New Medicines Reviews 2013

Appendix 7: Individual NHS board feedback

The below feedback is provided for each of the 12 NHS boards that provided complete data.

NHS Ayrshire & Arran

NHS Ayrshire & Arran was 100% compliant with making their ADTC decisions on the 23 medicines within 90 days. 91% (21 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made.

The board's website was also easily to navigate and when using the website's main search function, and using the search terms noted in Appendix 2, links were provided to the NHS Ayrshire & Arran formulary. NHS Ayrshire & Arran also displayed their ADTC decisions in a manner consistent with the CMO guidance (see Appendix 6).

Of the 23 medicines, 17 were included on the NHS Ayrshire & Arran formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	15
2	2
3	0
4	2
5	1
6	3

NHS Borders

NHS Borders was 70% compliant with making their ADTC decisions on the 23 medicines within 90 days. 70% (16 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made.

The board website failed to provide access to the NHS Borders formulary or links to the board's ADTC decisions.

Of the 23 medicines, 17 were included on the NHS Borders formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	17
2	0
3	1
4	1
5	0
6	4

NHS Dumfries & Galloway

NHS Dumfries & Galloway was 96% compliant with making their ADTC decision on the 23 medicines within 90 days. 70% (16 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made.

NHS Dumfries & Galloway's website provided poor access to the board formulary and there was no readily available record of ADTC decisions. Using the search terms, detailed in Appendix 2, no relevant search results were found. NHS Dumfries & Galloway do have an external formulary website, which provides excellent access for patients and the public to local formulary decisions. However, a link was not provided on the board's main website.

Of the 23 medicine, 13 were included on the NHS Dumfries & Galloway formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	8
2	5
3	3
4	0
5	3
6	4

NHS Fife

NHS Fife was 91% compliant with making their ADTC decisions on the 23 medicines within 90 days. 100% (23 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made. Both medicines that did not have a decision made on them within 90 days were cancer therapy medicines that required a decision from a regional cancer network on use before an ADTC decision could be made.

NHS Fife's website provided excellent access for patients and the public, with the first search term (from Appendix 2) providing a link to the ADTC section of the board website, which then provided links to the Fife joint formulary and ADTC decisions.

Of the 23 medicines, 21 were included on the NHS Fife formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	21
2	0
3	0
4	1
5	1
6	0

NHS Forth Valley

NHS Forth Valley was 100% compliant with making their ADTC decisions on the 23 medicines within 90 days. 48% (11 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made. This discrepancy was due to publication dates not being provided for 11 of the 12 remaining medicines.

NHS Forth Valley's website provided very poor access for patients and the public with regards to access to ADTC decisions or the NHS Forth Valley formulary. None of the agreed search terms provided any relevant results.

Of the 23 medicines, 20 were included on the NHS Forth Valley formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	20
2	0
3	0
4	3
5	0
6	0

NHS Grampian (including NHS Orkney and NHS Shetland)

NHS Grampian was 57% compliant with making their ADTC decisions on the 23 medicines within 90 days. 83% (19 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made. The formulary decision publication deadline was missed for four medicines and was related to server issues in all cases.

NHS Grampian's website had easy access for patients and the public to view the board's formulary or ADTC decisions. In most cases, when searching for the terms detailed in Appendix 2, links were provided to the NHS Grampian medicines management website; however these links did not always work. NHS Grampian indicated that they have been experiencing server issues in recent months, but are instigating a new system that should resolve these problems.

NHS Orkney and NHS Shetland are signed up to the decisions made by NHS Grampian's ADTC. NHS Shetland did not publish these ADTC decisions on their website. NHS Orkney provided good access to the NHS Grampian formulary and also displayed their ADTC decisions in a manner consistent with the CMO guidance (see Appendix 6). NHS Orkney and NHS Shetland did not return completed data collection forms, as they duplicate the decisions of NHS Grampian.

Of the 23 medicines, 15 were included on the NHS Grampian formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	14
2	1
3	0
4	2
5	6
6	0

NHS Greater Glasgow and Clyde

NHS Greater Glasgow and Clyde was 100% compliant with making their ADTC decisions on the 23 medicines within 90 days. 100% (23 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made.

NHS Greater Glasgow and Clyde's website provided excellent access to ADTC decisions and the board's formulary. When searching the website (using the search criteria detailed in Appendix 2), links were provided to the medicines section of the board website where the above information could be found intuitively.

Of the 23 medicines, 20 were included on the NHS Greater Glasgow and Clyde formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	20
2	0
3	0
4	0
5	0
6	3

NHS Highland (and NHS Western Isles)

NHS Highland was 78% compliant with making their ADTC decisions on the 23 medicines within 90 days. 52% (12 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made.

NHS Highland's website provided excellent access for patients and the public to view the board's formulary and their ADTC decisions. When using the search terms (detailed in Appendix 2), search results were returned for the pharmacy section of the website, which provided the formulary and links to the ADTC decision bulletins.

NHS Western Isles follows the ADTC decisions of NHS Highland. As NHS Highland was 74% compliant and NHS Western Isles was 65% compliant with making their ADTC decisions on the 23 medicines within 90 days, it can be concluded that there is a delay between NHS Highland's ADTC decisions being made and NHS Western Isles making their subsequent decision. NHS Western Isles did not provide dates of when their ADTC decisions were published on their website and when searching the board website they did not provide access to the board's (or NHS Highland's) formulary or ADTC decision bulletins.

Of the 23 medicines, 15 were included on the NHS Highland (and NHS Western Isles) formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	15
2	0
3	0
4	8
5	0
6	0

NHS Lanarkshire

NHS Lanarkshire was 100% compliant with making their ADTC decisions on the 23 medicines within 90 days. 100% (23 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made.

NHS Lanarkshire's website provided good access to the Lanarkshire formulary. However, this was only found after searching for 'ADTC' or 'formulary' on the board website. When using the other search terms detailed in Appendix 2, such as medicine, no relevant results were provided. Links were also provided to the NHS Lanarkshire ADTC bulletins. NHS Lanarkshire also displayed their ADTC decisions in a manner consistent with the CMO guidance (see Appendix 6).

Of the 23 medicines, 23 were included on the NHS Lanarkshire formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	23
2	0
3	0
4	0
5	0
6	0

NHS Lothian

NHS Lothian was 74% compliant with making their ADTC decisions on the 23 medicines within 90 days. 100% (23 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made. NHS Lothian's website did not provide easy or intuitive access for patients and the public to view the board's formulary or ADTC decisions. When searching the board's website, using the search terms detailed in Appendix 2, one of the results provided was 'links'; when selected, a series of links to external websites was provided; one of these was the Lothian Joint Formulary website. This link was not placed in a particularly intuitive location. However, when found, Lothian's Joint Formulary website provided excellent information for patients and the public, detailing all local formulary decisions.

Of the 23 medicines, 13 were included on the NHS Lothian formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	11
2	2
3	0
4	3
5	3
6	4

NHS Tayside

NHS Tayside was 91% compliant with making their ADTC decisions on the 23 medicines within 90 days. 26% (6 out of 23) of the ADTC decisions on the 23 medicines were published on the board's website within 14 days of the ADTC decision being made.

NHS Tayside's website does not have a search facility. Within the links section of the website, there is a link to the NHS Tayside ADTC website, which has links to the NHS Tayside formulary. There is also a link to the formulary and a new medicines search index, with accompanying text describing the local new medicines process. However, these links would not necessarily be apparent to patients.

Of the 23 medicines, 18 were included on the NHS Tayside formulary.

The breakdown of ADTC decisions on the 23 medicines is provided below.

ADTC decision categories	Number of medicines
1	18
2	0
3	0
4	3
5	0
6	2