Terms of Reference, September 2011
- Purpose and function of the London New Drugs Group
The purpose of the London New Drugs Group (LNDG) is to act as an expert collaborative advisory body to support commissioners and providers make rational decisions regarding new medicines and strategic medicines issues. The group focusses particularly on issues where significant clinical or financial impact is envisaged for a given medicine. The group works to ensure evidence of efficacy, safety, and cost-effectiveness is reflected in evaluations and as such the outputs support the QIPP agenda.
The LNDG considers medicines only where they will not be or have not yet been considered by NICE; in addition, LNDG seeks not to repeat the work of other NHS medicines review bodies unless there are specific local circumstances warranting action. The LNDG does not consider orphan, ultra-orphan, or unlicensed medicines routinely unless there are specific circumstances warranting action.
LNDG undertakes the following specific functions:
- Early identification of new medicines and strategic medicines issues
A continual programme of horizon scanning using NHS resources identifies new medicines with potential implications. In addition, other strategic medicines issues are identified through the group’s membership and networks.
- Publication of detailed timely reviews according to a defined work programme and format
A process of triage seeks to ensure detailed review of medicines only where there is a definite need. The process involves group members and external stakeholders considering identified new medicines and issues; takes account of the work of other national and regional review bodies; and ultimately seeks to ensure providers and commissioners have access to detailed peer-reviewed advice on given medicines in a timely manner.
- Publication of reviews that consider the evidence-base, expert opinion, and provider and commissioner views
The networks of the LNDG ensure a range of views from stakeholders form part of the process of review production, thus ensuring the work is grounded in the reality of the NHS in London.
- Publication of reviews that recommend particular courses of action where appropriate
Whilst LNDG outputs are primarily evaluative, specific courses of actions are sometimes recommended where supported by the evidence-base and where a reasonable consensus has been reached with stakeholders. There is, however, no obligation for commissioners or providers to adhere to recommendations from the LNDG.
- Prevention of duplication of effort across NHS organisations
By undertaking the drug review work once and sharing, duplication of effort is prevented across NHS organisations.
- Governance and accountability arrangements
The evaluative (as opposed to decision making) function of the LNDG means governance arrangements in relation to individual NHS organisations are not formalised. The LNDG may be considered a joint sub-group of the cluster PCT lead pharmacists and the provider Chief Pharmacists groups for London. As such LNDG is nominally accountable to Chief Pharmacists in provider and commissioner organisations through the Director for East and South-East England Specialist pharmacy services.
The majority of the review work of the group is undertaken by pharmacists from East and South-East England Specialist Pharmacy Services (SPS) and accountability arrangements reflect the management structure for SPS.
- Relationships with other organisations, stakeholders and networks
The LNDG works to analyse and interpret the evidence, but also taps into knowledge from expert networks in order to inform and disseminate thinking on specific issues. As part of the review process, the group seeks input on the likely impact of new medicines from networks of pharmacists, medics, and commissioners working across NHS organisations. Review authors seek to enable pharmaceutical industry comment on specific content where appropriate, but work to the principle that final outputs are always NHS-led.
The group works closely with the London Cancer New Drugs group, the London HIV treatments group, and the London Procurement Programme Pharmacy and Medicines Management group. The group also has good working relationships with other similar NHS review bodies.
- Membership
The LNDG looks to ensure the following membership:
- Senior pharmacy representation from a commissioner and a provider organisation from each sector across the NHS in London
- Specialist medical and pharmacological input
- Appropriate editorial representation from pharmacists responsible for content delivery through E&SE England Specialist Pharmacy Services
- Meetings and expectations of members
The LNDG meets approximately 4 times annually in central London, with meetings lasting around 2 hours; meeting dates are available 1 year in advance. Intermittent teleconferences are also held.
Members of the group are expected to contribute to discussions on work programmes, documents and other issues. Members of the group are also expected to contribute outside meetings by commenting on documents produced by the specialist pharmacy services team; there is, however, no expectation upon members to write drug reviews since all such work is undertaken by specialist pharmacy services.
Ben Rehman / David Webb
Director, London Medicines Information Service / Director, East and South East Specialist Pharmacy Services
Sept 2011