Embed Size (px)
Citation preview
VOLUME 1 ISSUE 15 April 2018
Pharmacy & Medicines Directorate News “Getting the best from pharmacy services and medicines for better health and safer care"
Welcome
Hello and welcome to the April edition of the Pharmacy & Medicines Directorate News.
This edition of the newsletter contains information on upcoming training events, provides updated information on melatonin and clozapine and includes articles regarding community eye care and vitamin D guidance.
In March, NHS Grampian hosted the inaugural Excellence in Pharmaceutical Care conference at RGU. This was a great event and our first article within the newsletter provides some key highlights from the day.
NHS Grampian will be holding “Make your Pharmacy young people friendly” training events in May and Sept. We have included an article within the newsletter providing information on what the session involves and where the sessions will be held. Places are limited so ensure that you have registered your interest in attending ASAP.
CPD requirements are changing; make sure you are prepared for the changes by reading our articles on the countdown to revalidation.
It is important that all pharmacy staff members are aware of what is happening within community pharmacy across Grampian. Please share this newsletter with all members of your pharmacy team to ensure that they are kept up to date and are aware of upcoming training events.
If you or any member of your pharmacy team have an article or topic that you would like us to include in our next edition of the Pharmacy & Medicines Directorate News, please let us know by emailing your article/ idea to [email protected] with a subject heading of Newsletter
Excellence in pharmaceutical care in Grampian conference
On 18th March 2018, NHS Grampian hosted the inaugural Excellence in Pharmaceutical Care one day conference at RGU, Aberdeen. Over 120 delegates attended this local event, which was chaired by David Pfleger, Director of Pharmacy NHS Grampian. Dr Rose Marie Parr presented on Achieving Excellence, Scottish Government’s most recent document outlining the way forward for Pharmacy in Scotland. Afterwards Dr Parr answered questions from the audience on topics relating to future recruitment of pre-registration candidates in Grampian, how to encourage research as part of daily business and the pipelines for technician developments. Delegates had the chance to attend 3 sessions out of 6. Parallel sessions included digital technology, enhanced pharmaceutical care, workforce, safer use of medicines in Grampian and the new GMS contract. The final session of the conference was a chance for delegates to have your say about achieving excellence in Grampian. Delegates were asked the following questions:
Inside This Issue
1) Welcome
2) Excellence in Pharmaceutical
Care in Grampian Conference
3) NES OTC event
4) Making your pharmacy young
people friendly training event
5) CPD Requirements
6) Melatonin
7) Clozapine, Constipation & GI
Complications
8) Prescribing Guidance
9) MAS Prescribing
10) Community Eye Care
11) Vitamin D Guidance
Page 2 PHARMACY NEWS P a g e | 2 PHARMACY NEWS
o What are the priorities for achieving excellence in pharmacy in Grampian? o What are you doing / going to do to achieve excellence in pharmaceutical care
and services in Grampian in the next few years? o What do you need from NHS Grampian to help you achieve excellence in
pharmaceutical care and services in Grampian in the next few years?
The information and suggestions delegates contributed will be written up and will help inform priorities and the work that we need to do in NHS Grampian. At the closing session winners of the poster categories were presented with certificates. Trainee Poster Award
“Investigation of the appropriateness of lipegfilgrastim prescribing in NHS Grampian” Paulina Mlawa, pre-registration pharmacist, ARI Safer Use of Medicines Poster Award
“Audit of As Required Psychotropic Medication” Jennifer Clarke, Pharmacist, Dr Grays Hospital Workforce Poster Award
“Exploring the role of pharmacy teams in Scottish GP practice: an interim analysis” Katie MacLure, RGU, Aberdeen Pharmaceutical care closer to home Poster award
“Optimising prescribing of medicines to patients attending hospital out-patient clinics in NHS Grampian” Judith Jordan, Pharmacist ,NOSCAN Overall Poster Award Winner: “A risk assessment approach to Controlled Drug (CD) inspection in GP practices” Anne Taylor, Lead CD Pharmacist, NHSG Congratulations to the poster winners and thank you to all that supported and attended the conference. Feedback from the event has been very positive with 100% of returned evaluation forms rating the event as good/excellent, and the parallel sessions were rated good/excellent by 75% of delegates. A flash report on the event will be available soon.
Page 3 PHARMACY NEWS P a g e | 3 PHARMACY NEWS
NES OTC Event
In March NES hosted the “improving the quality of over the counter consultations training event”. The event was well attended by pharmacy staff and provided the opportunity for staff from Huntly and Elgin to VC into the event.
Resources discussed at the event are available via Turas https://learn.nes.nhs.scot/Search/SearchResults?searchterm=otc&page=1
Thank you to all those that attended the event.
Making your pharmacy young people friendly training event – Open to all members of the pharmacy team.
Pharmaceutical services are growing and young people are being encouraged to access their local pharmacy for health care advice as well as pharmacy services such as contraceptive, smoking cessation, urinary tract infection etc.
Coming in to a pharmacy can be a nervous experience for young people and many might feel embarrassed or worried about speaking to the pharmacy team.
Help ensure that your pharmacy is young people friendly by attending the NHS Grampian “Make your Pharmacy Young People Friendly” training event.
Our training event will highlight ways to ensure that your pharmacy is a welcoming place for young people and will provide hints and tips on how to make young people more comfortable when speaking with pharmacy staff.
This training event is open to all members of the pharmacy team and is free to attend.
Places on the training event are limited. To book a space please email [email protected] detailing which event you would like to attend and we will email you back to confirm your space.
Wednesday 30th May - Macgillivary centre, Aberdeen Maternity Hospital – 7pm
Wednesday 12th September – Conference Room, Fraserburgh Hospital – 7pm
Did you know that revalidation will replace the current CPD requirements?
Here’s a countdown to revalidation – what it means for you and how can you get ready?
o There is more information about revalidation for pharmacists and pharmacy technicians on the GPhC website, including a video presentation about revalidation, the revalidation framework documents, and some FAQs
o RPS and APTUK members can check out members web pages for videos and information o See your own revalidation timeline at https://www.pharmacyregulation.org/your-revalidation-timeline o Discover the new types of CPD you will be expected to submit: https://www.pharmacyregulation.org/revalidation-
resources-pharmacy-professionals o FAQs
RPSScotland are hosting a revalidation evening for members on 17th April and APTUK Aberdeen have planned a session on 25th April, non members are welcome. For more information contact [email protected]
Page 4 PHARMACY NEWS P a g e | 4 PHARMACY NEWS
How can you get ready?
Now If you are not used to receiving emails from GPhC log in and check your contact details also check in your junk mail revalidation emails may be sent from Chief Executive Duncan Rudkin preferably use a personal address as your username and PIN will be included in the email
From Monday 26th March 2018 MyGPhC will no longer be available to access
Friday 30th March 2018 Revalidation replaced the current requirement for registrants to complete CPD
Sunday 1st April 2018 The current CPD system, www.uptodate.org.uk, will become read-only
April 2018 Expect a letter with a PIN code and instructions on how to set up your new
account, you may be contacted at a different time from your colleagues. Set up your account as soon as possible after you hear from GPhC so you are ready to record your revalidation activity and renew your registration.
By Friday 1st June 2018 If you want to keep any CPD entries you have previously recorded in www.uptodate.org.uk, you will need to print them as PDFs. Note: CPD needs to be current and relevant to current practice, do you really need to print all these records?
Pharmacy professionals with a registration renewal deadline of 31 October will be the first group to submit Submit revalidation on time when requested by GPhC
January 2019 GPhC will start reviewing CPD records, if you are selected, you will receive personalised feedback from GPhC. If you are not selected, you will receive summary feedback based on the reviews GPhC have done.
https://www.pharmacyregulation.org/revalidation
Youtube video from GPhC
Melatonin
Communication from the NHS Grampian Primary Care Prescribing Group regarding Melatonin was circulated to community pharmacies on the 23rd March 2018. Melatonin may be prescribed in primary care, on the recommendation of a consultant specialist for the treatment of sleep disorders in children, adolescents and adults with learning difficulties. NHS Grampian currently spends approximately £700k (Nov 16- Oct 17) annually on melatonin products. There is the potential for approximately £440k savings if patients currently prescribed melatonin & Bio-melatonin 3mg tablets were switched to melatonin 3mg capsules. Therefore, for patient requiring IR melatonin, 3mg capsules is now the product of choice in NHSG and all new patients initiated on immediate release melatonin should be prescribed 3mg capsules. It has also been requested that patients currently being prescribed melatonin 3mg tablets (including Bio-melatonin 3mg tablets) should be reviewed and switched to melatonin 3mg where appropriate.
Page 5 PHARMACY NEWS P a g e | 5 PHARMACY NEWS
Community Pharmacists should note melatonin capsules are available from a number of specialist suppliers including; Oxford Pharmacy Stores, Pharma Nord and Quantum. If you have any questions regarding melatonin please contact your local specials team:
Clozapine, Constipation & GI Complications
Clozapine is a high risk medicine licensed for treatment resistant schizophrenia and treatment resistant psychosis in Parkinson’s disease. Clozapine is associated with varying degrees of impairment of intestinal peristalsis attributed to its anticholinergic properties. These range from constipation (very common; >1 in 10) to intestinal obstruction, faecal impaction and paralytic ileus (very rare; <1 in 10,000). On a few occasions cases have been fatal.
In October 2017 the MHRA issued a Drug Safety Update reminding healthcare professionals of the potential risk of intestinal obstruction, faecal impaction and paralytic ileus associated with clozapine:
https://www.gov.uk/drug-safety-update/clozapine-reminder-of-potentially-fatal-risk-of-intestinal-obstruction-faecal-impaction-and-paralytic-ileus
and issued the following advice:
o Exercise particular care in patients receiving other drugs known to cause constipation (especially those with anticholinergic properties), patients with a history of colonic disease or lower abdominal surgery, and in patients aged 60 years and older
o Clozapine is contraindicated in patients with paralytic ileus
o Advise patients to report constipation immediately
o Actively treat any constipation that occurs
Prevention of Constipation
Discuss the risk of constipation with the patient before starting clozapine treatment and
o Provide appropriate lifestyle advice on diet, fluid intake & exercise o Consider the use of prophylactic laxatives, as appropriate o Monitor for signs of constipation regularly (weekly) during the first 4 months of treatment as this seems to be a
higher-risk period
Information for patients on recognising constipation and action to be taken can be found on the choice and medication website:
http://www.choiceandmedication.org/generate.php?sid=113&fname=handyfactsheetclozapineandconstipation.pdf
Treatment of Constipation
When constipation occurs in a clozapine patient an abdominal examination is indicated. If intestinal obstruction can be excluded treat with an appropriate laxative regime:
o Stool softener (e.g. docusate sodium) plus stimulant (e.g. senna; bisacodyl)
Or
o Osmotic laxative (e.g. macrogol) plus stimulant (e.g. senna; bisacodyl)
Page 6 PHARMACY NEWS P a g e | 6 PHARMACY NEWS
Severe constipation needs to be managed but does not generally warrant clozapine discontinuation, although a dose reduction may be helpful. However in case of serious motility impairment (e.g. intestinal obstruction, faecal impaction & paralytic ileus) clozapine must be stopped immediately and the patient referred to a specialist for treatment.
Where Community pharmacists provide OTC laxatives this should be communicated to the patient’s Community Mental Health Team.
References
1. MHRA Drug Safety Update 26th October 2017 2. Zaponex Fact Sheet Constipation 3. NHS inform Handy Fact Sheet Clozapine and constipation
Prescribing Guidance
The NHS Grampian good prescribing guide has been available for some time now. It is geared towards GPs for their prescribing and community pharmacists to inform their expectation regarding what should be prescribed. For a copy of the prescribing guidance please email [email protected]
As a prompt for pharmacists it should be noted that where prescribers are being advised on a topic e.g. melatonin, rubifacients, glucosamine, omega 3 oils, the same advice applies to community pharmacists with regard to the products they prescribe through MAS for example.
MAS Prescribing
Please remember that the use of a PGD is no longer required in order to provide liquid paracetamol under MAS for the purpose of pre-immunisation dosing for MenB vaccination in infants. There is no requirement for pharmacy staff to see the child’s red book prior to issuing paracetamol on MAS for this purpose.
Items prescribed via MAS should be prescribed generically where appropriate.
Community Eye Care
The Community Eye Care website and app have been developed by NHS Grampian and NHS Forth Valley, with the support of the Optometry department of NHS Education for Scotland (NES Optometry) and the Scottish Centre for Enabling Technologies, University of the West of Scotland. The guidelines give advice to support the management and care of patients in a primary care setting and have based on the Scottish General Ophthalmic Services Contract.
For more information see https://communityeyecare.scot.nhs.uk/guideline-links
Pharmacies are encouraged to work together with their local optometrists and should be using the Eye Health Network Form included in the Minor Ailments Formulary when referring patients to an optometrist.
Quit your way
The NHS Smoking Cessation service in Scotland has been rebranded as “Quit Your Way – with our support”.
The brand was created after research by Health Scotland found smoking cessation services should have one national identity to improve uptake.
NHS Inform’s Smokeline has already rebranded to Quit Your Way Scotland and all health boards are in the process of adopting the identity.
More information regarding materials to promote the new brand will be circulated once available.
For more information on Quit Your Way Scotland:
https://www.nhsinform.scot/care-support-and-rights/nhs-services/helplines/quit-your-way-scotland
Page 7 PHARMACY NEWS P a g e | 7 PHARMACY NEWS
Vitamin D guidance – Health start vitamins
Following recent advice from Scottish Government regarding vitamin D, parents of children aged 1- 4 years of age are being encourage to give their child a daily supplement containing 10μg vitamin D.
At present patients that are eligible for the Healthy Start scheme will receive vitamins via their health visitor or midwife.
Patients that are NOT eligible for the Healthy Start scheme are being encouraged to purchase Healthy Start vitamins via their local community pharmacies.
Please ensure that your pharmacy has stock of both the Healthy Start vitamins for women and the Healthy Start vitamins drops for children that patients can purchase.
https://www.healthystart.nhs.uk/
