Clive Jackson, Director, The National Prescribing Centre

UPDATE

The National Prescribing Centre (NPC) became part of NICE in April 2011. The work previously carried out by NPC is now part of the NICE Medicines and prescribing community, which provides guidance, advice, and support for delivering quality, safety, and efficiency in the use of medicines.

Guidance produced by the NICE Medicines and prescribing community includes:

  • medicines evidence summaries
  • medicines practice guidelines
  • key therapeutic topics.

For more information visit: www.nice.org.uk/mpc

The National Prescribing Centre (NPC) is a DoH-funded NHS body, based in Liverpool. It was formed 4 years ago following the recommendations of a formal review, commissioned by the NHS Executive, of centrally funded support for prescribing within primary care.

Over the intervening period the NPC has become a key element of the national strategy around medicines use and has developed a strong reputation for the quality of its work and independence of its reviews.

The national prescribing centre
Set up 1 April 1996
Aim To facilitate the promotion of high quality, cost-effective prescribing and medicines management through a coordinated and prioritised programme of activities aimed at supporting all relevant professionals and senior managers working in the new NHS
Status An NHS organisation managed by the NHS Executive. The NPC remit covers England, but Wales and Northern Ireland currently purchase services from the NPC.
Senior personnel Director: Clive Jackson
  Assistant Director: Annie Coppel
  Medical Director: Martin Duerden
  Manager – New Drugs Initiative: Katrina Simister
  Head of MeReC Publications: Under recruitment
Contact details: Address: 70 Permbroke Place, Liverpool, L69 3GF
  Tel: 0151 794 8134
  Fax: 0151 794 8139
  Website: http://www.npc.co.uk

The main outputs for the period 1999/2000 include:

  • MeReC publications (Bulletin, Briefing, CD ROM)
  • Combined Table of Contents and Connect Newsletter
  • Therapeutic Reference Sheets and Information Resource
  • 'New Drugs' publications
  • National support documents (e.g. GP Prescribing Support)
  • National conferences
  • Therapeutic workshops
  • Targeted seminars/other events
  • Prescribing initiatives database
  • NPC websites' content (internet/NHSnet)

The NPC's work programme is divided into three main core elements:

  • Information
  • Education and training
  • Dissemination of good practice.

In addition, there are two other overarching areas, routinely considered when developing and planning the NPC's programme:

  • Using developments in information technology (IT) effectively to support core programme elements
  • Informing research and development nationally around needs relating to prescribing and medicines management.

Over the past 4 years, the emphasis of the NPC's work programme, and the range of audiences it supports, have changed significantly, for a number of reasons.

In the first half of the 1990s, prescribing was often seen as an area of healthcare to be managed in isolation from the rest, and GP prescribing was deemed totally separate from hospital prescribing, with little coordination across this interface.

However, with the new millennium, the NHS has been given unified, cash-limited budgets to cover all the health-care needs of each locality. These budgets include the funding for prescribing in both hospitals and general practice. This unification of budgets has brought into sharp focus the impact that one element of healthcare has on another, especially if it s not managed effectively.

The recent problem with generic medicines (the 'Category D' issue) is a particularly vivid illustration of why prescribing now needs to be addressed within the wider context of healthcare delivery. It has also further raised the priority of medicines management within the NHS.

Area prescribing committees are increasingly providing professional/ management advice which applies across the whole of their HA's remit. Consequently the impact on primary care services, of decisions made within secondary care (and vice versa), are now usually considered and agreed jointly, in advance.

The development of an evidence-based medicine approach to patient care, linked to the production of high quality, national guidelines (from NICE and from National Service Frameworks), further reinforces the fact that prescribing is no longer considered in isolation from other treatment interventions.

As cost-effective prescribing now has such a high priority within the NHS and is routinely considered and managed as part of the wider delivery of healthcare to patients, the NPC audience that requires support to deliver this agenda has inevitably increased.

No longer does the NPC concentrate purely on HA medical/pharmaceutical advisers and GPs. Over the past 2 years, a new range of professionals and managers have been added to our audience, including:

  • HA chief executives
  • Directors of public health
  • NHS trust chief executives
  • NHS trust chief pharmacists
  • Hospital drug and therapeutic committee (DTC) secretaries
  • Community pharmacists
  • Prescribing nurses and their community trust managers
  • PCG chief executives and board members
  • PCG prescribing advisers and prescribing leads
  • Clinical governance leads

This increase in our audience has been accommodated, in part, by ensuring that we use the effort and resources put into delivery of core work optimally, and by targeting different outputs (or different versions of the same primary output) to different audiences.

Prioritisation of our workload, and who gets what, is essential to ensure that we maximise the potential of our expertise and resources and don't dilute our support for our longer-standing audiences.

Early planning ensures that, wherever possible, the various core elements of the NPC's work programme are coordinated effectively; this helps reinforce key clinical and policy developments, plus other relevant healthcare messages.

Home page of the National Prescribing Centre website
picture of npc home page

 

We run a series of therapeutic workshops throughout the year, covering at least four different therapeutic topics (e.g. respiratory disease, gastrointestinal disease). Potential items for coverage in our information outputs (such as MeReC Bulletin and MeReC Briefing) have, more recently, been considered and agreed at the same time as workshop topics.

There are currently a number of major new developments at the NPC. Two of the most important relate to NICE, plus the method of delivery of training to the significant number of new prescribing advisers now working within PCG and GP practices.

 

Approximately 25% of the NPC's work and funding now falls under the umbrella of NICE. In particular, MeReC publications will increasingly be used to aid the dissemination of NICE appraisals and guidelines, especially to our core audiences. We have worked very closely with NICE, over the past 6 months, to identify and plan how best to realign and utilise the NPC's expertise and resources to support its aims and work programme.

 

In terms of training for PCG and practice-based advisers, the NPC is setting up a system of cascade training. This initiative aims to ensure that we can continue to provide high-quality therapeutic training events, but with an increased ability to deliver them to all members of this important new professional group.

At the time of writing, the NPC was recruiting a number of highly experienced, suitably skilled professionals, from around the country, who will be trained and supported to provide therapeutic seminars within their locality.

 

The next couple of years will see further significant changes to the NHS and to the support requirements of the professionals and managers working within it. The NPC aims to build on its current skills, outputs and reputation to ensure that prescribing and medicine use are optimised for the benefit of both patients and the health service.

Guidelines in Practice, July 2000, Volume 3
© 2000 MGP Ltd
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