It is interesting to see the diversity in application forms. And in a way I have no problem with this. Local determination may mean that local health economies take a slightly different position on medicines and therefore they might ask slightly different questions. After all the application needs to be in line with three things:
- The local commissioning framework
- The local ethical framework
- The formulary decision matrix
This seems obvious that to be able to offer a standardised decision that is compatible with both the ethical and commissioning frameworks then the application form needs to ask the right questions.
It is a little disappointing to see so few decision matrices used in committee and even more worrying when the application form does not ask the applicant a question related to every area of the matrix.
I always tell consultants – and it is usually consultants that apply – that the form is asking you to present a logical and compelling argument. However they so often answer it badly or refer it to the pharma industry to help. Sometimes there is a clinical pharmacist at the hospital that helps and then the form is usually great.
In the past I have actually earned money from training / presenting to clinicians on how to complete applications.
With the increased need for openness and transparency it is increasingly important to look at the process and ensure:
- That the application form asks all the questions related to the decision matrix
- The application is logical and sensible in its layout and flow.
- That a guide is provided to clinicians to ensure that they understand what is required
- That suitable support is available to ensure that the application is appropriate, accurate and complete
Remember – if the application is not right then you can’t make a decision in a consistent manner.