Clinical decision based on accounting objectives: Instructions to GPs to prescribe cheaper medicines

Roedd y cais yn llwyddiannus.

Dear Hywel Dda Local Health Board,

On how many occasions has the CHC instructed/advised GP's to
prescribe medicines which are cheaper than certain ones being
prescribed?

If so, other than financial considerations, what authority in law
does the CHC have to circumvent the clinical judgement of a GP?

If this practice has occurred, please advise as to the medicines
concerned and those which were recommended as
substitutes/replacements?

Yours faithfully,

Stephen Holloway

Yours faithfully,

Stephen Holloway

Freedom of Information (Hywel Dda Health Board), Hywel Dda University Health Board

Dear Mr Holloway

I am writing to ask for clarification of 'CHC'. Please note that until I receive clarification, I am unable to process this request and as such the time for compliance under the Act has stopped.
Kind Regards

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board
Llys Myrddin/Merlins Court
Lôn Winch/Winch Lane
Hwlffordd/Haverfordwest
SA61 1SB
Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222
________________________________________
From: Stephen Holloway [[FOI #138178 email]]
Sent: 13 November 2012 13:38
To: Freedom of Information (Hywel Dda Health Board)
Subject: Freedom of Information request - Clinical decision based on accounting objectives: Instructions to GPs to prescribe cheaper medicines

Dear Hywel Dda Local Health Board,

On how many occasions has the CHC instructed/advised GP's to
prescribe medicines which are cheaper than certain ones being
prescribed?

If so, other than financial considerations, what authority in law
does the CHC have to circumvent the clinical judgement of a GP?

If this practice has occurred, please advise as to the medicines
concerned and those which were recommended as
substitutes/replacements?

Yours faithfully,

Stephen Holloway

Yours faithfully,

Stephen Holloway

-------------------------------------------------------------------

Please use this email address for all replies to this request:
[FOI #138178 email]

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-------------------------------------------------------------------

Dear Freedom of Information (Hywel Dda Health Board),

Please replace all references to CHC in my request to Hywel Dda Health Board.

Yours sincerely,

Stephen Holloway

Freedom of Information (Hywel Dda Health Board), Hywel Dda University Health Board

FOI/242/12

 

21st November 2012

 

Dear Mr Holloway

 

Information Requested Under The Freedom Of Information Act 2000

 

Thank you for your recent request for the supply of information relating
to instructions to GPs to prescribe cheaper medicines. 

 

Under the Act, the Health Board is required to supply the information to
you within 20 working days.  In terms of your request, this means that the
information should be provided by 19th December 2012.  If this is not
possible, a further letter will be sent advising you of the progress made
in satisfying your request.

 

Please find attached our leaflet giving guidance on our procedure for
managing requests for information that is covered under the Freedom of
Information Act 2000.

 

Yours sincerely

 

 

 

 

Swyddog Rhyddid Gwybodaeth/Freedom of Information Officer

 

Enc – [1]Hywel Dda [2]Health Board Freedom of Information Leaflet

 

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board

Llys Myrddin/Merlins Court

Lôn Winch/Winch Lane

Hwlffordd/Haverfordwest

SA61 1SB

Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222

 

References

Visible links
1. http://www.wales.nhs.uk/sitesplus/862/op...
2. http://www.wales.nhs.uk/sitesplus/862/op...

Freedom of Information (Hywel Dda Health Board), Hywel Dda University Health Board

1 Atodiad

Dear Mr Holloway
 
I enclose a response to your recent request for information.
 
Regards
Karen
 

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board

Llys Myrddin/Merlins Court

Lôn Winch/Winch Lane

Hwlffordd/Haverfordwest

SA61 1SB

Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222

 

Dear Hywel Dda Local Health Board,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Hywel Dda Local Health Board's handling of my FOI request 'Clinical decision based on accounting objectives: Instructions to GPs to prescribe cheaper medicines'.

A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/cl...

Yours faithfully,

Stephen Holloway

Freedom of Information (Hywel Dda Health Board), Hywel Dda University Health Board

1 Atodiad

Dear Mr Holloway
 
I enclose an acknowledgement letter in response to your e-mail dated 12th
December 2012.
 
Please note further clarification has been requested and until we receive
this the 20 working day timescale to respond will not be enacted.
 
Regards
Karen Morris
 

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board

Llys Myrddin/Merlins Court

Lôn Winch/Winch Lane

Hwlffordd/Haverfordwest

SA61 1SB

Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222

 

Freedom of Information (Hywel Dda Health Board), Hywel Dda University Health Board

1 Atodiad

Dear Mr Holloway
 
We do not appear to have received a response from you.  As stated in my
e-mail below please note that until we receive further clarification the
20 working day timescale to respond will not be enacted.
 
Regards
 
Karen Morris
 

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board

Llys Myrddin/Merlins Court

Lôn Winch/Winch Lane

Hwlffordd/Haverfordwest

SA61 1SB

Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222

 

 

--------------------------------------------------------------------------

From: Freedom of Information (Hywel Dda Health Board)
Sent: 14 December 2012 13:02
To: [FOI #138178 email]
Subject: FOI/242/12 - Appeal Acknowledgement and Request for Further
Information
Dear Mr Holloway
 
I enclose an acknowledgement letter in response to your e-mail dated 12th
December 2012.
 
Please note further clarification has been requested and until we receive
this the 20 working day timescale to respond will not be enacted.
 
Regards
Karen Morris
 

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board

Llys Myrddin/Merlins Court

Lôn Winch/Winch Lane

Hwlffordd/Haverfordwest

SA61 1SB

Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222

 

Dear Freedom of Information (Hywel Dda Health Board),

Thank you for your e-mails.

You have requested that I clarify my reason for a review of your response, and seek an explanation of the issues that were not addressed .

Firstly, my question clearly sought clarification as to the legal basis for any approach to GP's in respect of the prescribing medicines. In fact the question asks: what is the Boards legal authority for this. Whilst I am aware that public bodies are required to spend their resources prudently - I am particularly interested in establishing the legal basis and authority and not the auditing process, which is a separate issue. In essence, can you please specify the legal authority which allows Health Boards the right to interfere in(you say 'encourage') the clinical judgments of GPs.

If, as you appear to suggest, the clinical judgement of GPs is sacrosanct, why is it deemed necessary to seek to influence this?

Are you aware of instances within the jurisdiction of the Board where GPs have been advised by the HDdHB to prescribe different medicines for a specific condition, where the chemical constituents are different and the potential side effects of change have not been tested, explored or considered?

Secondly, can you advise of any sanctions imposed by the Health Board against a GP or a GP practice where the 'encouragement' of the Board has been ignored, and if so will you please reveal the identity thereof. Furthermore, has your Board recommended that GPs prescribe alternative medicines which have not featured in the document to which your refer in your letter. If so, upon what basis are such recommendations made, other than upon financial imperatives?

Yours sincerely,

Stephen Holloway

Freedom of Information (Hywel Dda Health Board), Hywel Dda University Health Board

1 Atodiad

Dear Mr Holloway

Thank you for your e-mail below. I enclose an appeal acknowledgement. You will receive a full response by Monday 4 February 2013.

Regards

Karen Morris

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board
Llys Myrddin/Merlins Court
Lôn Winch/Winch Lane
Hwlffordd/Haverfordwest
SA61 1SB
Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222
________________________________________
From: Stephen Holloway [[FOI #138178 email]]
Sent: 07 January 2013 00:03
To: Freedom of Information (Hywel Dda Health Board)
Subject: Internal review of Freedom of Information request - Clinical decision based on accounting objectives: Instructions to GPs to prescribe cheaper medicines

Dear Freedom of Information (Hywel Dda Health Board),

Thank you for your e-mails.

You have requested that I clarify my reason for a review of your
response, and seek an explanation of the issues that were not
addressed .

Firstly, my question clearly sought clarification as to the legal
basis for any approach to GP's in respect of the prescribing
medicines. In fact the question asks: what is the Boards legal
authority for this. Whilst I am aware that public bodies are
required to spend their resources prudently - I am particularly
interested in establishing the legal basis and authority and not
the auditing process, which is a separate issue. In essence, can
you please specify the legal authority which allows Health Boards
the right to interfere in(you say 'encourage') the clinical
judgments of GPs.

If, as you appear to suggest, the clinical judgement of GPs is
sacrosanct, why is it deemed necessary to seek to influence this?

Are you aware of instances within the jurisdiction of the Board
where GPs have been advised by the HDdHB to prescribe different
medicines for a specific condition, where the chemical constituents
are different and the potential side effects of change have not
been tested, explored or considered?

Secondly, can you advise of any sanctions imposed by the Health
Board against a GP or a GP practice where the 'encouragement' of
the Board has been ignored, and if so will you please reveal the
identity thereof. Furthermore, has your Board recommended that GPs
prescribe alternative medicines which have not featured in the
document to which your refer in your letter. If so, upon what basis
are such recommendations made, other than upon financial
imperatives?

Yours sincerely,

Stephen Holloway

dangos adrannau a ddyfynnir

Freedom of Information (Hywel Dda Health Board), Hywel Dda University Health Board

1 Atodiad

Dear Mr Holloway
 
I enclose a response to your appeal request for information.
Regards
Karen Morris
 

Freedom of Information Officer
Bwrdd Iechyd Hywel Dda/Hywel Dda Health Board

Llys Myrddin/Merlins Court

Lôn Winch/Winch Lane

Hwlffordd/Haverfordwest

SA61 1SB

Rhif ffôn/Tel: 01437 771 265 /WHTN: 01623 1265
Ffacs/Fax: 01437 771 222