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APG Library

Area Prescribing Group (APG)

NHS MLCSU provide bespoke support for four large APGs who each operate slightly different governance processes. Overall, the time for new drug decision making and consultation is very similar for each of the committee but the decision making varies. This is either delegated to the APG or the APG makes recommendations to the constituent organisations for ratification. Equally there are differences on where the work is delivered with a subgroup model or a single committee model.

The following provides some of the key documents that we have been involved with development used by each of these Groups.

1. Operating model A

This model includes consideration of the clinical evidence, cost-effectiveness, and subsequent prioritisation with governance to enable decisions at single APG meeting on behalf of all organisations. Organisational representatives have delegated authority.

2. Operating model B

This model involves a single APG to consider the clinical evidence, cost-effectiveness, and subsequent prioritisation with recommendation to constituent (ICB) organisations. Decision then ratified by individual organisations (where these are guidelines) or at the Medicines Optimisation Committee of ICBs (where these are new medicines).

3. Operating model C

This model involves consideration of the clinical evidence, cost-effectiveness, and subsequent prioritisation and management of consultation with primary and secondary care stakeholders by APG subgroups – recommendation made at single APG meeting. The APG decision is then recommended to the commissioner to ratify and enact.