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A Report into the Uptake of Patient Access Schemes in the ... - BOPA

A Report into the Uptake of Patient Access Schemes in the ... - BOPA


A Report into the Uptake of Patient Access Schemes (PAS) in the NHSSection Three: Aims and ObjectivesThe Cancer Network Pharmacist Forum (CNPF) members agreed that a researchproject was needed to look at the impact of Patient Access Schemes on pharmacyin the NHS. The research question was:‘What has been the impact on pharmacy of implementing Patient Access Schemesto improve access to cancer medicines in the National Health Service?’The aims of the project were:1. To assess the impact on pharmacy services of managing patient accessschemes2. To gain feedback from users of schemes on what factors are important inmaking a good scheme3. To find out what if any capacity is needed to manage patient access schemes,specifically how much extra time is needed for each patient episode(prescription)4. To compare four common schemes for oncology medicinesNovember 2009 Page 6 of 34

A Report into the Uptake of Patient Access Schemes (PAS) in the NHSSection Four: Study Design and Methods4.1 Outline of Research Method ChosenA survey using an online questionnaire as the data collection tool was used tooffer a non experimental design that described reality. The survey focuses on fourkey areas, uptake of schemes, feedback on specific types of schemes, impact oncapacity and suggestions for improving schemes. The questionnaire asked aboutfour specific schemes that had been in operation for at least 12 month betweenJuly 2007 and July 2009.The specific schemes that data was collected on were.• Erlotinib (Tarceva®) (pre-NICE) for lung cancer• Sunitinib (Sutent ®) for renal cell cancer or GIST (DH approved)• Bortezomib (Velcade®) for multiple myeloma (DH approved)• Cetuximab (Erbitux®) for advanced colorectal cancerThe questionnaire asked specific questions relating to the running of eachscheme. There was a series of general questions about the schemes to allowcomparison of schemes. Each scheme asked for an assessment of the time takenrunning the scheme per patient episode, given as a choice of 0 to 5 minutes, 6to10 minutes etc. In addition a subjective assessment of the rating of the schemewas required. This was to see if any one type of scheme was more favourablethan the other.Pharmacists from the North of England Cancer Network (NECN) helped to designthe questionnaire. A pilot study of the nine acute Trusts within the NECN wasundertaken to refine the questionnaire. The project was discussed at the CNPFmeeting in June 2009, the questionnaire was reviewed and minor amendmentsmade the following suggestions by the CNPF group.The pilot and discussion with CNPF raised a few minor issues of clarity around thedesign of the questionnaire which was then amended accordingly e.g. menuoptions were changed. The pilot showed that the questionnaire took 15 minutes tocomplete on average.The questionnaire consisted predominantly of closed questions of the Yes/No orselect from a list variety. Where appropriate comments sections were included togather qualitative data. The focus group proved useful in selecting areas forcomments. A Likert scale was used in a questions assessing opinions on PAS.4.2 Data Management and AnalysisThe online survey software ‘Survey Monkey’ was used as the data collection tool.Northumbria Trust and NECN have accounts with the software providers. Thesurvey was accessed via a web link distributed electronically. Respondents simplyclicked the link and were taken directly to the survey. Results were available foranalysis online and were download into an excel spreadsheet database. Analysiswas possible down to the individual response level to see the details of particularresponses. The software facilitates comparison of open-ended questions.November 2009 Page 7 of 34

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