Life as a South East London, Vocational Training Scheme, Foundation Pharmacist
Mery Ayele is a pharmacist on the South East London Foundation Pharmacist Vocational Training Scheme (SEL FP VTS) pilot commissioned by Health Education England (HEE). Mery is one of the first pharmacists in the UK to participate in a multi-sector foundation pharmacist training programme across 3 pharmacy sectors - hospital, community & GP practice pharmacy. Below, Mery discusses her time at NHS London Procurement Partnership as part of her vocational training journey.
The NHS London Procurement Partnership (NHS LPP), Medicine Optimisation and Pharmacy Procurement (MOPP) work stream delivers cost-effective prices on medicines and related products, and supports London-wide medicine optimisation. Medicines cost the NHS approximately £2.6bn a year in London alone. 1, 2 MOPP monitors medicine expenditure, savings, and cost-avoidance and lost savings opportunities, as well as helping to establish clinical guidelines to support best value use of medicines.
After working as a multi-sector pharmacist, both in hospital and community pharmacy, I was fortunate to get the opportunity to do a rotation at NHS LPP. This rotation has exposed me to the projects the MOPP team carries out. Some examples of my work from this work stream include:
London Best Value Biologics Medicine implementation group meeting
As the biosimilar market develops, increased competition between suppliers has the potential to deliver significant savings of at least £300m per year by 2020/21.3 The MOPP team contributes to the biosimilar switching opportunities in a proactive, systematic and safe way, and keeps track of the volume of biosimilar use within NHS trusts and the cost savings achieved via biosimilar uptake. The project I worked on was to identify the clinical and financial impact of the use of biosimilar insulins across London.
Tranche B Adjudication Analysis with the Commercial Medicine Unit (CMU)
The MOPP team also supports tendering by the CMU for some therapeutic medicines. There are some diseases and conditions which can be treated by more than one branded medicine within the same therapeutic category. To support informed decision making, therapeutic categories sitting within a competitive market have been allocated to a “Tranche” tendering system. The MOPP team liaises with procurement leads, Chief Pharmacists and Commissioners to highlight these cost saving opportunities to facilitate timely uploading of new contract details so that maximum financial benefits can be realised. I now understand that early savings can be reinvested back into NHS services.
Contract Variance Reports (CVR)
I have been involved in a project currently being carried out by the MOPP team to investigate why trusts are not purchasing CMU contracted medicines and therefore not paying CMU contract prices. The purpose of the project is to develop a set of metrics to help quantify and monitor off-contract purchases; identify processes to mitigate avoidable loses and to rectify system financial reporting errors which leads to inaccurate variance reporting. The conclusion of the project will provide us accurate data on contractor supply performance which may be used to inform future procurement strategies.
The NHS long term plan is now the driver behind the direction the MOPP team and wider LPP team. The organisation plays a key role in supporting development of medicine optimisation in Integrated Care Systems, helping to ensure a focus on whole health economies. I have identified tools such as the Diabetes Toolkit, Mental Health and Pain Management Guidance, RightBreathe, etc. NHS LPP supports the RightBreathe tool to ensure optimum use of the tool for patients and NHS colleagues. I have learnt how background work is required to sustain a healthcare aid tools to ensure they remain up to date. I will be using these tools in my daily practice when I am placed as a member of the multidisciplinary team within a GP Practice for the next step of my rotational pharmacist role. I have a much clearer understanding of the causes of medicines shortages, and the strategies and procedures for dealing with those shortages at local, regional and national levels. I will be able to utilise and share the NHS LPP work in my multisector practice. The opportunity to work in the NHS LPP MOPP team is a unique experience that not many rotational pharmacists are exposed to. I have developed an understanding around procurement strategy, best value use of medicine and financial reporting.
Time well spent!
NHS Digital (2019); ‘Prescription cost analysis’; available at www.digital.nhs.uk/data-and-information/publications/statistical/prescription-cost-analysis/2018 ; accessed on 21/10/19.
Define (2019); ‘Measure of prescribing practice’; available at www.rx-info.co.uk; accessed on 21/10/19.
NHS England and NHS Improvement (2019 ); ‘What is biosimilar medicine guide’; available at
www.england.nhs.uk;accessed on 4/10/19.
Spotlight on: new formulary to improve access to medicines for Londoners
RightBreathe Website Quick User Guide for Patients, Carers and Parents
RightBreathe app for patients, carers and parents
Jackie Eastwood to speak at Clinical Pharmacy Congress
Jackie Eastwood, LPP's Outsourced Medicines Supply Services Lead, will be speaking at the Clinical Pharmacy Congress on 27th and 28th April 2018.