18 May 2015
One of our, Dr Srikanth Bellary, a senior lecturer in metabolic medicine and honorary consultant physician at Aston University, has developed a unified formulary to ensure equal access to medication for patients across Birmingham. He tells us how he did it:
“In Birmingham we have a population with a high prevalence of diabetes and a significant variation in socio economic status. Diabetes services are provided by 4 different CCG groups, three main acute trusts and a community trust that worked across the CCGs and patients often tend to move within these areas. Although we have many common problems there was not much co-ordination between the different providers and with the dissolution of the previous clinical network, it was proving increasingly difficult to find common solutions. A classic example was the variation between the acute trust and primary care formularies, which had different products on their formularies. This led to inconsistency in prescription, poor monitoring of usage and cost pressures. There were also restrictions on use, with patients from one area having access to certain drugs while those in other areas did not.
Recently we have successfully introduced a Pan Birmingham unified formulary. This was a joint effort that was possible due to the involvement of a lot of people representing the different providers and leads of medicines management. The main thing that facilitated this change was the recognition of the problem and willingness to work together and change practice. I would like to give credit to the leads of medicine management in Birmingham for highlighting this issue and taking the first steps towards setting up a clinical group. What then contributed to the success was the engagement of all providers and clinical leads who agreed on common principles. This was followed by open discussions and debate and eventual agreement on common decisions. In short, the group owned the decisions but were also accountable for it. Another key element was that those who were part of the group represented interests of patients and were free from any external influence.
The unified formulary will provide equal access to all patients regardless of where they live. There will be more consistency in the way drugs will be prescribed and less confusion. It also allows some of the newer therapies to be used responsibly and their use to be monitored.”