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Health: Drug Tariff

Volume 698: debated on Tuesday 5 February 2008

asked Her Majesty's Government:

Whether the healthcare professionals who advised the Department of Health on reclassification of Part IX of the Drug Tariff were informed that this classification would be used as the basis of a proposed pricing system; and [HL1499]

Whether the healthcare professionals who advised the Department of Health on reclassification of Part IX of the Drug Tariff will be reconvened to consider correcting the errors, omissions and inaccuracies identified by industry; and [HL1500]

How many errors, inaccuracies and omissions were identified by industry within the Department of Health's new Part IX Drug Tariff categories; and [HL1501]

What discussions they have had with (a) the British Association of Urology Nurses; (b) the Royal College of Nursing; and (c) the Association for Continence Advice, to assess the impact on the workload of specialist nurses if the Department of Health's proposals relating to Part IX of the Drug Tariff are implemented; and [HL1502]

What assessment they have made of the impact on specialist nurses' ability to comply with (a) the Nursing and Midwifery Council's Code of Professional Conduct; (b) national occupational standards outlined in Skills for Health; and (c) Medicines and Healthcare Products Regulatory Agency standards on the use of medical devices should the Department of Health impose restrictions on follow up visits to stoma and continence patients; and [HL1503]

What assessment they have made of the risk of increased patient infections if visits from specialist nurses are capped, as proposed in the Department of Health's consultation on Part IX of the Drug Tariff. [HL1504]

The healthcare professionals who advised the department on the classification were asked to focus on whether or not products could meet similar medical need. They were not asked to consider price.

The panel will be reconvened but it will be extended to include representatives from industry and patients.

Over 5,000 items are listed in Part IX of the Drug Tariff. In relation to the proposed classification that was published in September 2007, 478 editorial changes have been requested; the majority could be considered errors, for example incorrect reference codes. In addition, 124 omissions have been identified mainly as a result of companies’ change of ownership during the course of this consultation. These will be corrected when the classification is revisited.

The role of National Health Service specialist nurses is outside the scope of this review and we do not anticipate that their workload will be affected. However, officials have met with representatives from the NHS, for example representatives from the Royal College of Nurses and the World Council of Enterostomal Therapists. They have also met with a nurse who specialises in childhood incontinence, as such patients have very special needs.

Under their terms of service, dispensing appliance contractors are not required to do anything but dispense an appliance. However, many of them employ nurses of their own; these nurses make home visits to patients at the discretion of the contractor. While we recognise the contribution these individuals make to patient care, we believe that their role is to complement the work of NHS specialist nurses. As such, we need to ensure that they are suitably qualified to deal directly with patients.

Given this, in the proposed amendments to dispensing appliance contractors' and pharmacists' terms of service it states:

“‘Specialist nurse’ means a person registered in the Nurses' Part or Specialist Community Public Health Nurses' Part of the professional register maintained by the Nursing and Midwifery Council under article 5 of the Nursing and Midwifery Order 2001”.

Compliance with this proposed amendment would be the responsibility of the employer, ie the dispensing appliance contractor or the pharmacist.

As noted, the role of specialist nurses employed by the NHS is not in scope. There are no restrictions on their ability to provide follow-up visits to users of stoma and incontinence appliances. As such, we anticipate that levels of infection should not increase. However, given the role of specialist nurses employed directly by providers to complement the work of NHS specialists, we will discuss this with interested parties when we next meet.