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NHS Lanarkshire Joint Formulary

NHS Lanarkshire Joint Formulary. Fiona Graham Formulary Pharmacist. Aim/background. Why have a Joint Formulary? -limited range of drugs -help reduce medication errors -promotes seamless prescribing -effective and economic prescribing. Aim/background (cont).

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NHS Lanarkshire Joint Formulary

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  1. NHS Lanarkshire Joint Formulary Fiona Graham Formulary Pharmacist

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

  3. 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

  4. Formulary development • Lanarkshire’s Area Drug & Therapeutics Committee (Area D&T 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?

  5. Formulary formats • Paper copy- 2nd edition Nov 2007 (1500 copies) • Intranet/MedEd site- Drugs & Prescribing • Internet- NHS Lanarkshire home page • GP Rxing systems (100 practices; 360 GPs, lots of locums & Rxing nurses):- • eLanJF- GPass ( diagnosis based + drug A to Z) • Vamp Vision (A to Z) and guideline based. • EMIS (A to Z)

  6. 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

  7. Formulary compliance-primary care • Prescribing Action Plan 2011/12 GP targets:- • ACE inhibitors % items >98% • Angiotensin 2 antagonists % items >98% • Proton pump inhibitors % items >94% • NSAIDS % items >88% • Antibiotics % items >86% • Antidepressants % items >72% • Wound management formulary % items >75%

  8. Formulary compliance (cont) • PRISMS stands for: Prescribing Information System for Scotland • Quarterly prescribing data for GPs • Can measure formulary compliance

  9. 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

  10. 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.

  11. Scottish Medicines Consortium(SMC) • Advises Area D&T committees on new drugs. • May or may not go on to the formulary • Area D & T Committee Prescribing Supplement- summary of formulary status of SMC considered drugs.

  12. Future for Lanarkshire’s Joint Formulary • Intranet/MedEd/Intranet version – most up-to-date. • Central servers for GPs prescribing systems • Paper copy? • App? • Other specialist formularies? E.g paediatric

  13. 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? Any questions?

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