Applying for a medicine decision review
Clinicians can apply for reviews under the Peer Approved Clinical (PACS) Tier Two process. You can make an application when:
- the medicine you want to use for an individual patient is not accepted by the Scottish Medicines Consortium (SMC) and not available for routine prescription
- a board rejects a request for the patient to access to the medicine.
A National Review Panel carries out the review. This review replaces each NHS board’s local appeal process. Panel members only consider cases from outside their NHS board.
Healthcare Improvement Scotland co-ordinates and provides support for the panel. None of our staff take part in the decision making process.
Requesting a review
National review panels meet monthly. We can arrange ad hoc meetings if there is clinical urgency.
You can request a review form and submit a review request by contacting us at his.nrp@nhs.scot. You need to make the request at least seven working days before each panel meeting date.
Panel meeting dates
15 September 2026: submissions by 8 September
20 October 2026: submissions by 13 October
17 November 2026: submissions by 10 November
15 December 2026: submissions by 8 December
19 January 2027: submissions by 12 January
16 February 2027: submissions by 9 February 2027
16 March 2027: submissions by 9 March 2027
Panel findings
The panel will make a finding on:
- whether the board’s decision is reasonable, based on the evidence provided
- whether due process has been followed
If there are grounds for a review of the original decision, the panel will send the case back to the NHS board. The board then convenes a meeting to revisit their decision. This new review panel must take into account the National Review Panel reasoning.
The final decision is for the NHS board to determine.