NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update Community Pharmacy

PostScript Community Pharmacy (April 2012)

Issue 68, April 2012

To read this bulletin in PDF format, please click here

In this edition:

  • APC update: February meeting
  • Buccal midazolam solution
  • Clozapine prescriptions for out patients in NHSGGC
  • Vaccine storage: New brief e-learning module: cold chain
  • Good practice in safe management of CDs in primary care
  • Glasgow Addiction Services: new contact details
  • Queen’s Diamond Jubilee: 5th June 2012
  • Egg free seasonal influenza vaccine

 

APC update: February meeting

 

As part of our commitment to sharing the work of the Area Pharmaceutical  Committee, the following items were discussed at the February meeting. The meeting had an excellent presentation from the community pharmacist members describing the role and current challenges faced by community pharmacy in NHSGGC. The comprehensive presentation highlighted the holistic approach community pharmacists take in providing personalised care to their patients and allowed APC colleagues to reflect on how more patient focussed practice may be developed across the service.

 

Discussion around the ongoing work on Improving Care for the Elderly included a brief description of a patient consultation held by the Board in late December 2011

attended by the APC chair and key points to be highlighted as part of the way forward to improve pharmacy services to the elderly.

 

The APC had submitted comments on draft consultation standards from the GPhC. The Committee had noted that the standards had now been published.

 

 

Buccal Midazolam Solution

 

Two batches of Epistatus® were produced with different oral syringes which measure up to 1.5ml instead of 1ml. There is a potential for overdose if not used correctly. Please ensure all users refer to the volume on the syringe not just the markings.

 

The newly licensed buccal midazolam solution (Buccolam®) was accepted by SMC and use is being considered in NHSGGC. Epistatus (unlicensed) is twice the strength of Buccolam, so any potential change will require careful implementation with training for all involved in prescribing, dispensing and administration. Until local assessment is complete, please continue to use midazolam 10mg/ml (Epistatus). More detail will follow soon.

 

Clozapine prescriptions for out-patients in NHSGGC

 

The Board has recently been made aware of some instances where clozapine has been supplied within primary care for patients who are not part of a shared care system and have received drug treatment out with the normal supply channels for this drug.

 

Clozapine is a second-generation antipsychotic with proven efficacy in treatment  resistant schizophrenia. Due to its licensing restrictions and side effect profile, it is subject to mandatory processes with regards to patient registration, prescribing and dispensing. As a consequence, systems have evolved that see clozapine managed by specialist services. There are approximately 1200 clozapine patients in NHS GG&C who mainly obtain their drug supply either from secondary care hospital pharmacies (either mental health or acute). Prescriptions are dispensed for both inpatients & out-patients only upon receipt of a valid blood sample result which is determined by ZTAS.

 

Out-patients collect their prescriptions from community mental health teams,  resource centres, CPNs or a few community pharmacies as appropriate. There are also a few ad hoc arrangements where specialist services send clozapine to community pharmacies for inclusion in compliance devices, again as appropriate.

 

Unless such formal arrangements are in place with GPs as part of shared care arrangement, GPs should not issue GP10 prescriptions for clozapine. If community pharmacies receive a GP10 prescription for clozapine and are not a registered shared care provider, they should not dispense the prescription and should contact mental health pharmacy services for advice.

 

Vaccine Storage: New brief E learning module – cold chain

 

Each year thousands of pounds of vaccines are destroyed because of problems with vaccine storage. A new learn pro course Cold Chain management has been  developed by NHSGG&C Pharmaceutical Public Health to provide practical advice to avoid this. Like all learn-pro programmes, the online course can be accessed anywhere, any time and takes less than 30 minutes to complete.

To access visit the website, register, click on "more learning" and it is under the  pharmacy tab.

 

A wide range of healthcare workers are involved in immunisation. While it has been designed for use in GP practices it will be of interest to all staff involved in the handling of vaccines providing practical advice and examples of best practice. Feedback from users will inform future development. Please forward any comments on the module to Liz McGovern.

 

Good Practice in Safe Management of CDs in Primary Care

The Accountable Officer’s Network (Scotland) has just published the first edition of this guidance for management of CDs in primary care. The guide focuses on the roles and responsibilities of healthcare professionals working within primary care and who are commonly involved in the management of CDs. It also covers issues raised at the interface between primary, secondary and social care. The Scottish Government issued specific guidance on the management of CDs in secondary care (CEL 7 (2008)) in February 2008. This guide aims to identify robust systems for obtaining, storing, supplying, recording, monitoring and disposing CDs safely, while helping to ensure appropriate and convenient access for patients who require CDs. It does not advise on the clinical choice and use of CDs.

 

The guide aims to help healthcare professionals to adopt a systematic approach to improvement in the management and control of CDs. This will strengthen patient and public safety while ensuring that there is minimum additional bureaucracy resulting in reluctance to prescribe CDs. Organisations holding stocks of CDs are legally required to develop and use standard operating procedures (SOPs) as a means of ensuring good practice becomes part of everyday health care activities. Advice on the development of SOPs can be found in Scottish Government CEL 14 (2007).

This guide should be of value in a wide range of settings where CDs are used including:

  • GP and out of hours services
  • Dental practices
  • Pharmacies
  • Midwifery services
  • Care services / care homes
  • Community nursing services
  • Community palliative care services
  • Substance misuse services

Glasgow Addiction Services: New Contact Details

Glasgow Addiction Services have now moved to new premises. Please update your records with the new details as below with immediate effect.

 

NHS GGC Addiction Service

Templeton Business Centre

Ground Floor/Building 3

62 Templeton Street

Glasgow

G40 1DA

TEL: 0141 277 7660

FAX: 0141 277 7655

 

  • Carole Hunter; Lead Addiction Pharmacist

Carole.hunter@ggc.scot.nhs.uk

07557 012874

0141 277 7660

 

  • Mary Clare Madden, Addiction Pharmacist

Maryclare.madden@ggc.scot.nhs.uk

07557 012877

0141 277 7541

 

  • Jennifer Kelly, Addiction Pharmacist

Jennifer.kelly@ggc.scot.nhs.uk

07557 012875

0141 277 7536

 

  • Amanda McCulley, Addiction Pharmacist

Amanda.mcculley@ggc.scot.nhs.uk

07557 012879

0141 277 7536

 

  • Leanne Blackwood, Alcohol Pharmacist

Leanne.blackwood@ggc.scot.nhs.uk

07557 012870

0141 277 7547

 

  • Aileen Cederval, Clinical Pharmacist

Aileen.cederval@ggc.scot.nhs.uk

07557 012872

0141 277 7547

 

  • John Campbell, IEP Manager

John.campbell@ggc.scot.nhs.uk

07557 012871

0141 277 7497

 

Queen’s Jubilee Holiday 5th June 2012

 

NHS Scotland has recently clarified that while Tuesday 5th June 2012 has been designated an additional public holiday, it will not be a public holiday for NHS Scotland managed staff. As such NHS premises will be open as usual.

 

The GPs in NHSGGC will however, be closed on Monday 4th June and Tuesday 5th June. As such we will shortly write out to community pharmacies seeking information on the level of service we can expect across this four day closure period. Contractors should indicate their anticipated opening hours for both days. Once this information is collated the Board will be in a position to decide whether a rota is required.

 

Egg Free seasonal influenza vaccine (Optaflu®)

 

Novartis Vaccines intend to market an egg free seasonal influenza vaccine suitable for adults 18 years and above under the brand name Optaflu® for the influenza season 2012/13. You may wish to discuss with your local GP practices whether they want to place a small additional order for specific patients