requesting information regarding Referral target schemes for GPs in NHS Ashford Clinical Commissioning Group

Transcription

1 August 2015 Our Ref: FOI.15.ASH0102 requesting information regarding Referral target schemes for GPs in NHS Ashford Clinical Commissioning Group a) Does the CCG currently operate any schemes for GPs which include a maximum number of referrals as a target? (Please list all relevant, including schemes to be implemented in the next year) I can confirm NHS Ashford Clinical Commissioning Group (CCG) currently have a Trauma and Orthopaedic triage scheme; however, whilst this is aimed at reducing referrals there is no set target for practices. a. Which procedures does this scheme target? (Please list all relevant) I can confirm the procedure targets all NHS Ashford CCG Trauma and Orthopaedic elective pathways. b. Are there any incentives or sanctions linked to achieving these targets? (Please give details. This could include a payment per patient for achieving targets, or loss of payments for exceeding them, but does not have to be financial) I can confirm NHS Ashford CCG does not have any incentives or sanctions linked to achieving these targets. b) Does the CCG have similar targets for prescribing, excluding schemes to switch from branded drugs to generics? (Please list all relevant, including schemes to be implemented in the next year) a. Which conditions or medicines does this scheme target? (Please list all relevant) I can confirm the following table shows the NHS Ashford CCG s list of cost effective options, which is revised regularly and changes throughout the year. The information below is current as at 11 th August 2015.

2 Project BNF Cost effective use of Proton Pump Inhibitors (May 2015) BNF Cost-effective use of Omeprazole (May 2015) BNF Cost effective mesalazine (March 2015) BNF Macrogol 3350-Cost effective options-cosmocol (first choice) or Laxido (March 2015) BNF Angiotensin-II receptor antagonist optimisation BNF Doxazosin Optimisation BNF Perindopril arginine (Coversyl Arginine and Coversyl Arginine DROP list (DRugs of LOw Priority) BNF Glyceryl Trinitrate sprays BNF Isosorbide Mononitrate MR 60mg optimisation BNF Amlodipine cost effective prescribing BNF Clopidogrel / Dipyridamole Optimisation (Safety) BNF Clopidogrel optimisation (May 2015) BNF Ezetimibe Optimisation BNF Omega-3 fatty acid compounds BNF Rosuvastatin (Note for analyst - Double counts) BNF Statin Optimisation BNF Salbutamol DRY POWDER inhalers- cost effective preparations BNF Salbutamol pmdi inhalers- cost effective preparations BNF LAMA Optimisation BNF ICS/LABA Project 1 Options for pmdi preparations (2000mcg BDP daily ) (Updated July 2015) BNF ICS/LABA Project 1a Options for pmdi preparations ( mcg BDP daily) (Updated July 2015) BNF ICS/LABA Project 2 Options for DRY POWDER preparations ( 800mcg BDP daily) (Updated July 2015) BNF ICS/LABA Project 2a Options for DRY POWDER preparations ( 800mcg BDP daily) (Updated July 2015 BNF Seretide 125/25 Evohaler impact of using branded generic Sirdupla (Added Aug 2015) (Note for analyst - Double counts) BNF Seretide 250/25 Evohaler impact of using branded generic Sirdupla (Added Aug 2015) (Note for analyst - Double counts) BNF Symbicort 400/12 and 200/6 Turbohaler impact of using branded generic DuoResp Spiromax (Note for analyst - Double counts) BNF Montelukast cost effective prescribing (May 2015) BNF Antihistamines DROP topic (DRugs of LOw Priority) BNF Decongestants, aromatic inhalations, cough mixtures. DROP list (DRugs of LOw Priority) BNF Antipsychotics optimisation-olanzapine BNF Antipsychotics optimisation-risperidone

3 BNF Amisulpride optimisation BNF Aripiprazole dose optimisation BNF Quetiapine immediate release vs Modified release (Note for analyst - Double counts) BNF use of branded generics for Quetiapine 150mg XL preparations. BNF use of branded generics for Quetiapine 200mg XL preparations BNF use of branded generics for Quetiapine 300mg XL preparations BNF use of branded generics for Quetiapine 400mg XL preparations BNF use of branded generics for Quetiapine 50mg XL preparations BNF use of generic quetiapine 100mg BNF use of generic quetiapine 150mg BNF use of generic quetiapine 200mg BNF use of generic quetiapine 25mg BNF use of generic quetiapine 300mg BNF Escitalopram cost effective prescribing (May 2015) BNF Sertraline cost effective prescribing (May 2015) BNF Venlafaxine optimisation BNF Modafinil cost effective prescribing BNF Orlistat BNF Analgesia for minor/common ailments. DROP list (DRugs of LOw Priority) [Some overlap with Paracetamol project] BNF Co-proxamol DROP list (DRugs of LOw Priority) BNF Fentanyl lozenges DROP list (DRugs of LOw Priority) BNF Fentanyl optimisation 100 micrograms (Added Aug 15) BNF Fentanyl optimisation 12 micrograms (Amended Aug 15) BNF Fentanyl optimisation 25 micrograms (Amended Aug 15) BNF Fentanyl optimisation 50 micrograms (Amended Aug 15) BNF Fentanyl optimisation 75 micrograms (Amended Aug 15) BNF Oxycodone immediate release preparation-optimisation BNF Oxycodone Modified Release Preparations-Optimisation 10mg BNF Oxycodone Modified Release Preparations-Optimisation 120mg BNF Oxycodone Modified Release Preparations-Optimisation 15mg BNF Oxycodone Modified Release Preparations-Optimisation 20mg BNF Oxycodone Modified Release Preparations-Optimisation 30mg

4 BNF Oxycodone Modified Release Preparations-Optimisation 40mg BNF Oxycodone Modified Release Preparations-Optimisation 5mg BNF Oxycodone Modified Release Preparations-Optimisation 60mg BNF Oxycodone Modified Release Preparations-Optimisation 80mg BNF Oxycodone/ Naloxone (Targinact ) DROP list (DRugs of LOw Priority) BNF Tramacet DROP list (DRugs of LOw Priority) BNF Tramadol Immediate release optimisation 50mg BNF Tramadol Modified release optimisation 100mg BNF Tramadol Modified release optimisation 150mg BNF Tramadol Modified release optimisation 200mg BNF Tramadol Modified release optimisation 50mg BNF Triptans-Cost-effective use BNF Pregabalin 25mg BNF Pramipexole cost effective prescribing (May 2015) BNF Buprenorphine sublingual cost effective prescribing (May 2015) BNF Galantamine optimisation BNF Minocycline. DROP list (DRugs of LOw Priority) BNF Intermediate and long acting Insulins- Use NPH insulin first line BNF Pen needles (Revised measure Oct 2014) BNF Gliclazide MR 30mg. DROP list (DRugs of LOw Priority) BNF Blood Glucose Test strips BNF Lancets BNF Prednisolone 5mg Optimisation BNF Desmopressin cost effective prescribing of nasal spray (May 2015) BNF Desmopressin cost effective prescribing of tablets (May 2015) BNF Bisphosphonate optimisation (May 2015) BNF COC (Project 1) Gedarel 20/150 in place of Mercilon BNF COC (Project 2) Millinette 20/75 in place of Femodette or Sunya 20/75 BNF COC (Project 3) Gedarel 30/150 in place of Marvelon BNF COC (Project 4) Lucette in place of Yasmin BNF COC (Project 5) Millinette 30/75 in place of Femodene or Katya 30/75 BNF COC (Project 6) Rigevidon in place of Microgynon 30, Ovranette or Levest BNF COC (Project 7) TriRegol in place of Logynon BNF POP Cerelle in place of Ceravette BNF Tolterodine MR to Neditol XL BNF Drugs for erectile dysfunction- generic sildenafil vs high cost alternatives (Amended Dec 2014)

5 BNF Sildenafil cost effective prescribing (May 2015) (Note for analyst - Double counts) BNF Anastrazole Optimisation (May 2015) BNF Gonadorelin analogues (May 2015) (Preparations for one month duration of treatment) BNF Gonadorelin analogues (May 2015) (Preparations for three months/12 weeks duration of treatment) BNF Appendix Nutritional supplements-ensure Cans BNF Appendix Nutritional supplements-aymes Shake is more cost effective than Complan Shake (March 2015) BNF A Colief DROP list (DRugs of LOw Priority) BNF A VSL#3 DROP list (DRugs of LOw Priority) BNF Vitamins and minerals-unlicensed BNF Calcium and Vitamin D -DROP list (DRugs of LOw Priority) BNF Ibuprofen and naproxen as % of all NSAIDs (Safety) BNF Glucosamine BNF Ibruprofen gel 10% switch to branded generic BNF Ibuprofen gel 5% to branded generic BNF Movelat to Algesal BNF Dorzolamide (and combination products) optimisation BNF Latanoprost (and combination products) optimisation BNF Mometasone nasal spray cost effective prescribing (May 2015) BNF Dental products DROP list (DRugs of LOw Priority) BNF Nystatin suspension optimisation BNF Cost effective emollients - ZeroAQS (Aqueous Cream Alternative) BNF Cost effective emollients - Zerobase (Diprobase Cream Alternative) BNF Cost effective emollients - Zerocream (E45 Cream Alternative) BNF Cost effective emollients - Zeroderm (Epaderm alternative) BNF Cost effective emollients - Zerodouble Gel (Doublebase Gel Alternative) BNF Cost effective emollients - Zeroguent Cream (Unguentum M Cream Alternative) BNF Emollient bath and shower - cost effective preparations BNF Fflornithine (Vaniqa) DROP list-drug of Low Priority BNF Topical Antifungals DROP list (DRugs of LOw Priority) BNF Cost effective Lymecycline Preparation BNF Vaccinations for Hepatitis B and Meningitis ACWY BNF Travel vaccines b. Are there any incentives or sanctions linked to achieving these targets? (Please give details. This could include a payment per patient for achieving targets, or loss of payments for exceeding them, but does not have to be financial)

6 I can confirm the NHS Ashford CCG prescribing quality scheme has three entry requirements as an entry point based on returning reports on the following: 1. Audit of antimicrobials 2. Audit of Non-steroidal anti-inflammatory drugs (NSAIDs) use 3. Regular review of safety alerts using Eclipse RADAR tool Support for GP practices to deliver safe and cost effective prescribing is funded by calculating the difference in prescribing spend per practice (adjusted for size, demographics, prevalence of high cost areas of prescribing and unusual patient groups) and the national spend. There is no target for any of the above measures listed in the table above. Practices are encouraged to engage with measures to address waste and processes in addition to considering cost effective preparations where available. Please include documents or details of these schemes that would be sent to GPs. Please see the attached documents. Some information has been redacted from the documents as the CCG considers that this information is commercially sensitive in nature and therefore exempt under section 43(2) of the FOI Act: Commercial Interests. The redacted sections contain detailed pricing information, effectively providing a unit cost for the service which, if released into the public domain, is likely to result in prejudice to the commercial interests of the Clinical Commissioning Group and its providers. Releasing the information will enable bidders to adjust their prices accordingly, undermining the competitive nature of the procurement process and the Clinical Commissioning Group s ability to secure the most advantageous price for the service.