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Minutes

15 March 2006 | 21 June 2005 | 17 June 2002 | 12 March 2002 | 30 October 2001 | 31 July 2001

Confirmed minutes of the Second Meeting of the New Prescribers Advisory Committee (NPAC)

Meeting held on 30th October 2001
Museum Room, Turnbull House
10:00am - 3:30pm

Present:

Associate Professor Margaret Horsburgh (Chair)
Dr Mark Adams
Ms Beryl Anderson
Dr Patrick Ball
Mr Alister Brown
Ms Trish Compton
Dr Denise Dignam
Ms Sue Driver
Dr John Edwards
Mr Peter Glensor
Ms Marion Hunter
Dr Stewart Jessamine
Professor John Shaw
Dr Dennis Thorburn
Associate Professor Judy Kilpatrick

Late: Professor Keith Grimwood

In Attendance:

Caroline Greaney (Secretary)
Peter Moody (PHARMAC) for part of the meeting

ITEM 1: Confirm minutes of previous meeting

  • There was a discussion about the confidentiality of the minutes.
  • Agreed: the minutes will be circulated soon after the meeting with comments sent back to the secretary. The minutes will be formally confirmed at the next meeting. If the minutes are to be placed on the website the Minister will be informed of anything that may be controversial. Matters may be dealt with in committee.
  • Confirmed: minutes of the first meeting, 31 July 2001.

ITEM 2: Correspondence out

Standing orders
  • The Committee has received a holding response in reply to its letter to the Minister. The Committee will continue to keep an eye on the progress of the Standing Orders.

Letter to Professional Bodies

  • Agreed: the secretary will circulate to NPAC a copy of the mailing list that the letter and template was sent to.
  • Agreed: a schedule of the meetings for next year and deadline dates for applications will be circulated to the professional bodies. The intention is that applications are received 1 month before meetings.
  • Agreed: that applications be circulated to NPAC members a month before the meeting with issues raised via email so that all members of NPAC are aware of the issues when NPAC meets.
Interim Template
  • The interim template needs minor amendments made after first applications received. It will also be reviewed after a number of applications have been received. Proposed amendments:
Part One
  • First section should be the name and description of registering body making application.
  • Add in a paragraph about the proposing body i.e. college etc - the proposing body may also be the registering body.
  • Third section should be the principle contacts of registration body.
  • Short description of applications - should include aim and purpose of extending prescribing authority.
Part Two
  • Section 4, Third bullet point 'client location' changed to read 'setting';
  • Section 4, Fifth bullet point - delete part on standing orders. Should read, "How will independent prescribing sit with other collaborative arrangements."
  • Section 5, There needs to be a link to the drugs that the applicants want to be funded. Need to distinguish between which drugs they want to prescribe and which ones need to be prescribed with funding. This is an area where the Ministry or an expert can provided technical feedback to the applying groups, and a small subgroup of the committee can examine in detail and report to NPAC on the appropriateness of the drugs in the indicative list.
  • Section 6, first bullet point - query over use of 'convenience'
  • Section 9, risks and benefits. The Terms of reference do not mention financial costs, the current template focuses considerably on financial costs. NPAC will not make decisions based on a costs benefit analysis. Bullet points 3 and 4 - 'costs' should be changed to 'arrangements'.
  • Section 10, consultation. The Committee would expect to see copy of letters and the distribution list, analysis of submissions. There was a large amount of public consultation on the extension of prescribing rights when the amendment to the Medicines Act went through Select Committee.
  • Agreed: secretary to ring Podiatrists Board and Opticians Board to clarify Section 9 of the Template and the expectations of how these requirements are met.

ITEM 4 - Dates for meeting in 2002

  1. Noted: NPAC will meet on 12 March 2002 and 16 July 2002

ITEM 5 - Nurse Prescribing Regulations

  1. The Committee had a brief discussion of the regulations and noted that the media release is inaccurate. Nurse Prescribing was not about the retention and recruitment, but about improving access to services.

ITEM 6 - Schedules of medicines

  1. The law does not allow brand names to be listed in schedules - only substances. Medsafe needs to determine the active ingredient and establish whether prescribers need access to all forms of the substance or only some forms. The schedules will read 'scope of practice X will have access to substance Y'. The form of substance that can be prescribed will be determined by best practice, standards for the profession, ethics, and whether it is funded by the Pharmaceutical schedule. "Specialist only" drugs refer to funding. All general practitioners and midwives can prescribe 'specialist only' drugs but their patients pay full cost.
  2. The Medical Classifications Committee (MCC) looks at whether drugs should be prescription only, pharmacy only, etc. MCC make all of the changes to the schedules.
  3. A discussion followed on updating schedules. There will be further information provided by Medsafe for the next meeting.

ITEM 7 - Post-Implementation review

  1. Noted:
  2. the paper on the post-implementation review;
  3. the committee has an interest in the post-implementation review and that the Ministry is responsible for undertaking the post-implementation review;
  4. Pharmac's process of monitoring prescribing;
  5. the Ministry should have a comprehensive approach to evaluating the impact of new Prescribers and the effect on health outcomes (taking into account hospital admissions etc);
  6. the document should be altered to reflect 'all new prescribers', not just nurse prescribers.
  7. Agreed: the Ministry should lay down set of base data to get a base line.

ITEM 8 - Pharmac

  1. Noted: Pharmac collects data as a means of monitoring prescribing patterns. Groups of new prescribers are likely to have a schedule determined which is connected to a list of funded pharmaceuticals.
  2. Noted: Health Benefits Limited collects the data and access to it is on a case-by-case basis. It can be requested under the Official information Act 1982.
  3. Carried forward for the next meeting:
  4. Revised template
  5. First draft of explanatory notes for professional bodies
  6. Standing orders update
  7. Evaluation and monitoring update.

The meeting closed at 3.40 pm

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