by EWAN LAMB
NHS Borders has given notice that it intends to seek an alternate supplier for cancer treatment products after a proposed link-up with neighbouring Lothian's aseptic unit fell through, and the existing facilities at Borders General Hospital were deemed "not fit for purpose".
The Borders health authority this week published a so-called Prior Information Notice (PIN) notifying potential suppliers of a contract with an estimated value of £6.7 million to supply aseptically prepared medicines to treat patients attending the region's main hospital.
According to the notice: "The Authority will be seeking bids from suppliers to replace our own internal aseptic unit capacity. The bid must provide a wide range of treatments such as oncology SACT [Systematic Anti-Cancer Treatment], anti-infectives and monoclonal anti-bodies."
The PIN points out that potential bidders must be able to evidence stability of products prepared, be in a position to supply products daily Monday to Friday, work with the authority to minimise waste, and be based no greater than three hours driving from the hospital.
Members of the Borders health board received a report in 2021which considered the option of moving to a shared aseptic service with NHS Lothian against a refurbishment of the local unit to ensure it met the necessary environmental requirements.
"This would mean that once implemented, NHS Lothian would provide the aseptic service and the aseptic suite at the Borders General Hospital would close", the report explained.
The Scottish Government had been seeking to reduce the number of production units since 2017 via a change programme.
The programme was created in response to challenges which were highlighted by NHS Boards, specialist aseptic pharmacists/technicians and their quality assurance colleagues in relation to: • ongoing problems with resilience and sustainability of Pharmacy Aseptic Services • increasing demand • a number of Aseptic units requiring refurbishment or rebuild, variation in prescribing practices and clinical service delivery.
In the case of the Borders facilities, it was stated: "The suite has not been refurbished since the hospital was built (over 30 years ago) and is no longer deemed fit for purpose. The unit has received appropriate maintenance during this time."
The cost of refurbishing the Borders suite was estimated at £1.5 million.
The 2021 report to the Board explained: "There are several challenges that prevent the current suite from meeting both this guidance and the best practice guidance for pharmacy facilities. These are: The suite does not have dedicated changing facilities; The suite does not have first and second-stage changing rooms; The suite does not have outer and inner support rooms separated by airlock hatches.
"The support room does not have units that are easy cleaning; The outer support room has consumables on open shelving rather than within units; The outer and inner support rooms are within the same room; In addition the air handling unit is due for replacement and has been breaking down on a regular basis. Due to the above the aseptic unit currently carries a high risk on the NHS Borders risk register in relation to its environmental condition which would also have an impact on business continuity."
A total of 175 patients received treatment monthly from the BMC at that time which accounted for 264 treatment episodes. Three main types of treatment regimens were provided to patients that included oral medication, medication that would be available in prefilled form and medication that would need to be supplied by NHS Lothian should this option be taken forward.
The issue of aseptic production was the subject of a further report last year when the options were re-submitted to NHS Borders board. By this time the unit at BGH was processing between 320-400 items a month, 96% of which were chemotherapy, representing increased demand of around 20%.
In a statement, NHS Borders told us: "“We have explored the option of manufacturing aseptic products collaboratively with NHS Lothian. Unfortunately, this is not possible at present, and therefore we have published a Prior Information Notice (PIN) to tender for aseptic products to seek another provider.
“In the meantime, we continue to manufacture our own aseptic products.”
A contract notice is expected to be published in August.
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