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

PostScript Community Pharmacy August 2013

To read in PDF format, please click here.

This edition contains information on:

  • Abbott Oral Nutritional Supplements
  • New Scottish Care Service Group
  • Recently Issued Circulars
  • IEP Training
  • Compliance Aids Revised Guidance
  • Specials Review
  • Macmillan Pharmacy Facilitator Team
  • Request for Sudafed Products
  • Fridge Audit Resuts

Abbott Oral Nutritional Supplements

As you are aware the oral nutritional supplement contract across GGC Health Board changed to the Abbott Ensure® range of oral nutritional supplements e.g. Ensure Plus Milkshake Style, Ensure Plus Juice in 2011. The Ensure ® range of oral nutritional supplements come in 220ml bottles as standard but are also available as Parallel Imports of 200ml tetra packs.

Prescribers have been advised to be clear with their prescribing and specify the 220ml bottles as these provide 10% more calories per unit. In addition to the higher nutrient content the bottles are easier for patients to hold, the lids can be replaced should a patient be unable to consume all at one time and they are less likely to be damaged than the tetra packs.

Patient feedback has highlighted that the tetra packs have an inferior taste which is affecting compliance. Nursing staff in care homes have reported that they are receiving a mixture of bottles and tetra packs which is causing difficulties for staff when trying to make sure residents are taking daily prescribed dose.

Please be aware that patients and prescribers are expecting this new range of sip feeds to be provided in the plastic bottles therefore if tetra packs are provided this may cause confusion for the patients.

The Ensure ® range bottle pack sizes are:

  • Ensure Plus Milkshake Style 220ml
  • Ensure Plus Juce 220ml
  • Ensure Plus Yoghurt Style 220ml
  • Ensure Plus Savoury 220ml
  • Ensure Plus Fibre 200ml
  • Ensure Twocal 200ml


New Scottish Care Services Group

Pharmacists and pharmacy technicians who support care homes and care at home services in Scotland are being invited to join a new group to share good practice. The "NHS Scotland Pharmacy Care Services Group" has been established with the support of Community Pharmacy Scotland, Royal Pharmaceutical Society and other national pharmacy groups.

The aim of the group is to share best practice and resources to support delivery of pharmaceutical care for patients who are either residents in care homes or receiving a care at home service. It will do this in two ways: First, by establishing a virtual network on the NHS Scotland Knowledge Network for sharing information and providing a support forum; second, by acting as a contact
point to enable pharmacy representation on national groups providing co-ordinated responses to consultations.

Pharmacists and technicians working in any care setting can join the group. For further information please contact Noreen Downes, Lead Clinical Pharmacist.

Recently Issued Circulars

Your attention is drawn to a series of recently issued NHS Circulars.

  • PCA(P)(2013)21 Pharmaceutical Services: amendments to Drug Tariff in respect of remuneration rates following the finalised 2013-14 & 2014/15 funding settlement
  • PCA(P)(2013)20 Pharmacist assistant training grant funding
  • PCA(P)(2013)19 Community pharmacist: supplementary and independent prescribing clinics: funding for 2013-14
  • CMO(2013)13 Seasonal influenza vaccination programme 2013-14

Copies can also be downloaded from the SHOW website


Injecting Equipment Provider (IEP) Pharmacies - Naloxone Pilot Reminder

IEP pharmacies are encouraged to take up the further dates that have been arranged to provide additional training opportunities for those pharmacies wishing to participate in the Naloxone pilot scheme. Locum costs will be reimbursed and payment of £200 per site is made on completion of the training. Subsequent supply under a PGD attracts a £15 fee per transaction. The Board has
allocated resource to this initiative until March 2014 in line with Scottish Government and local policy in an attempt to reduce drug deaths amongst the target population. The initiative positions community pharmacies as key providers of care to this client group if sufficient numbers sign up for the training and then participate in the scheme.

Dates are as follows and further details can be obtained from Amanda McCulley and 0141 277 7660

  • Wed 7 August 09.30 – 16.00 Pond Hotel, Great Western Rd
  • Tues 13 August 09.30 – 16.00 Glasgow Drug Problem Service 123 West Street, Glasgow
  • Fri 6 September 09.30 – 16.00 Glasgow Drug Problem Service 123 West Street, Glasgow


Improving patient outcomes – the  better use of multi-compartment  compliance aids (MCAs)

Revised guidance on the use of MCAs in practice was published by the Royal Pharmaceutical Society on 27 July and contains a number of recommendations now being considered by the Community Pharmacy Development Team. This also extends to include the need to work with social care providers at local and national level to ensure that appropriate mechanisms are in place to support the administration of medicines in the home setting which do not solely rely on the use of an MCA. This dialogue will
also be informed by findings from the Alternative to Compliance Aids initiative once these are collated.


‘Specials’ prescriptions

Pharmacists will be familiar with the revised guidance on obtaining supplies of ‘specials’ and imported prescription items which came into place in February 2013. To ensure full reimbursement for costs incurred in obtaining these items, pharmacists are required to contact this office for prior authorisation unless the item is listed in Part 7S of the Scottish Drug Tariff. These new arrangements are expected to be reviewed in August with the opportunity to for community pharmacists to influence the eventual
model based on practical experience. Comments can be submitted via the Community Pharmacy Scotland website.


Macmillan Pharmacy Facilitator Team

Following the successful evaluation of the original pilot scheme involving four CHPs, the Board and Macmillan Cancer have jointly agreed to fund an extension of the scheme to include all CHPs within NHS Greater Glasgow & Clyde. The recruitment process is now complete and I am pleased to advise that the following personnel have been recruited to these posts.

  • Lead – Kate McCusker
  • Pharmacists – Pauline Brown, Sandra Reynolds, Alex  McMillan, Jane Stuart, Nadia Afzal
  • Pharmacy Technicians – Anne McGowan, Carol Pettigrew, Leighanne Bee, Linda McMunigal, Raina Morris
  • Administrator – Charanpreet Srna

Details on actual start dates and locations will be announced shortly.


Requests for Sudafed Products

Pharmacists in a number of locations across Glasgow are reporting a higher level of requests for pseudoephedrine containing products and Sudafed in particular. As you will be aware, pseudoephedrine does have abuse potential and is also used in the manufacture of methamphetamine.

Most of these questionable requests are being made by people with a Chinese background who may not speak or understand English. As a consequence, requests may be in writing or on a mobile phone screen. Many do not appear to know what the product is used for and do not present with associated symptoms. Previous guidance issued by the regulator remains extant and requires a pharmacist to be directly involved in the sale and supply of these products. Supply should be refused if the pharmacist is not convinced the request is genuine.

In areas of high demand it may be necessary to remove these items from view as
an interim measure. Please contact this office or the Glasgow Addiction Service should you have concerns about this particular issue.


Fridge Audit Results

Results from the previously completed fridge audit are currently being distributed to all pharmacies within NHS GGC and continue to show improvement in the standards of practice. Details include

  • individualised results specific to each pharmacy along with anonymised results for your CHP.
  • Multiples have also been sent details of results for pharmacies within their chain.

Grateful if you could note the outcome from your individual audit, compare this with the CHP list and implement any action identified.