Transcript Document
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)
• NHS Lanarkshire Primary Care drug budget
2011/12 = £120M.
• Cost effective/evidence based choices
• Abridged version of the BNF
• NHS Lothian formulary framework
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?
Formulary formats
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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 systems:100 practices; 360 GPs, locums
& Rxing nurses:– Vamp Vision eformulary diagnosis based.
– EMIS eformulary diagnosis based, A to Z.
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 & StoppingMaudsley guideline
Formulary compliance-primary care
• Prescribing Action Plan 2011/12
GP targets:–
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ACE inhibitors
Angiotensin 2 antagonists
Proton pump inhibitors
NSAIDS
Antibiotics
Antidepressants
Wound management formulary
% items >98%
% items >98%
% items >94%
% items >88%
% items >86%
% items >72%
% items >75%
Formulary compliance (cont)
• PRISMS stands for:
Prescribing Information System for Scotland
• Quarterly prescribing data for GPs
• Can measure formulary compliance
Formulary compliance –
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nd
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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
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.
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
Bulletin- summary of formulary status of
SMC considered drugs.
Future for Lanarkshire’s Joint
Formulary
• Intranet/MedEd/Intranet version – most upto-date.
• Central servers for GPs prescribing systems
• Paper copy?
• APP- just about to be launched in
NHS Lanarkshire.
• Other specialist formularies? E.g paediatric
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