Final proposals have been published for reimbursing the cost and supply of generic medicines supplied to community pharmacies and dispensing doctors.

Proposals

• Manufacturers would need DoH’s agreement to price increases if there is a limited number of manufacturers of a generic medicine or supply is concentrated
• Manufacturers would submit quarterly information on generic medicines income revenues, costs of purchases and transaction volumes
• Manufacturers would set prices of new generic products — provided they were lower that the equivalent branded product
• Prices that pharmacy contractors are reimbursed would be linked with the prices charged by manufacturers
• Incentives would be provided for pharmacies to benefit from procurement decisions where they also benefit the NHS
• Manufacturers would be free to alter the generic medicine price of certain items when sold to wholesalers or dispensing contractors — without notifying DoH

Every year the NHS spends over £1bn on generic medicines in primary care. The proposals would replace the maximum price scheme introduced in 2000.

Lord Warner, health minister said:

‘The new system is aimed at securing better value for money for the health service and ensuring a reliable supply of medicines for patients. The aim of the scheme is to prevent the NHS paying too high a price for generic medicines.’

The latest medicines management self-assessment for NHS hospitals has two aims:

• to clarify trust chief executives’ responsibilities concerning the management of medicines
• to help trusts develop systems for the value for money audits (due to commence in 2005)

Two components make up medicines management: clinical and cost-effective prescribing along with safe and secure handling of medicines. It is the responsibility of the chief executive to ensure that policies are in place to deliver these two components.

The previous assessment in 2001 showed that improvement was needed in:

• raising senior management involvement and awareness in medicines management
• formulary management
• improving ward-based services around patients

Chief executives, chief pharmacists and medical directors will undertake the assessment and pass on the results to the strategic health authority by December.

An eight-week consultation on the pharmaceutical price regulation scheme (PPRS) has begun. The current voluntary scheme — introduced in 1999 and ending in 2004 — limits the price of branded prescription medicines by controlling the resulting profits that drug companies make.

Views and comments are sought on:

• rolling forward the 1999 PPRS agreement without change
• possible changes to the PPRS agreement
• the potential for deregulation

The consultation is for the NHS and other stakeholders. The pharmaceutical industry will become involved by the end of the year.

The Health Secretary and general practitioners committee of the British Medical Association have reached agreement on the following elements of the new general medical services contract:

• GP payments for flu vaccinations to patients under 65
• 2003/04 pay deal details
• GP premises improvement

John Reid commented:

‘The new measures aimed at improving premises will help deliver our target of having up to £1bn invested to refurbish 3,000 GP premises and establish 500 one-stop primary care centres by December 2004. These measures, combined with the work already being done under the NHS Lift scheme, will ensure GPs will be providing their services from premises fit for the 21st century.’

The range of diagnosis and treatment centres is to be expanded to ensure that patients wait no longer than six months by the end of 2005. The location of centres and a list of healthcare providers have now been announced.

Healthcare providers from the independent sector will work with the NHS in the new centres — either new buildings or refurbished hospitals — to provide 250,000 operations a year (135,000 extra operations and 115,000 existing NHS operations). Providers are now finalising contracts with the NHS to commence work in 2004, with all being operational by 2005.

Treatment centres will be based at the following areas:

• Ashford, Surrey (Mercury Health)
• Barlborough Links, Nottinghamshire (Care UK Afrox)
• Bradford (Nations Healthcare)
• Burton (Nations Healthcare)
• Chase Farm, Barnet, London (Anglo Canadian)
• Daventry (Birkdale Clinic)
• Derriford, Plymouth (Care UK Afrox)
• Didcot, Oxfordshire (Mercury Health)
• East Berkshire (Slough, Bracknell, Maidenhead and Windsor/Ascot) (Mercury Health)
• Horton Hospital, North Oxford (Mercury Health)
• King George Hospital, Redbridge (Anglo Canadian)
• Lincolnshire (Mercury Health)
• Maidstone (Care UK Afrox)
• North East Yorks (Mercury Health)
• Northumberland (Mercury Health)
• Royal National Orthopaedic Hospital, Stanmore (New York Presbyterian)
• Royal National Throat Nose and Ear Hospital, Kings Cross (Anglo Canadian)
• Shepton Mallet, Somerset (New York Presbyterian)
• Southampton (Mercury Health)
• South West Peninsula (Mercury Health)
• Trafford, Greater Manchester (Netcare UK)

Two mobile units will offer ophthalmology services in the following areas:

• Cheshire and Merseyside (Netcare UK)
• Cumbria and Lancashire (Netcare UK)
• Dorset/Somerset (Netcare UK)
• Hants and Isle of Wight (Netcare UK)
• Horton, Oxfordshire (Netcare UK)
• Kent/Medway (Netcare UK)
• North Tyneside (Netcare UK)
• North West Peninsula (Netcare UK)
• South West Oxfordshire (Netcare UK)
• Surrey and Sussex (Netcare UK)
• Thames Valley (Netcare UK)
• Wycombe, Bucks (Netcare UK)

Preferred bidders to run the schemes are:

• Anglo Canadian (Canada)
• Birkdale Clinic (UK)
• Care UK Afrox (South Africa)
• Mercury Health (UK)
• Nations Healthcare (USA)
• Netcare UK (South Africa)
• New York Presbyterian (USA)

2004/05 will see £3m invested in the Oxford Institute of Cancer Medicine, a new cancer research centre. It will house the national translational cancer research network (NTRAC), a system for improving patients’ access to new and experimental treatment.

A joint UK/USA fellowship cancer research programme will be established. Run by NTRAC, specialists will work in both countries to share treatment knowledge.

Health minister Rosie Winterton has announced measures to provide faster and simpler access to repeat prescriptions at the British pharmaceutical conference in Harrogate.

The measures include:

• Repeat dispensing arrangements — allowing patients to receive repeat prescriptions for up to a year, without contacting their GP — to be extended to 40 additional PCTs
• Medicines Management Collaborative — helping patients get the most out of their medicines — to be extended to cover 146 PCTs and 10 hospitals
• £1m to be spent this year on training pharmacy technicians and pharmacy assistants
• A revised medicines management framework (see NHS news story: Hospitals to assess medicines management plans)

A £65.2m package for dental services has been announced by health minister Rosie Winterton.

The money, which ‘will allow more patients to see and be treated by NHS patients’ will
be used as follows:

• £35m for PCTs to tackle problem areas (eg, establishing dental surgeries in health centres)
  - PCTs will propose to their strategic health authorities how they would spend — over two years — a share of the £35m

• £30m for incorporating dentistry into the national IT programme
  - £3m this year, £12m for 2004 and £15m for 2005

• £0.2m for developing dental leadership skill within strategic health authorities and PCTs
  - To be spent over three years

Jonathon Asbridge has been appointed patient champion for A&E by health minister Rosie Winterton.

The patient champion will be expected to assist and encourage staff to respond to the needs of patients and act as a spokesperson on promoting good A&E practice throughout the NHS.

Jonathon Asbridge’s CV

• Nursing and Midwifery Council: President
• St Bartholomews and London NHS Trust: Interim chief executive
• St Bartholomews and London NHS Trust: Chief nurse
• Oxford Radcliffe Hospital: Director of Nursing
• Addenbrookes Hospital: Director of Nursing