New Medicines Reviews 2013

Appendix 2

Refresh of Area Drugs and Therapeutics Committees (ADTC)

BACKGROUND

ADTCs are key to ensuring that adequate systems and processes relating to medicines governance are in place in local NHS Boards. They are clinically led and clinically driven committees ensuring medicines issues are addressed across the health system.

The last guidance issued relating to the function and roles of ADTC was issued in the early 1990s. The Quality Strategy, Health and Social Care Integration agenda require us to refresh that guidance so that it is fit for purpose.

PURPOSE and FUNCTIONS

To provide professional advice, clinical advice and leadership to the NHS Board, that supports safe, clinically effective, cost effective and patient centred medicines governance, in all care settings.

Examples of this include

• developing, maintaining and/or promoting policies and systems for safe and secure use of medicines (e.g. Unlicensed and off-label medicines, recording and management of medicines)
• providing clear direction and delivery in relation to the NHS Board formulary following Scottish Medicines Consortium advice, promoting safe and cost effective medicines use
• monitoring trends, analysis and dissemination of learning from medication incidents
• participating in the Yellow Card Scheme for reporting adverse drug reactions.

To advise and support the strategic direction of all aspects of medicines governance and usage in all care settings ensuring inclusion within wider strategic planning carried out by the NHS Board.

Examples of this include

• supporting Antimicrobial Stewardship through the work of the Scottish Antimicrobial Prescribing Group (SAPG) via the Antimicrobial Management Teams
• supporting the NHS Board in meeting its statutory responsibilities in relation to medicines and prescribing
• supporting the NHS Board in the delivery of a comprehensive approach to national policy regarding medicines, linking with Regional and National groups where appropriate.
• Supporting the eHealth agenda and Scottish Patient Safety Programme and Significant Adverse Events

To ensure multi-stakeholder engagement and joint working on all medicine related issues within all care settings, including social care settings.

Examples of this include

• Developing, in conjunction with Communication teams, internal and external communication strategies for the public, patients and health care professionals regarding medicines use in the Board area
• Involving members of the public in the work of the ADTC
• Supporting the engagement of clinicians in initiatives to develop, implement and monitor systems to ensure seamless care for patients at the transition points of admission and discharge from hospital e.g. Quality Hub, Quality Improvement Teams
• Developing policies to support safe and effective use of medicines with social care partners.
• Through multi-stakeholder engagement ensuring that medicines are used safely in all community settings
• Working with the pharmaceutical industry in line with "A Common Understanding".
• Contributing to learning and safe practice through liaison with under graduate and post graduate tutors in relation to local educational initiatives to improve medicine use
• Promoting safe practice through liaison with R and D and audit committees to improve medicine use
• Publishing all information in an accessible format
• Providing end of year report to the Board.

To inform the financial planning and governance of the NHS Board to ensure the effective use of resources, in relation to medicines.

Examples of this include

• Contributing to effective horizon scanning to ensure the NHS Board have information on new medicines
• Advising on resource implications on the introduction of new medicines.
• Co-ordinating the qualitative review of medicines use, and providing clinical information on changing trends in medicines use.

REPORTING ARRANGEMENTS

The ADTC is the key professional advisory group for medicine governance and will report into the NHS Board via the Board's clinical governance structure.

The Director of Pharmacy is responsible for medicine governance; with a line management responsibility from Director of Pharmacy to Medical Director and Chief Executive Officer to NHS Board.

The NHS Board needs to define what functions, if any, are directly delegated to the ADTC.

NHS Board ADTCs will network to share good practice and develop consistent policies where appropriate.

MEMBERSHIP

The membership should predominantly include clinical practitioners with an interest in medicines use within the Board. The Board should appoint the Chair*.

Membership should be open to local flexibility and be commensurate with the size and needs of the NHS Board but as a core would include:

Chair* (Consultant, General Practitioner, lead Pharmacist or non-executive director)
Professional Secretary
Director of Pharmacy
Administrative support (from the Board Secretariat)
Hospital Consultants (from a range of clinical specialities)
General Practitioners
Pharmacists (representing both Hospital and Community)
Nurses

NHS Boards may wish to engage with other stakeholders as required on specific work streams or to extend membership to include; Dentists, Social care staff, Executive Medical Director, Executive Nurse Director, Managers, Allied Health Professionals, Finance and Academia/ Research, Clinical Governance Leads.

There should be cross representation with other key related workstreams such as Scottish Patient Safety Programme (SPSP).

The ADTC must be able to demonstrate effective patient and public engagement.

SUB GROUPS

The Antimicrobial Management Team (AMT) is a nationally recognised sub group of the ADTC.

ADTC may wish to develop further Sub Groups to take forward specific areas within the overall remit. Where these are convened they should have delegated authority to act on behalf of the ADTC, reporting and referring upwards as required.