Dorset Clinical Commissioning Group

Dorset Medicines Advisory Group

The NHS Constitution states that “you have a right to expect local decisions on funding of other drugs and treatments to be made rationally following a proper consideration of the evidence. If the local NHS decides not to fund a drug or treatment you and your doctor feel would be right for you, they will explain that decision to you.”

In Dorset we follow a triage process to make local decisions on funding requests to ensure the most appropriate local group considers the evidence for the efficacy, safety and cost effectiveness of a medicine. The funding of medicines is not viewed in isolation from funding of other health services.

Where you are one of a group of patients who may require a decision on a medicine’s use this will be taken either by the local hospital’s drug and therapeutics committee or by the area prescribing committee. The committee includes the hospitals in the area, GPs and Clinical Commissioning Group (CCG) staff. The area prescribing committee is known as the Dorset Medicines Advisory Group (DMAG) (previously the Bournemouth, Dorset and Poole Health Technologies Forum). It provides recommendations on the prescribing and commissioning of medicines.

Typical drugs considered include newly licensed drugs or those that have a new indication and drugs used to treat conditions with which primary care prescribers may be less familiar. The recommendations from the DMAG are then considered by the CCG as they commission local services. The formulary and “traffic light status” provides details of the drugs recommended by the DMAG.  In addition a section of the formulary indicates those drugs which have not been recommended by the DMAG and the reason for that decision.

The DMAG ensures that Technology Appraisals published by the National Institute for Health and Care Excellence (NICE) are adhered to.  A checklist is now available on this page providing details of the CCG's adherence to NICE TAs.

Individual Funding Requests are required for treatments not covered within the CCGs commissioning agreements with the local doctors. The individual funding request team has delegated authority to decide whether treatments should be funded or not. These decisions need to be made in the context of the duties of the CCG. CCGs are under a statutory duty to promote the health of the local community as well as individuals. They are also under a duty not to exceed their annual financial allocation. This inevitably means that, from time to time, difficult choices have to be made.