Committees : Primary Care Medicines Optimisation Clinical reference Group (PCMOCRG)

The Medicines Management Guide to Prescribing (MMGTP) aims to provide clarity for prescribers on a variety of clinical and non-clinical scenarios.

The guide has been developed in sections to assist in finding the relevant content. Section 1 provides an introduction and further signposting.

To support the cost effective prescribing of oral contraceptives, a resource has been developed to identify the locally preferred products for both combined and progestogen-only contraceptives.

See document: NHS Pharmacy Contraception Service - local product recommendations.

The recommendations are applicable to both general practice and community pharmacy colleagues and is intended to highlight the locally preferred products and those that are less preferred.

OptimiseRx will be utilised to reinforce these recommendations in general practice.

The Surrey Heartlands Medicines Optimisation Clinical reference Group have approved the updated statement relating to the use of compliance aids and 7-day scripts.

The statement is provided by Community Pharmacy Surrey & Sussex and the Surrey & Sussex LMC - see guidance document below for details

Enteral feeds in Surrey Heartlands should not be dispensed via community pharmacy. Contracts are in place with enteral feeding companies to supply feeds directly to patients.

The Surey Heartlands Guidelines for the Community Proivion of Enteral Feeds for Children and Adults set out the processes to follow in each geographical place within Surrey Heartlands.

This policy has been updated to support best prescribing practice within Surrey Heartlands ICB.

The guide references key publications from the BMA and aims to clarify the meaning of unwarranted variation and provides examples of such.

The Surrey & Sussex LMC have been consulted with.

Guide to Managing Requests from NHS Providers outside of Surrey Heartlands where there is a conflict between our Traffic Light Status and their formulary.

The aim of this tool is to support prescribing decisions where our local Traffic Light status is in conflict with the status from a requesting organisation who is not represented at the Surrey Heartlands APC e.g. tertiary centre.

Refer to this guide and associated template letters for support.

For further information relating to the contract with local trusts please refer to the Interface Prescribing Policy

The local recommendations for the "Safe & Secure Management of NHS Prescription Stationery" has been updated - see documents below

The National guidance from the NHS Counter Fraud Authority remains unchanged (Mar 2018) and can be found here Management and control of prescription forms (cfa.nhs.uk)

The Medicines Optimisation Clinical Reference Group have considered a number of resources aimed at supporting prescribers with drug stock shortages. The resources (available below) include:

• The MIMS Live Stock Sortages Tracker listing the current drug shortages, the likely duration of the problem (where known), a link to advice on alternative products and a list of drugs that are no longer in short supply https://www.mims.co.uk/drug-shortages-live-tracker/article/1581516

• a local guide for managing stock shortages in primary care including good practice advice for Community Pharmacies and General Practice

Lists of current stock shortages available from:

• Communty Pharmacy England - monthly list of drugs with a price concession applied
• Specialist Pharmacy Service - Medicine Supply Tool (login required) list of medicines with supply problems and possible re-supply dates
• MIMS - Shortages Tracker with possible alternatives and re-supply dates
• PrescQIPP - Out of stock bulletins and intelligence around supply issues (login required)

See links to each of the resources

Additional resources to support practices in managing prescription requests from patients can be found here: https://surreyccg.res-systems.net/PAD/Guidelines/Detail/5198

A Practice Prescribing Policy will help make sure that all prescribers practise safe prescribing. All Practices will have slightly different processes and mix of staff; therefore it is important that the practice prescribing policy accurately reflects your own processes.

Guidance for writing a practice prescribig policy has been developed for practices to use as an aid to ensure all appropriate sections are included within their own policy. This guidance should be locally adapted to reflect your own processes and used in combination with the Repeat Prescription Management Guidance.

Both resources are available on this page

Repeat prescribing has been defined as “a partnership between patient and prescriber that allows the prescriber to authorise a prescription so it can be repeatedly issued at agreed intervals, without the patient having to consult the prescriber at each issue”. This document ("Repeat Prescription Management Guidance" below) describes 
the different ways repeat prescriptions are generated as well as including a list of  standards  to help review your practice repeat prescribing process.

The Expiry Date guidance for care homes has been updated and agreed by the Primary Care Medicines Optimisation Clinical Reference Group.

See resource below

The Primary Care Medicines Optimisation Clinical reference Group approved a number of resources to support care homes in managing, ordering and receiving medicines.

See resources below

The Good Practice Guidance for Care Homes ‘When Required’ (PRN) Medication was  updated and approved for use by the Primary Care Medicines Optimisation Clinical Reference Group - see guide for details

The Primary Care Medicines Optimisation Clinical reference Group approved a number of resources to support care homes in managing the transfer of care around medicines.

See resources below

The Primary Care Medicines Optimisation Clinical reference Group approved a  resource to support care homes in ordering medicines.

See resources below

The Primary Care Medicines Optimisation Clinical reference Group approved a resource to support care homes in ordering repeat presriptions for inhalers.

See resource below

The Primary Care Medicines Optimisation Clinical reference Group approved a number of resources to support care homes in managing the administration, including self-administration, of medicines

See resources below

When community pharmacies suffer an IT failure and EPS system goes down for an extended time i.e., more than 24 hours, they should have mitigations put in place as part of their business continuity plans, including contacting affected GP practices.

The document below provides practical advice around mitigations GP practices should consider when there is a community pharmacy closure /IT failure and EPS is unavailable.

Several companies are now offering prescribing services to practices that will provide a non-medical prescribing (NMP) pharmacist to cover some of the practice prescribing needs remotely. This is different to arrangements for employing pharmacists directly to work within the PCN or practice through ARRS funding to meet the requirements of the PCN DES. Before entering any such arrangement practices should be aware of appropriate governance arrangements and processes to follow.

The document below ("Outsourcing repeat prescribing services") provides advice for any practice considering thes services.

Advice relating to the use of prescribing cost centres and codes can be found here: https://surreyccg.res-systems.net/PAD/Guidelines/Detail/4979

The PCMOCRG approved the information resources to provide advice to people who require vitamin D supplementation for prevention or treatment of deficiency.

This supports the NHSE advice for self care with vitamin D supplementation.

See Patient resources in additional information  

The Sharps & Clinical Waste Disposal document below has been updated.

The document describes the local arrangements for the disposal of healthcare waste from patient's own homes.

The table on page 3/4 lists each of the Surrey Borough Councils, their contact details and their sharps and waste collection arrangements.