What might the current Westminster Government mean for ... - BOPA

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Community role in chemotherapy explored Various service models for the supply of oral chemotherapy from community pharmacies are currently being explored by a working group that includes members of BOPA, the Professional Leadership Body, key stakeholders in community pharmacy and the Department of Health. No final decisions have been made yet but some features common to the models being considered include the need for community pharmacists offering the service to: • Be able to access to chemotherapy protocols in order to check that the drug doses have been prescribed appropriately • Receive appropriate training and/ or have previous experience in oncology. The level of training and competency that is required could be dependent on the level of service to be offered BOPA members are to benefit from an improved website. This decision stems from feedback from delegates at last year’s symposium, which concluded that the current BOPA website is no longer fit for purpose, technology having advanced since it was last upgraded in 2007. Improvements are aimed at increasing the usability and functionality of the website, in line with BOPA strategy and members’ expectations. During a tender process started last December, a number of bids were received but, after a detailed examination, the committee believed that only two of these (from Polydiam Infosoft and Succinct Communications) would be likely to result in a website being developed to the desired specification. After further consideration of the two bids, which were financially comparable, and taking into account the need to maintain membership and other secretariat functions, the committee decided to pursue discussions with Succinct to build and host the website as a priority. Both parties are currently working on a detailed specification and intend to sign a contract in the near future. Work on the website will then start. Some ‘screen shots’ of the new website should be available in time for the 2010 BOPA symposium, with the upgraded website ready to go live in 2011. • Develop links with specialist secondary care pharmacists who can advise them as necessary. This initiative follows on from the DH’s ‘Chemotherapy services in the community’ document and from the Pharmacy White Paper. The former describes how PCTs could commission and set up intravenous chemotherapy services and the latter recognises a potential for community pharmacists to be involved in the dispensing, administering and monitoring of patients receiving oral chemotherapy in the community. BOPA is committed to working with professional leaders to help ensure that this exciting opportunity for our profession moves forward while maintaining quality and safety. We aim to build on the expertise of, and practice developed by, secondary care oncology pharmacists. It The BOPA website is valued by members, having received between 7,500 and 15,500 ‘hits’ each month since monitoring began in 2008. Netty Wood, lead pharmacist, Essex Cancer Network Pharmacist and BOPA Vice Chair, will continue to lead the website team, supported by Calum Polwart, network pharmacist, North of England Cancer Network, Bruce Burnett, consultant pharmacist, Glan Clwyd Hospital, Colin Ward, lead pharmacist, East Midlands Cancer Network, Andrew Pyke, IT support officer and David Thomson. Should you be interested in being part of the website team, or have any queries, please e-mail: nettywood@nhs.net. is anticipated that BOPA members will be given the chance to comment and help shape the output of this work stream in the near future. Contributed by Steve Williamson, consultant pharmacist, North of England Cancer Network and BOPA Committee Member BOPA website to be upgraded Up to 15,500 “hits” have been recorded on the BOPA website each month since monitoring began in 2008 18000 16000 14000 12000 10000 8000 6000 Contributed by Netty Wood JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC MONTH 2008 2009 2010 BOPA Bulletin Issue 1 Summer 2010
Horizon scanning for new cancer regimens underway A tool developed by members of the South East London Cancer Network (SELCN) is on the way to becoming an established method of ‘horizon scanning’ to prioritise funding for cancer medicines that have yet to be appraised by NICE. The tool was used by all five cancer networks in London in the financial year 2009-10 and its use has been extended to include cancer networks in the south east coast of England and Mount Vernon for this current financial year. The tool is used to review regimens that are either scheduled to receive NICE guidance, or are likely to be licensed for a new indication, by the end of the following financial year. For other regimens, a review can be perofrmed at the specific request of an oncology consultant. Each regimen is assessed by a ‘scoring panel’ consisting of clinicians, pharmacists and medical directors from the cancer networks taking part, using information from the NICE website, Scottish Medicines Consortium, London Cancer New Drugs Group (LCNDG) and All Wales Medicines Strategy Group. If no information is available from these sources, primary data is reviewed. The panel attribute scores to each regimen (see box). These are reviewed at a consensus seminar to which clinical representatives, commissioners, patients and carers are invited. If individuals do not agree with the score given to a particular regimen (e.g. because a new study has since been published) they are invited to produce evidence as to why a score should be changed. A ‘traffic lighted’ colour code is then assigned to each regimen, based mainly on the scores achieved. For example, higher scoring regimens are highlighted ‘green’. Treatments for particularly rare tumours (where there may not be sufficient patient numbers for a randomised study to have been completed) are assigned ‘light green’. Treatments that are considered ‘noninferior’ rather than ‘superior’ but also improve patient experience (e.g. because they are oral rather than IV or have an improved toxicity profile) are highlighted ‘blue’. Low scoring regimens are assigned ‘red’ and regimens that would otherwise be ranked red but appear to have the potential to meet the NICE ‘end of life’ criteria are highlighted ‘amber’. The ‘green’, ‘light green’ and ‘blue’ treatments are recommended for funding if they also achieve a positive review from the LCNDG. Regimens recommended for funding are then costed at a likely incidence per 100,000 and at a 50% predicted uptake to inform commissioners of the likely cost impact for their PCTs. Some other cancer networks across England have already expressed an interest in becoming involved for the next financial year. Indeed it is hoped that further rolling out this modified Delphi consensus approach will reduce the amount of duplication of effort and provide a consistent mechanism for patients to gain access to cancer medicines before they have been reviewed by NICE. Contributed by Jacky Turner, Macmillan pharmacist, South East London Cancer Network. Contact Jacky.Turner@gstt.nhs. uk for more information News How the prioritisation tool works The tool evaluates four domains, ‘magnitude of benefit’, ‘quality of life’, ‘alternative standard treatment’ and ‘quality adjusted life year’. A numerical score (0 to 20) for effectiveness is partnered with a ‘strength of evidence’ letter (A to U) to reflect the standard of the evidence base from which the numerical score was obtained. For each regimen, the highest possible ranking is 20A (i.e. strong evidence of good effectiveness) with the lowest ranking being 0A (i.e. strong evidence of poor effectiveness). The tool was developed by Dr Jamie Ferguson, acting medical director SELCN, Jacky Turner, Dr Paul Ross, chair of the Guy’s and St. Thomas’ Oncology Drugs Expenditure Committee and Dr Nic Ketley, chair of the SELCN Drugs and Therapeutics Committee. It is itself an extension of an earlier scoring tool developed in the south east of London. 1 Before being used, the tool was tested on five cancer drugs for which NICE had published technical appraisals (three of which were positive and two of which were negative) and it correctly discriminated between those drugs recommended by NICE and those not recommended. 1. Ferguson JSJ, Summerhayes M, Masters S, Schey S, Smith IE. New treatments for advanced cancer: an approach to prioritization. British Journal of Cancer 2000;83:1268-73. Excellence in Oncology Awards 2010 Entry for The Excellence in Oncology Awards is about to close. The awards recognise and reward initiatives that help to improve cancer care in the UK and therefore provide an opportunity to share best practice throughout the oncology community. Pharmacists and their teams are among the oncology healthcare professionals invited to enter and the awards are also open to patient and professional associations, charities and hospitals’ in-house communications’ departments. The deadline for entries is 5.00pm on Friday 16 July 2010. For further information visit www.excellenceinoncology. org. Winners will be announced at a dinner ceremony to be held during the National Cancer Research Institute Cancer Conference on Tuesday, 9 November 2010 in Liverpool. These awards are organised and funded by Pfizer Limited in association with the British Oncological Association (BOA). BOPA Bulletin Issue 1 Summer 2010 7
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