Gateshead Prescribing and Medicines Management Committee

Annual Report 2012/13

Introduction

The Gateshead Prescribing and Medicines Management Committee is now in its seventh year.

In the past year the GMMC has worked work to establish itself in the new NHS primary care structures in Gateshead and build a working relationship with Gateshead Clinical Commissioning Group (GATNET). It continues to ensure the medicines management agenda remains a high priority for all stakeholder organisations. During the year the GMMC has kept its Terms of Reference under review to reflect the ongoing changes in healthcare management structures locally.

Achievements 2010/11

·  Local Decision Making Around Medicines

Following the creation of Clinical Commissioning Groups within the NHS Together the group has worked to ensure appropriate policies and processes remain in place for the handling of all requests for drugs to be added to the local formulary.

·  Transfer of Information About Medicines

The GMMC is working with stakeholders across NHS South of Tyne & Wear to implement the recommendations of the Royal Pharmaceutical Society on the transfer of information about medicines between different healthcare settings/providers.

·  Shared Care Guidelines

The GMMC has continued to work with stakeholders across NHS South of Tyne & Wear to harmonise existing shared care arrangements and guidelines across Gateshead, South Tyneside and Sunderland.

The GMMC this year has worked across the primary/secondary care interface providing input into the development and implementation of shared care protocols in the following areas:

Ø  Degarelix

Ø  Memantine

Ø  Prostate Cancer Local Enhanced Service

·  Development of New Guidelines

The GMMC has worked with stakeholders in Gateshead and across NHS South of Tyne & Wear to develop/launch guidelines in the following areas in the past year:

Ø  Dabigatran for atrial fibrillation
Ø  Gout
Ø  Gluten Free Food Guidance for Primary Care
Ø  Appliance Guidance for Primary Care
Ø  Opioid Guidelines for Chronic Non-malignant Pain
Ø  Drugs that should not be prescribed (Grey List)
Ø  Switch from Diamorphine to Morphine in Primary Care
Ø  Guidelines for the Management of Common Ophthalmological Conditions in Primary Care

·  Review of Existing Guidelines

The group has worked with stakeholders to review the following guidelines:

Ø  GHFNT Acute Pain Guideline

Ø  COPD Guideline

Ø  Constipation in children

Ø  Parkinson’s Disease Guideline

Ø  Prevention & Management of Infection in Patients with Autoimmune Rheumatic Disease

Ø  Management of Rheumatic Disease Patients in the Orthopaedic Perioperative Period

Ø  NHS SOTW Stop Smoking Guidelines

Ø  NHS SOTW Antimicrobial Prescribing Policy

Workplan 2012/13

·  Shared Care Protocols

The group is continuing to work across the primary/secondary care interface to develop shared care protocols where there is a need for them identified.

·  Development of New Guidelines

The GMMC is working with stakeholders in Gateshead to develop guidelines in the following areas:

Ø  Requests for Community Nurses to Administer Injectable Medicines
Ø  Benign Prostatic Hyperplasia
Ø  Vitamin D Supplementation in Adults & Children

·  Cost Improvements and Cost-effective Use of Medicines

The GMMC will continue to work with stakeholders in Gateshead to introduce measures to manage the increasing drug spend in both primary and secondary care. These are aimed at ensuring the cost-effective use of medicines for the wider healthcare economy which will release money to fund new additions to the formulary, and new medicines as they come to market.

New drugs added to Gateshead Formulary in 2011/12

Of the fifteen applications received for addition to the formulary in 2011/12 twelve were accepted, two were rejected, and one awaits commissioning approval after being referred to the North East Treatments Advisory Group (NETAG).

DRUG / STATUS / INDICATION
Hydrocortistab / Red / High Volume Saline Injection in Achilles Tendonopathy
Intranasal Diamorphine / Red / Acute severe pain in children in A&E only
Testosterone gel (Tostran®) / Green + / Alternative to injection in male hypogonadism
Aquacel surgical dressing / Red / Orthopaedic surgery only
Moviprep / Red / Replacement for Klean Prep in Bowel Cancer Screening Programme
Rasagiline / Green + / 1st line MAO-B inhibitor in Parkison’s disease
Ferinject / Red / To replace cosmofer
Exenatide once a week / Green + / Type 2 diabetes in patients unable to comply with daily exenatide
Dabigatran / Green / Atrial fibrillation as per NICE guidance
Sugammedex / Red / Reversal of rocuronium or vecuronium
Ribavirin / Red / Hepatitis C as per NICE guidance
Peginterferon / Red / Hepatitis C as per NICE guidance

Drugs are categorised under a ‘traffic light’ system of:

RED Drugs for hospital use only

AMBER Shared care drugs

GREEN + Drugs normally initiated by a hospital specialist but where the provision of an information leaflet may be appropriate to facilitate continuing treatment by GPs.

GREEN Drugs where prescribing by GPs is appropriate.

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April 2013

Gateshead Medicines Management Committee