NHS Lanarkshire Joint Formulary

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NHS Lanarkshire Joint Formulary

• Fiona Graham
• Formulary Pharmacist

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Aim/background

• Why have a Joint Formulary?
• -limited range of drugs
• -help reduce medication errors
• -promotes seamless prescribing
• -effective and economic prescribing

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Aim/background (cont)

• NHS Lanarkshire Primary Care drug budget 2011/12
  120M.
• Cost effective/evidence based choices
• Abridged version of the BNF
• NHS Lothian formulary framework

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Formulary development

• Lanarkshires Area Drug Therapeutics Committee
  (Area DT C)
• Formulary pharmacist in post July 2005
• Formulary sub-groups
• Cost effective/evidence based choices
• Joint formulary covers Primary Secondary Care
• Guess the Rx volume split? 1ry 2nd care?

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Formulary formats

• Paper copy- 2nd edition Nov 2007 (1500 copies)
• Intranet/MedEd site- Drugs Prescribing
• Internet- NHS Lanarkshire home page
• NHS Lanarkshire APP for iDevices
• GP Rxing systems100 practices 360 GPs, locums
  Rxing nurses-
• Vamp Vision eformulary diagnosis based.
• EMIS eformulary diagnosis based, A to Z.

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Formulary- additional information

• Primary Care- first line antibiotic policy
• Acute Division first line antibiotic policy
• Antibiotic IV to oral switch therapy protocol
• Gentamicin and vancomycin protocols
• Antidepressants- Swapping Stopping- Maudsley
  guideline

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Formulary compliance-primary care

• Prescribing Action Plan 2011/12
• GP targets-
• ACE inhibitors items gt98
• Angiotensin 2 antagonists items gt98
• Proton pump inhibitors items gt94
• NSAIDS items gt88
• Antibiotics items gt86
• Antidepressants items gt72
• Wound management formulary items gt75

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Formulary compliance (cont)

• PRISMS stands for
• Prescribing Information System for Scotland
• Quarterly prescribing data for GPs
• Can measure formulary compliance

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Formulary compliance 2nd care

• Prescribing Action Plan 3 (2011/12)
• No formulary compliance targets (yet)
• Hospital JAC data provides some data
• 40 of hospital Rxing influences GP Rxing
• Formulary choices aim to encourage seemless
  prescribing e.g Isotard XL

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Formulary amendments

• Want to change any drugs in the formulary?
• Formulary amendment request form with the new
  cost effective/evidence.
• Submit to Area D T via formulary pharmacist for
  discussion or referral to formulary sub-groups.
• May be asked to appeal in person.

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Scottish Medicines Consortium(SMC)

• Advises Area DT committees on new drugs.
• May or may not go on to the formulary
• Area D T Committee Prescribing Bulletin-
  summary of formulary status of SMC considered
  drugs.

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Future for Lanarkshires Joint Formulary

• Intranet/MedEd/Intranet version most
  up-to-date.
• Central servers for GPs prescribing systems
• Paper copy?
• APP- just about to be launched in
• NHS Lanarkshire.
• Other specialist formularies? E.g paediatric

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Main challenges for the future

• National formulary?
• Change over to EMIS Vision GP prescribing
  systems
• Paper copy vs on-line formulary?
• formulary compliance in 2 care?
• THE END