1. Please provide details of medicines and pharmacy savings schemes (aka cash releasing efficiency schemes, cost improvement schemes, cost reduction schemes etc)  for 2013-14, 2014-15, 2015-16 and plans and progress to date for 2016-17.  Please provide details of the total saving for each year and predicted savings target for 2016-17.

2013/14  £536k

Staff transformation as below including non-recurrent staffing vacancies

2014/15 £734.7k

Chemotherapy tender – price reductions in most cases

Generic zoledronic acid injection

Utilising in house outsourced provider for antiTNF

Enoxaparin contract prices

Reduction in usage of FP10s (improved formulary management)

General drive on improving inpatient and outpatient prescribing and pharmacy team challenging and monitoring against formulary

2015/16 £70.3k

Botox to Dysport switch in paeds.

Alternative provider for rituximab ready to use product

Los of pay protection ending following transformation.

16/17 Plans not agreed

2.  For each year, please provide details of any projects, specifically:
1.  Details of any formulary schemes in which for example, therapeutic drug switches were made Branded inhalers combinations e.g. Fostair/Seretide (15/16)

2.  Details of any schemes in which switching supplier for medicines or associated sundries generated savings  Nothing specific other than related to the medicine itself.  This may of course result in a different supplier but this wasn’t necessarily the root cause for the change.

2015/16 For renal medicines, the directorate were asked to prescribe internally following a preferential contract price for generic immunosuppressants rather than use FP10s. No value has been identified but the prescribing has been brought back in house.

2015/16 Reviewing changes in formulation e.g. purchasing pre-filled syringes from alternative provider e.g. azacytidine

3.  Details of any gainshare agreements with commissioning bodies made for each year, and how long each agreement is scheduled to last.

NIL in place

4.  The value of contract savings made under regional or national contracts.  Please note, the detail is unnecessary so the high level figure will not breach any commercial or pricing confidentiality clauses.

2013/14   £875,869.59

2014/15   £705,556.71

2015/16  £360,270.69

5.  Any projects that involved limiting supplies of medicines to patients on an outpatient or discharge basis – eg not supplying medicines at discharge for patients with a length of stay less than 48 hours.

2014/15 started & continuing – Where patients have regular medicines at home, the discharge letter is annotated as such and medicines are not supplied at discharge. The TTO is documented as ‘more at home’.

2014/15 started and continuing – Promotion of drug treatment referral letters in outpatients to avoid prescriptions being written.

6.  Details of any pharmacy staff posts that have been given up to generate savings.

2016/17  £71k  This followed a critical review of the budgets and where vacancies were appearing.  There were lots of very small amounts which were spread throughout the budgets and cost codes and following a skill mix review, the posts were given up for CIP. (£32K technicians, and £29k pharmacists)

In 2013/14 £238k was released following a pharmacy transformation. A key objective to delivering this saving was to critically review the higher banded staff and replace them with more lower banded staff where appropriate.  One outcome was to ensure that the level of service provided to ward based medicines management improved e.g. by appointed by appointing band 6 and 7 pharmacists and losing band 8a and 8b pharmacists.

7.  Details of any invest to save projects 

2013/14  Appointment of assistant technical officers to manage the returns of suitable medicines in pharmacy from wards.

8. Any other projects that generated recurrent savings in excess of £10k per annum  

2016/17  Critical review of medicines which had received a negative decision by NICE e.g. Xiapex, Faslodex (a while ago) to ensure no new prescribing takes place.

2015/16 Branded to generic prescribing e.g. linezolid

2015/16 Reviewing sizes of ampoules/vials to see if using a smaller size might be more cost effective e.g. Sugamadex.

2015/16 Taking advantage of new prices prior to contract prices being issued/agreed e.g. voriconazole.

2015/16 Providing blister packs from outsourced provider rather than use FP10s to obtain from community pharmacist.