Managing medicines: Prescribing committees

Last updated: Sunday, July 11, 2021

There are Area Prescribing Committees (APCs) throughout England, although the one in your vicinity might have a different name. Sometimes they are called ‘Medicines Optimisation Committees’ (MOCs), for example. APCs are meetings of healthcare professionals and managers from primary and secondary care to discuss how best to use medicines in their geographical area. An APC might, say, cover an entire county and encompass two or three hospital trusts, several Clinical Commissioning Groups (CCGs), and a mental health trust.

An APC is a forum where primary and secondary care professionals can meet to make decisions about medicines. They can look at issues like these:

  • Should we recommend use of the new drug, A, for our local patients and advise that it's added to formularies? And if so, which patients would benefit? 
  • Could specialist medicine, B, be prescribed by GPs, or should only hospital consultants prescribe it? 
  • How can we respond as a community to the continued shortage of medicine C? 
  • The MHRA has issued a safety warning about medicine D, what should we do to protect our local patients? 

These issues, and others like them, require a community to come together to adopt a common approach, rather than each organisation deciding by itself. The decisions made by APCs are usually referred to as ‘recommendations’, but all the healthcare organisations that sit on the APC are expected to enforce them. Sometimes an APC commissions its own local assessment of a topic in order to make a recommendation; in other cases it considers work published by others such as NICE or an RMOC (see page 6).
The committee that ensures that APC recommendations are carried out in each individual organisation is often referred to as a Drugs and Therapeutics Committee (D&TC), but is also known by various other names such as a ‘Prescribing Committee’ or a ‘Medicines Committee’. These committees frequently consist mainly of doctors and pharmacists from the healthcare organisation concerned.

Each D&TC typically has roles such as the following for its host organisation:

  • Approving internal medicines-related guidelines of any kind. 
  • Deciding which medicines are added to the formulary or removed from it, and managing non-formulary prescribing. 
  • Assisting with the implementation of NICE or RMOC guidance (see page 6).

  • Is there an APC in your area? What is it called? What geographical area does it cover? 
  • Who from Pharmacy sits on this committee? 
  • What is the D&TC called in your organisation? 
  • Talk to someone who attends it, to find out what it’s like. Is it possible for you to attend a meeting to better understand how it works?

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