NHS pharmacy procurement in Scotland, Wales and Northern Ireland

Devolved nations

The devolved nations of Scotland, Wales and Northern Ireland have independent authority over health care within their respective regions. While there is joint working across all nations for some therapy areas, this article summarises how pharmacy procurement is undertaken within each of these nations.

NHS Scotland

National Procurement and Logistics is the procurement arm of NHS National Services Scotland. It leads the collaborative procurement of medicines and associated services on behalf of Scotland’s Health Boards.

Off-patent medicines

The majority of ‘off-patent’ medicines are contracted via eight therapy-specific frameworks which are re-tendered every two to three years.

In-patent medicines

The ‘Negotiation without Advert’ procedure is used frequently for in-patent medicines with individual product-specific frameworks. The Negotiation without Advert procedure is a tender process that can be used for novel medicines, when there is no competition.

Secretariat role

National Procurement also provides the secretariat for the organisations below.

NHS Scotland’s Patient Access Scheme Assessment Group

The Patient Access Scheme Assessment Group (PASAG) agrees commercial arrangements approved by NHS Scotland’s health technology assessment process.

The PASAG Secretariat also co-ordinates the assessment of Pre‐Health Technology Assessment Free of Charge Pricing Scheme (pre‐HTA FOC) proposals.

NHS Scotland Medicines Homecare National Governance and Management Group

The Medicines Homecare National Governance and Management Group (MHNGMG) collaborates between Scotland’s Health Boards on medicines homecare. This includes undertaking central reviews of homecare services proposed by manufacturers, so they are only reviewed once for Scotland.

NHS Scotland Primary Care Rebate Scheme Review Group

The Primary Care Rebate Scheme Review Group assesses primary care rebate schemes proposed by pharmaceutical companies and advises on their appropriateness for implementation in NHS Scotland.

Collaboration with NHS England

There are a small number of product areas where there is joint procurement with England; this includes plasma products and blood clotting factors.

Some of the products and services typically managed by regional collaborative purchasing organisations (CPOs) in England are also procured on behalf of Scottish Health Boards by National Procurement. For more information on CPOs, see the article on Regional procurement of pharmacy products and services in England (SPS page)

NHS Wales

In NHS Wales, the integrated health service structure provides chief pharmacists with overall accountability for patient safety and expenditure on medicines and pharmacy services in the managed sector and in primary care.

NHS Wales Shared Services Partnership

The NWSSP invites and manages all the medicine contract categories and services for the seven health boards and Velindre NHS Trust.

The National Procurement Lead Pharmacist provides clinical procurement and quality assurance to support the contracting process.

Medicines procurement services

Other key medicines procurement services that are part of the national approach in NHS Wales include:

• medicines homecare services
• primary care rebate schemes
• commercial agreements outside of a formal tender process usually related to new medicines or indications that have been subject to the health technology appraisal process completed by the All Wales Medicines Strategy Group (AWMSG) or the National Institute for Health and Care Excellence (NICE)
• free of charge supply of medicines pre-health technology appraisal (HTA; for more information see the all-Wales free of charge medicines supply guidance)

All-Wales Drug Contracting Committee

The All-Wales Drug Contracting Committee (AWDCC) acts as the awarding body for all contracts and ensures compliance with all the legal and governance requirements under the public procurement regulations.

The committee membership consists of:

• health board medicine procurement lead pharmacists
• the National Quality and Assurance Lead Pharmacist
• chief pharmacist representation
• a finance director
• the senior category manager (Medicines)

Health and Social Care Northern Ireland

Health and Social Care Northern Ireland’s (HSCNI) Public Procurement Policy is developed by the Department of Finance with advice and guidance from the NI Department of Finance’s Construction and Procurement Delivery (CPD).

Centres of Procurement Expertise

Public procurement, including pharmaceuticals, is undertaken or is advised by the Centres of Procurement Expertise (CoPEs).

Business Services Organisation Procurement and Logistics Service

Health service procurement including pharmaceuticals is undertaken by the Business Services Organisation Procurement and Logistics Service (BSOPaLS).

Regional Pharmaceutical Procurement Service

Professional and technical support, advice and leadership is provided by the Regional Pharmaceutical Procurement Service (RPhPS), based within the Northern Health and Social Care Trust.

Regional Pharmaceutical Contracting Executive Group (RPCEG)

The procurement workplan is agreed with the RPCEG comprising:

• Trust heads of pharmacy and medicines management
• senior representation from the Department of Health
• BSOPaLS.

Procurement workstreams

There are four main procurement work streams:

• generic medicines (2 tender exercises per year)
• branded medicines
• medical devices (limited to surgical dressings and wound management products)
• medical gases

Collaboration with England

RPhPS and BSOPaLS also contribute to the Public Health Agency and Department of Health strategies for :

• procurement of seasonal influenza vaccines
• co-ordination of childhood vaccines distribution (with NHS England)
• local storage and distribution arrangements and stockpile management

Shared contracts

The current programme of work includes:

• nutritional services
• unlicensed medicines
• homecare services
• wholesaler services

Contracts typically operate over a ‘2+2+2’ year period (that is, an initial 2-year term, with 2 separate 2-year extensions) with pricing review, pre-extension and review of transition products incorporated into the programme.

Northern Ireland has also implemented a Dynamic Purchasing System (DPS) to support the medicines procurement portfolio.

HSCNI is also included within some national procurement arrangements including a number of NHS England frameworks.

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