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Medicines Management
Issue no 2, p8
March/April 2002

Features

How to bid to join the "collaborative"

After one application failed, but the next succeeded, Brian Curwain describes the process of applying to join the medicines management "collaborative" programme

It is said that there is a skill in making successful applications for NHS funding streams and in the New Forest area we learnt a lot after we were disappointed not to be successful with our first-wave application to join the National Prescribing Centre's collaborative programme on medicines management services. We were delighted and relieved when we made it the second time round.

If you think you want to be part of the next wave of pilots, speak to one of the NPC team early on in order to signal your interest and pick up some preliminary information. For previous waves, the invitation to apply required us to notify the regional offices of our intentions. Regional pharmaceutical advisers are asked for their views so it is worth having a few conversations with the person concerned.

This may still happen for the third wave but, with the imminent demise of regional offices, the future situation is uncertain. To date, pilot sites have been distributed throughout the English NHS and each region has between four and six second-wave sites.

How applications are processed

The procedure for processing applications has been that the NPC team sift through them, take advice from regional offices and come up with a list of recommendations which are sent for ministerial approval. The final announcement is handled by the Department of Health.

A successful application requires that you demonstrate an understanding of the collaborative methodology. This involves making a series of small changes in a system (eg, repeat prescribing within a practice). These changes are evaluated, and, if they work, built into the system. Lessons learned in this way are then transferred to other parts of the PCG/T.

The New Forest PCT had not been involved in the primary care collaborative (which is longer established than the medicines management one) and our first application probably suffered as a result.

Unlike applications for grants in other fields, the NPC team are not looking for definite answers to the problems of medicines management. Our first application included some specific developments that we intended and feedback suggested that this did not help. If you already think you know the answers, then an NHS collaborative is not the right way to proceed.

The application needs to demonstrate that your organisation is committed to supporting medicines management services in the long term, and that it will be a fit and fertile place for collaborative work. Working relationships that exist between your PCG/T and its various partners in health and social care need to be clearly stated. The application form also requires that several of your partners (acute trusts, mental health trusts) as well as the PCT management and finance team sign up to register their support and knowledge of the project. We also got support from the chairs of the local pharmaceutical and medical committees, our clinical governance lead and from hospital chief pharmacists. This means that the people concerned will need to have read something close to the final version of your application.

The application form comes by e-mail and you can then create an electronic working version of it. The technology allows you to alter the size of the various boxes and we were told it was fine to do this (be sensible).

The form requires detailed information about each of the five participating practices and about the PCT itself. This is easily gleaned from PCT/HA documents and from PACT data (practice list sizes, proportion of population over 65 years). It also asks about current medicines management activities in your organisation. We described practice audits, work around ulcer healing drugs and NSAIDS, repeat prescribing protocols, work in care homes and the beginnings of joint working with community pharmacists. Things that are in the early stages of development should be included.

Show you understand "collaborative"

The section on how you will ensure the spread of continuous improvement is a chance to demonstrate your understanding of the collaborative methodology and also to show what mechanisms your organisation already has to facilitate the spread of good practice. We mentioned the work of our prescribing task groups, our newsletter Scriptbits and links between various parts of the PCT. We also appended to our second-wave application two PCT documents: a strategy for medicines management and our prescribing strategy.

When our first wave application failed, we asked a successful colleague to send us a copy of her application. We had to admit that it was better than ours with more about commitment and fitness for purpose and less about solutions to problems. If you intend to apply, get sight of one or two good applications. We had also not shown a completed draft to our excellent HA pharmaceutical adviser although I had discussed aspects of the application with him. I think I wanted it to be our very own work, but with hindsight, that was a mistake.

Dr Brian Curwain is chief pharmacist for New Forest PCT