the use of anticancer and supportive care medicines.
    • Nutrition – this established and similarly complex workstream, delivered by one LPP lead dietitians (one 0.5 fte), has five components and will also be monitored by its own dashboard which will be shared with dietitians across London. Loss leading in acute care has been the case for many years. Our focus is on trying to influence product choice in acute trusts as a means of influencing long-term costs in primary and community care.
    • The Secondary Care Dashboard - to track savings achieved, this is modelled on the established primary care dashboard. Performance indicators for acute and mental healthcare initiatives are agreed during the year. The dashboard can be accessed via the link to the right of this page.
    • Patient Access Schemes - NHS LPP is continuing the Patient Access Scheme/s (PAS) project initiated in 2013, which has now been expanded to encompass all non-cancer and cancer PAS, both NICE-approved and those in the CDF. The project aims to identify, map and track use of PAS in London, and to identify any barriers to implementation. Cost avoidance derived from the use of PAS is also calculated for each drug and organisation. PAS operate via two main mechanisms:
      • “Price discount schemes” – the pharmaceutical company passes on a straight forward discount of X% on the price of the drug. This will be the price invoiced to the organisation and no new internal process/mechanisms require implementation.
      • “Manual managed discount schemes” – an internal process/mechanism has to be implemented in order to allow the potential cost avoidance to be realised. This may be resource intensive and involve multiple departments within the organisation.

Visit the PAS Project page via the link in the More Information box on the right of this page.

    • Benchmarking – Define® is web-based benchmarking software, developed in collaboration with 23 NHS trusts in South West England and the West Midlands. As well as enabling intra- and inter-organisational clinical and financial benchmarking of medicine use, Define® is a flexible and user-friendly tool for use by clinical pharmacists and pharmacy managers to inform medicines optimisation and support budget planning & management by providers and commissioners. Access is available in the majority of acute and mental health trusts in NHS England (London Region) and is in use in approximately 50 per cent of all acute NHS trusts nationally.

Links to the secondary care dashboard, details of specific initiatives, a tender schedule for LPP frameworks, and other information supporting the dashboard can be downloaded from the supporting information box on the right. 

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