New PACS Tier Two process

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The Scottish Government has asked all NHS Boards to move to a new Peer Approved Clinical System Tier Two process which replaces local Individual Patient Treatment Requests from 1 June 2018.

The PACS Tier Two process provides an opportunity for clinicians, on a case-by-case basis and with peer support, to request the use of a licensed medicine for an individual patient that:

  • Is a medicine for an indication that has been considered and not recommended for use in NHS Scotland by the Scottish Medicines Consortium (SMC); or
  • Is a medicine accepted for restricted use by SMC but the intended use is out with SMC restrictions; or
  • Is a medicine which has been submitted to and is awaiting/undergoing evaluation by SMC

Access to unlicensed medicines, use for indications outside of marketing authorisation (off label), medicines not included in Tayside Area Formulary (TAF) and medicines which have been considered as not recommended for use in NHS Scotland by SMC due to non submission, or are not yet submitted to SMC, are not covered by PACS Tier Two and should be dealt with using the existing process within directorates/clinical groups.

A PACS Tier Two panel has been established in NHS Tayside which will meet to consider submissions on the third Friday of each month, although urgent requests can be dealt with between scheduled meetings.

The NHS Tayside Non Formulary requests (including Peer Approved Clinical System Tier One and Two) Policy has been updated and can be accessed via the TAF website.

With immediate effect any applications that meet the criteria above should be submitted using the national paperwork available on TAF website.

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