nhs forth valley formulary 11 - Community Pharmacy

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WebsiteAn Adobe® Acrobat® version of the formulary can be found on the Forth ValleyPharmacy Pharmacy Services intranet site at the following address:http://intranet.fv.scot.nhs.uk/home/Depts/PrimaryPharmacy/Pharm_Primary_Intro.aspThe web-based version of the formulary will be updated after each ADTC meeting andwill represent the most up to date version at any point in time.Formulary StatusThe formulary is intended for use across both primary and secondary care. The key for usehas been agreed as follows:- Initiate and continue- Continue where appropriateGPs should not normally be expected to prescribe non-formulary drugs on therecommendation of hospital specialists unless sound clinical reasons are given in writing.If this does not happen, the GP can contact the specialist concerned. This requirement alsoextends to patients attending outpatient clinics.AppealsIf a drug has been omitted from the formulary, and a consultant or GP maintains that suchan omission could compromise patient care, the case for formulary inclusion can bereconsidered. Appeals against any formulary decisions should be made with fullsupporting evidence to the New Drugs Sub Group via the Medicines Informationdepartment at Forth Valley Royal Hospital. Final decisions on appeals are taken by theADTC.Page 8
Non-formulary drug supplyIn exceptional clinical circumstances a non-formulary medicine may be required for aparticular patient. For certain non-formulary drugs which are being continuouslymonitored and for recent non-formulary decision this will require completion of a nonformularyrequest form by the consultant or clinical pharmacist for all hospital initiatednon-formulary drugs.Within primary care, it would be expected that the majority of prescribing would be fromformulary choices.Non-formulary drug use is reviewed by Drug and Therapeutics Committees, and thereafterby the ADTC.An example of the Non-formulary request form has been included (Appendix 2). This isavailable within the electronic version of the Formulary at the following linkhttp://intranet.fv.scot.nhs.uk/home/Depts/PrimaryPharmacy/Pharm_Joint_Formulary/pharm_formulary.aspGuidance on prescribingLocal and National GuidanceThe appendices of this formulary include Primary Care, Secondary Care and area-wideForth Valley Guidelines. Where national guidance is applicable references to webaddresses have been included (as links in the electronic version). Prescribers are remindedthat the electronic document is a dynamic document, which will be updated after eachNew Drugs Sub Group meeting. Similarly local and national guidance is continuallyupdated and may influence prescribing. Some useful web addresses are included below toprovide access to the latest national guidelines:British Hypertension SocietyBritish Thoracic SocietyNational Institute for Health and Clinical ExcellenceScottish Intercollegiate Guidelines NetworkIn hospitalshttp://www.bhsoc.org/http://www.brit-thoracic.org.uk/http://www.nice.org.uk/http://www.sign.ac.uk/A Medicines Code of Practice is in existence within Forth Valley Royal Hospital that givesguidance on the writing of prescriptions and the safe and secure handling of medicines.Combination productsPlease note: Whenever possible prescribe individual drug components rather than a fixedratio combination as it allows flexibility of dosing and is usually more cost effective.Page 9
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