A system to regulate high-cost drug prescriptions in Jersey that was recommended in response to the rheumatology scandal has been delayed by over a year, it has emerged.

Published last year, the Royal College of Physicians’ review of Jersey’s rheumatology service exposed serious prescribing failures that saw hundreds of patients misdiagnosed and given powerful immune-suppressing drugs they didn’t need.

It raised major concerns about the lack of built-in challenge in prescribing practices, particularly around expensive biologic drugs used to treat inflammatory conditions, by the Hospital Pharmacy team.

The review found that doctors in the department were routinely prescribing outside UK and European guidelines, without sufficient checks or challenges from the Hospital Pharmacy team.

A separate review of the Hospital Pharmacy, carried out by experienced chief pharmacists in UK hospitals, also found cases of “inappropriate” prescribing where national guidance had not been followed.

“No agreed licence”

As a result, the Health Department pledged to introduce the Blueteq High-Cost Drug System to monitor the prescribing of high-cost medicines in “early 2024”.

But it has now emerged that this software has been “deprioritised” due to “capacity issues” – and “no date has been given” for its introduction.

A Government progress report confirmed that while the budget for Blueteq was approved for 2024, “there is no agreed licence from 2025”.

The report added that “work continues with relevant partners to look at funding implementation”.

Express asked the Government to confirm:

• Has a date has been set for the introduction of the Blueteq High-Cost Drug System yet?
• Has the license for the Blueteq High-Cost Drug System been agreed for 2025 yet?
• Has there been any progress on work to look at funding implementation for the Blueteq High-Cost Drug System?
• Can you explain why the Blueteq High-Cost Drug System is not viewed as a priority given the severity of the previous issues with high-cost drugs in rheumatology?

A “key priority”

In response, Medical Director Simon West reassured islanders that the implementation of the BlueTeq system remains a “key priority”, with “significant progress” made during 2024.

“This included securing recurrent funding to ensure the system’s continued operation and planning for phased delivery,” he added.

Mr West explained that the system is currently being configured for use in Jersey, and the Pharmacy team has been engaging with clinical services to tailor it to local needs.

He said: “Once implemented, BlueTeq will enhance clinical governance by ensuring high-cost and highly specialised medicines are used appropriately, improving transparency and streamlining approval processes for clinicians.”

The Medical Director added that “it will also support more effective financial oversight” within Health, which was on track for a £28m deficit by the end of 2024 with warnings of “difficult decisions” expected in 2025.

Failures exposed

The RCP rheumatology review exposed the risks posed by weak prescribing oversight in Jersey’s health system.

In one in four cases, patients had their biologic medications discontinued entirely because they were deemed unnecessary. The findings prompted the Health Department to expand its review to cover 2,400 additional patients, revealing that 45% of diagnoses had to be changed.

Many affected patients and families are exploring legal action. Within six months of the full extent of the scandal coming to light, law firm Viberts said it had received more than 100 enquiries from patients and put forward more than a dozen formal letters of claim.

Ahead of the full RCP report’s publication in January 2024, Treasury had already set aside at least £1.3 million to deal with potential compensation claims. By June, another £1.1m had been allocated to deal with further repercussions of the damning review.

Further rheumatology funding has been approved by Health bosses for 2025. The amount has not been confirmed, but the funding was described as being at a “lower level than previous years”. Express has asked the Government to confirm the total.

As of January this year, Health officials had held meetings with relatives of over 30 deceased rheumatology patients whose deaths are believed to be linked to the treatment they received.

Coming soon?

Mr West told Express said that the BlueTeq system will be trialled “within the coming months”.

The primary focus is Rheumatology, where it will be piloted.

Expansions to other specialities across Health will happen “in the next phase”, Mr West said.