Procurement systems in Scotland, Wales and Northern Ireland

Tim Root, Assistant Head, NHS Specialist Pharmacy Service, Specialist Pharmacy ServicePublished

The Devolved Health Administrations in Wales, Scotland and Northern Ireland have different but complementary systems for procuring medicines for acute care

NHS Scotland

National Procurement, part of National Services Scotland, leads 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 seven therapy-specific frameworks which are re-tendered every two-years (staggered with 3 frameworks tendered in one year and 4 the next).

In-patent medicines

The Negotiation without Advert procedure is used frequently for in-patent medicines with individual product specific frameworks.

National Procurement

National Procurement also provides the secretariat for the following organisations.

Scotland’s Patient Access Scheme Assessment Group (PASAG)

The PSAAG agrees commercial arrangements linked to the health technology assessment process.

The PASAG Secretariat also co-ordinate 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 (MHNGMG)

The MHNGMG is a focal point for collaboration between Health Boards on medicines homecare including undertaking once for Scotland reviews of homecare services proposed by manufacturers.

NHS Scotland Primary Care Rebate Scheme Review Group

This group assesses primary care rebate schemes proposed by pharmaceutical companies and advises on their appropriateness for implementation in NHS Scotland.

Collaboration with England

There are a small number of product areas where there has been joint procurement with England; a key example is Recombinant Factor VIII (rFVIII).

Some of the products and services typically managed by Regional CPOs in England are also procured on behalf of Scottish Health Boards by National Procurement.

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 (NWSSP)

The National Procurement Lead Pharmacist provides clinical procurement leadership to the contracting process managed by the NWSSP – Procurement Services.

The NWSSP invite and manage all the medicine contract categories and services for the 7 health boards and Velindre NHS Trust.

Medicines procurement services

Other key medicines procurement services that are part of this 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 AWMSG or NICE
  • Free of charge supply of medicines pre-health technology appraisal (HTA)

All-Wales Drug Contracting Committee (AWDCC)

The AWDCC act as the awarding body for these contracts and ensure 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)

HSC Northern Ireland

NI Public Procurement Policy is developed by the Department of Finance with advice and guidance from the Construction and Procurement Delivery (CPD).

Centres of Procurement Expertise (CoPEs)

Public procurement is undertaken or is advised by the CoPEs.

Business Services Organisation Procurement and Logistics Service (BSOPaLS)

Health service procurement including pharmaceuticals is undertaken by the BSOPaLS.

Regional Pharmaceutical Procurement Service (RPhPS)

Professional and technical support, advice and leadership is provided by the RPhPS, based within the Northern Health and Social Care Trust.

Regional Pharmaceutical Contracting Executive Group (RPCEG)

The portfolio of work 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 three main procurement work streams:

  • Generic medicines
  • Branded medicines
  • Medical devices (limited areas: surgical dressings, wound management products)

Collaboration with England

RPhPS / 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 NHSE&I)
  • 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 with pricing review, pre-extension and review of transition products incorporated into the programme.

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

Medicines Optimisation Regional Efficiency (MORE)

The Department of Health leads the MORE Programme to then be delivered by the Trusts and the Health and Social Care Board (HSCB).

One of the initial targets was to deliver £90m of efficiencies from the prescribing budget across Primary and Secondary care over the period 2016/17 to 2018/19.

The efficiencies over the initial three year period were approximately £100m and the MORE programme has been extended.

Collaboration with others

NI HSC is also included within some national procurement arrangements including a number of NHSE&I frameworks and participation in the National Procurement Scotland Contrast Media Framework.