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Prescribing

Prescribing 25th Aug 2020

Email sent by Wessex LMCs, on Tuesday, 25 Aug 2020 Dear %recipient.firstname%, I hope that this finds you well and some people have managed to take annual leave, time away from practice and not got caught up in having to isolate on their return. Sadly the downside of annual leave is coming...

Practice Nurse Newsletter - April 2019 24th Apr 2019

Email sent by Wessex LMCs, on Wednesday, 24 Apr 2019 Dear All Hope this finds you well and you have enjoyed the sun over the Easter break. Attached is the April newsletter, if you would like to be featured in the next newsletter or would like to have something included please let me...

Advanced Clinical Practice - Social Prescriber

Please click here to access our Covid-19 Practical and Operational Issues page The following has been taken from NHS England webpage - Social Prescribing: 'Social prescribing is a key component of Universal Personalised Care. Social prescribing is a way for local agencies to refer people...

Antibiotic Prescribing in the Community

Guidelines for Antibiotic Prescribing in the Community These guidelines are intended to provide advice on the effective and safe treatment of infections commonly presenting in primary care (doses are for adults unless otherwise stated) in mainly Wessex, but also Surrey Heath, Berkshire East and...

Antibiotic Resistance

This topic is reported on a regular basis and the blame for prescribing 90% of all antibiotics is usually laid at the door of GPs. This, of course, is associated with the fact that GPs clearly do not see any really ill patients because we send all of these to hospital. Is that a fair or...

British Pharmaceutical Industry's Code of Practice

The pharmaceutical industry effectively self regulates and operates to the highest ethical standards as laid out in The Association of the British Pharmaceutical Industry's Code of Practice for the Pharmaceutical Industry (the Code). The ABPI Code covers the promotion of medicines for...

Changes to Antibiotic Prophylaxis Guidelines

Changes to Antibiotic Prophylaxis Guidelines issued by Wessex Cardiologists to Prevent Infective Endocarditis in at Risk Patients Undergoing Dental Procedures Letter to Dentist on changes to Antibiotic Guidelines Letter for Referral from Cardiologist Letter to Patient The LMC view this...

Community Pharmacy - A Guide for GPs

This is an excellent summary of how Community Pharmacies work, the funding streams and contracting arrangements and the requirements for being a community pharmacist (training, qualification, control and regulation) written by PSNC, NHS employers and the BMA. The document, together with further...

Counter Fraud - Drug seekers

Wessex LMCs hosted a meeting with NHS Counter Fraud services to discuss the issue of patients who try to obtain drugs (usually opiates and benzodiazepines) under false pretences. This is a summary of some useful points we believe are worth sharing with practices across Wessex Some patients may...

Drug Driving

A new offence of driving, attempting to drive, or being in charge of a vehicle, with certain specified controlled drugs in excess of specified limits has come into force. This offence is an addition to the existing rules on drug impaired driving and fitness to drive, and applies to two groups...

Duration of Prescriptions and 7 day Prescribing

This is a recurrent issue and something that we are contacted about at the office on a regular basis with GPs and practices asking whether or not there is any obligation to provide prescriptions for seven days of medication. The answer is no - but never say never. There will be times when a...

Electronic Prescribing EPS and eRD inc. Remote consultations

Electronic Prescribing Service - EPS NHS Digital are continuing to drive Electronic Prescribing. Electronic Prescribing Service - Phase 4 was deployed from 18th November 2019, initially to TPP SystmOne following a pilot in 2018. The roll out plans for EMIS, Vision and Microtest will follow....

Good Practice in Prescribing

This guidance was published by the GMC on 31st January and came into effect on 25th February 2013. In 'Good Medical Practice' it is stated - in providing care you must: Prescribe drugs or treatment including repeat prescriptions, only when you have adequate knowledge of the patient's health...

GP Leadership Fellows

In the face of unprecedented pressures, the landscape of the NHS is changing rapidly, and the centre of gravity is moving rapidly towards Primary Care. This represents an exciting opportunity for new GPs to be involved in improving frontline services for our patients. With the largest curriculum...

Hajj

The Hajj is a pilgrimage to Mecca undertaken by Moslems from all over the world. It is the "Fifth Pillar of Islam" and there is an obligation on every able bodied Moslem who can afford to go, to undertake this pilgrimage at least once in a lifetime. In 2008 over 3 million pilgrims visited. The...

Hepatitis B and Occupational Health

This is a complex area and one that keep cropping up. If in doubt after reading this then please contact the office. 1. Is there a requirement under the Regulations to prescribe and administer Hepatitis B vaccination for occupational health purposes? The Regulations requires GPs to manage...

HPV Vaccination

All girls aged 12 to 13 are offered HPV (human papilloma virus) vaccination as part of the NHS childhood vaccination programme. The vaccine protects against cervical cancer. It's usually given to girls in year eight at schools in England. According to Cancer Research UK, cervical cancer is the...

Internet Pharmacies

Practices across Wessex have been approached by internet pharmacies who are asking the practice to send out promotional material to patients on their behalf. Whilst there is no problem with practices providing patients with information on the available pharmacy services, we should not be...

Midwife Requests for Diamorphine "Just in Case"

We took advice from NHS Hampshire's Accountable Officer for CD prescribing whose advice is below Key message Midwives are able to possess and administer opioids so that should be the mechanism used for clinical governance and drug safety and accountability reasons As I am neither clinician...

Non-Medical Prescribing Guidance for Prescribers In General Practice

We are in a time of great change in general practice with practices merging, evolution of federations, locality working and the emerging accountable care systems. The list based system of general practice remains a cornerstone of the NHS and is the main reason that the NHS is judged...

Nursing Homes and Residential Homes

The provision of care in private hospitals and care home generates a considerable number of queries. There are a number of reasons for this: The classification of services under the new GMS contract The reclassification of some former residential and nursing homes to private hospitals The...

Patient Specific Directions (PSDs) and Patient Group Directions (PGDs)

Patient Specific Directions (PSDs) The Medicines Act 1968 does not permit nurses who are not qualified prescribers to administer or supply prescription only medicines (POMs) unless one of three types of instruction are in place signed prescription signed Patient Specific Direction...

Patients Travelling Abroad - Prescriptions & Advice

Prescriptions for patients travelling out of the country By law, the NHS ceases to have responsibility for the medical care of patients when they leave the UK. People traveling within Europe are advised to carry an authorised European Health Insurance Card (EHIC) at all times and this gives...

Pharmacies Ordering Repeat Precriptions

We have heard concerns about these schemes across the whole of Wessex and, on further enquiry, it is apparent that there is a national problem. Managed repeat prescription services are when the pharmacy retains the patient's prescription repeat request form and submits it to the surgery on their...

Pharmacy - Prescription Direction

'Prescription direction' occurs where a patient is being directed by their GP practice to a certain pharmacy to have their prescription dispensed. Patients have a free choice between any community pharmacy and in some cases, a GP dispensary. Actions by practices seeking to influence a patient's...

Prescribing - Self Prescribing & Family Members

Over the last year LMC has been made aware of a number of GPs who have been reported to the GMC for self-prescribing. The LMC would strongly advise GPs not to prescribe for themselves or their family, except in exceptional circumstance. The areas of high risk are controlled drugs, psychiatric...

Prescribing - Bowel Preparations for Endoscopic Investigations

In May 2009 the NPSA issued a warning about deaths and harm occurring from the use of these agents prior to procedures such as colonscopy and barium enemas. It has now been agreed that it is the responsibility of the clinician ordering the test to: assess the patient's suitability for the...

Prescribing - Co-proxamol

In January 2008 the normal distribution of co-proxamol ceased but its usage has not been banned outright. The Medicines and Healthcare Products Regulatory Agency (MHRA) recognised that a small number of patients will find it difficult to find a suitable alternative. They have therefore allowed...

Prescribing - Low Molecular Weight Heparins

Prescribed doses of low molecular weight heparins (LMWHs) such as daltaparin, enoxaparin, tinzaparin, bemiparin (Fragmin, Clexane, Innohep, Zibor) for the treatment of a thromboembolic events, are dependent on the weight of the patient and renal function. Underdosing has an increased risk of a...

Prescribing - Medicines not available at the pharmacy

We are all aware of the situation when a patient is prescribed a relatively common medication and returns from the pharmacist to say that it is not available and that an alternative is required. For many of us our first thought is that there is some sort of financial motive behind the problem....

Prescribing - Nurseries, schools and OTC Medications

Non-prescription (OTC) medication does not need a GP signature/authorisation in order for the school/nursery/childminder to give it. It has been brought to the attention of the GPC Clinical and Prescribing Subcommittee that the revised 'The Early Years Foundation Stage Statutory Framework',...

Prescribing - Repeat

Batch prescribing is a process which allows patients on repeat prescriptions of stable, regular medication to receive their medication in a new way. The GP can prescribe medication for a suitable period (perhaps twelve months for something like thyroxine) and the patient can then pick up all...

Prescribing - Unlicensed Medicines

The term 'unlicensed medicine' is used to describe medicines that are used outside the terms of their UK licence or which have no licence for use in the UK. Unlicensed medicines are in common use especially in paediatrics, psychiatry and palliative care. You may prescribe unlicensed medicines...

Prescribing and Dispensing

New Pharmaceutical Regulations came into force on 1st September 2012, and replaces the 2005 regulations and its many amendments. The regulations comprise 186 pages and includes ten pages of Amendments, Revocations and Explanatory Notes. One of the amendments removes the 100-hour pharmacy...

Requests to convert private prescriptions to NHS FP10

Under NHS GMS Regulations the patient is entitled to receive any drug which is available on the NHS, via an NHS prescription. Therefore, GPs can convert a private script to an FP10 if the patient requests this. However, the GMC duty to prescribe only in the best interests of the patient and...

Shared Care

The decision about who should take responsibility for on-going care should be based on what is in the patient's best interest, and not based on what is in the clinicians' convenience, the cost of the medication or the cost of the monitoring or follow-up. Shared care requires agreement on all...

Sutures

ETHICON has reviewed the Drug Tariff suture codes with members of the Association of Surgeons in Primary Care, and made the necessary amendments to ensure that the offering meets the needs of GP surgeries across the UK. You can click here to see the table of the complete range. Codes...

The Drug Tariff

The Drug Tariff is produced monthly by the Pharmaceutical Directorate of the NHS Business Services Authority, NHS Prescription Services for the Secretary of State and states: what will be paid to pharmacy contractors for NHS services provided either for reimbursement (the cost of the drugs,...

The Emergency Doctors Bag

What drugs should I carry or have accessible? GPs must be able to defend themselves on grounds of good clinical practice. Different practices operate in different settings with different resources around them i.e. a GP practising in a remote rural setting will have different considerations from...

Travelling with Prescribed Drugs

The rules concerning travellers who are carrying prescribed drugs controlled under Schedules 1, 2, 3 and 4 Part 1 of The Misuse of Drugs Regulations 2001 changed. Historically until D.S.T. December 2007, those travelling for a period of up to 28 days were automatically covered under the...

Used Medication and Dressings

An estimated £450m worth of prescription medicines are discarded every year in England, Scotland, Wales and Northern Ireland, with around 1% of dispensed items eventually returned to a pharmacy or dispensing GP practice unused or partially used. Guidance in the UK states that any medicine...

Varicella Vaccination

You cannot, as a practice, treat your NHS patients privately and although you could refer to another local practice it is frowned upon by the Competition Commission to have a sort of 'cosy arrangement' set up between you. This could be overcome by ensuring you offer a choice to patients which...

When No PSD or PGD is needed

Emergency Drug Exemptions The following list of medicines for use by parenteral administration, are exempt from PGDs, prescriptions or PSDs when administered for the purpose of saving life in an emergency: Doses are not specified in the legislation Adrenaline 1:1000 up to 1mg for...