Download medicines optimisation group (`mog`)

MEDICINES OPTIMISATION GROUP (‘MOG’)
Established by Trust Board
Reports and accountable to the Information Governance Group(IGG)
(Non-Statutory)
TERMS OF REFERENCE
Overview
The Medicines Optimisation Group is a formally constituted part of the internal governance
arrangements of the Trust.
Summary of purpose
To provide a strategic direction for the Trust on medicines optimisation related to
documentation, training, practices, policies, prescribing and guidelines to IGG
Objectives and Purpose
To promote evidence based prescribing and monitor the introduction of new medicines,
related documentation, practice policies, prescribing and use by:
Commissioning Trust wide Audit on medicines optimisation where appropriate
Review audit results and advise on actions to localities/speciality directorates
To commission and monitor training programmes relating to medication and publishing
newsletters for staff.
To advise the Trust on policies to be accepted, through endorsement and
recommendation to the Quality and Standards Committee.
To make decisions on new drugs and explicitly consider the clinical effectiveness of
treatments, safety, cost, value for money and availability of resources (following
standards as criteria for decision making (NICE GPG1)
To develop and maintain treatment guidelines to encourage evidence based and cost
effective prescribing.
To manage the introduction of new mental health medication in conjunction with the
localities and specialist units.
To review progress, oversee compliance and make recommendations on improving
medicines optimisation to ensure readiness for Foundation Trust application.
To adhere as closely as possible to the recommendations given in the NICE Medicines
Practice guidelines.
Plan for and manage the introduction of new medicines and new indications for existing
medicines in the treatment and management of mental health conditions through the use
of ‘Formulary decision guide’ (where there is a NICE TA) or ‘Product Evaluations’ as
appropriate.
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To ensure that medicines available for use by prescribers in AWP are evaluated by MOG
are evidence based and cost effective.
To review the use of unlicensed / off-label medicines and ensure risk assessments are in
place for their use where needed (See Procedure ‘Med 10’).
To consider applications for specific treatments for clients as one off applications (done
through the ‘non-formulary request / Specialist use only request’ form on Ourspace).
To have process(es) in place for applications for new drugs to the AWP formulary or as
‘one-off’ requests.
To review NICE guidance and identify appropriate leads for the NICE guidance and
ensure implementation within AWP where appropriate. NICE page on Ourspace here
To include medicines with a positive NICE technology appraisal into the AWP formulary
automatically, where clinically appropriate to the services provided by AWP.
To adopt medicines with a NICE technology appraisal as ‘option for treatment’ into the
AWP working formulary (where clinically appropriate) and identify its place in the relevant
care pathway(s) in line with NICE recommendation. (Or otherwise ‘agree as no action as
necessary, as this does not directly affect Trust services’).
To have an Appeals process in place to adhere to the NICE GPG1 recommendations.
To ensure implementation of medicine related safety alerts within AWP.
To regularly review drug expenditure against allocated budgets. To advise on resource
allocated for medicines across the Trust e.g. in year budget to support decisions on new
drugs.
To develop and approve shared care agreements, product evaluations (for new drugs
relevant to psychiatry) and relevant policies and procedures.
To monitor the use of antibiotics as part of the Antimicrobial Stewardship Implementation
plan.
Any Shared Care Agreement / prescribing guidance for use in Primary care must also be
approved by the relevant Joint formulary Group / Drug & Therapeutics Committee for
that local area or Acute Trust.
Provide guidance on medicines optimisation issues that have an effect on clinical
practice and the overall delivery of healthcare in the local health economy, e.g.
developing and keeping the AWP working formulary up-to-date; agreement of medication
related policies, patient group directions (PGDs) and self-funding by individual clients.
To work closely with the Joint formulary and Drug & Therapeutic groups of the local
Acute Trusts and *CCGs that commission their services from AWP to ensure access to
medicines across the interface and on discharge.
Ensure that its advice, once agreed, is implemented and / or endorsed by relevant
organisations, e.g. by an implementation and monitoring plan.
Consider the treatment options available, ensuring the choice of medication is the most
appropriate for the individual service user. Patient safety must also be an integral factor
when considering treatment options, as well as the way medication is used in practice.
To advise on medicine related safety alerts as and when appropriate.
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To advise on all matters of quality in relation to medicines optimisation that impact on
safety, effectiveness or patient experience.
To consider the policy and procedural issues emerging from medication incidents as
reported to the ‘MOG’ by MIRG.
*Clinical Commissioning Groups
Scope
The information the Medicines Optimisation Group will use to undertake its duties is shaped
by national guidance e.g. NICE, CQC, Trust incidents, integration with Acute Trusts
formulary groups and other NHS bodies. The Medicines Optimisation Group, on behalf of
IGG, has oversight of the use of medicines in AWP Trust and complies with NICE and
relevant national guidance.
Accountability/reporting requirements
This Committee is accountable to the Information Governance Group.
Minutes will be prepared after each meeting of this Group and circulated to members of
the Group and others as necessary. These will be reported at the next meeting of IGG
following the meeting of the Group.
Reports will be submitted to the Quality and Standards Committee on an exceptional
basis to escalate issues, and an annual report will be provided.
Minutes will be prepared after each meeting of this Group and circulated to members of
the Group and others as necessary. These will be reported at the next meeting of IGG
following the meeting of the Group.
The Committee will draw to the attention to any other Management Group or Committee
any issues which it believes requires that forum’s consideration.
Membership
Medical Director/ deputy (Chair)
Chief Pharmacist/ deputy (Deputy Chair)
Specialist Clinical Pharmacist x3
Representative from each Locality Unit
Trust Lead for non-medical prescribing
Chair of MIRG
Deputy Director of Finance
CCG/Heads of medicines management representative (BNSSG, Wiltshire)
Service User Representative
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Meeting requirements
Quorum – The group will be considered in quorum if the Chair, and 6 other members are
present, as long as at least 4 are clinical (medical, nursing or clinical pharmacy
representatives)..
Substitutes/Deputies – All members are asked to send a deputy if they are unable to
attend so that there is appropriate representation for all relevant professions
Invitees – Specific invites will be given to relevant expert clinicians for discussions on
particular medications or policies or other relevant parties as required (e.g. Clinical Audit
lead or Head of Quality Academy)
Attendance – is required at each meeting. If a member cannot attend apologies must be
received. Representatives from the Locality and Specialist Delivery units must act as a
link between local quality governance and MOG and must provide feedback to the
relevant management triumvirate structure. They are authorised to make decisions on
behalf of Clinical Directors or Heads of Professional Practice for their LDU/SDU. They
also have an expert role in advising on their area of clinical practice.
Support – The work of this Group will be supported by the Medical Director (also the
Chair) who will normally attend and ensure appropriate attendance from other
representatives.
Frequency of Meetings – The Group will meet bi-monthly, on the 3rd Thursday of the
month.
Administration of Group – The PA to the Medical Director shall provide appropriate
administrative support to the Chair and Group members. The minutes will be published
on the MOG page on Ourspace within 3 weeks of ratification. The minutes (excluding
any Governance content) will also be published on the Trust internet page.
Notice of Meetings – Unless otherwise agreed, notice of each meeting confirming the
venue, time and date, together with an agenda of items to be discussed, shall be
available to each member of the Group and other person required to attend no later than
*4 working days before the date of the meeting, unless it is deemed inappropriate to wait
until the next meeting (2 months later) e.g. new guidance directly relevant to meeting
such as NICE TA, complex fast-track needing discussion etc. Each member will have
authorised access to a designated link to the ‘Medicines Optimisation Group’ page on
ourspace where the papers will be uploaded.
Conflicts of Interest – Each member of the group is responsible to declare any potential
conflicts of interest relevant to the group by completing a ‘Declaration of interest’ form at
the start of the meeting. Declarations of interest may include any gifts or hospitality
received from the pharmaceutical company, presentations, advisory panels, sponsorship
of research, consultancy work, conference fees, honoria or lecture fees etc. funded by
pharmaceutical company, shares held in the company, drug lunches. Please refer to the
‘Guidance on the Declaration of gifts and Hospitalities’ and ‘Standards of Business
Conduct Policy P075’ on ourspace for further information.
Lead contact for this Meeting
PA to the Medical Directorate
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Monitoring Effectiveness
In order to support the continual improvement of governance standards this Group is
required to complete a self-assessment of effectiveness at least annually and advise the
Trust Board of any suggested amendments to these Terms of Reference which would
improve governance arrangements. The process for monitoring will take the form of a report
to the Senior Management Team on the work of the Group, membership and attendance.
The group has an action log in relation to its responsibilities and monitor progress on the
work plan on a regular basis.
Review
These Terms of Reference were agreed by the Medicines Optimisation Group on 30 th
June 2016.
The Terms of Reference of this Group must be reviewed and subsequently approved by
the Trust Board at least annually.
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