Presentation on theme: "Nottingham West CCG Prescribing Team Beth Carney/ Dawn Gajree / David Sharpe September 2014."— Presentation transcript:
Nottingham West CCG Prescribing Team Beth Carney/ Dawn Gajree / David Sharpe September 2014
Who we are… Beth Carney and Nayna Zuzarte – Prescribing Advisor Dawn Gajree – Primary Care Pharmacist Kate Morris – Primary Care Pharmacist David Sharpe – Care Homes Pharmacist Total 2.5WTE
And the wider team Shared team across the five Nottinghamshire county CCG’s: – Area Prescribing Committee / Interface team Nicky Bird, Amanda Rawlings, James Sutton – Clinical Governance and Care Homes Lead Coral Osborn – Data Analyst Tim Oxley and Chris Day
What do we do? “Promote evidence based cost effective prescribing” £12 million prescribing budget £323,000 QIPP
A day in the life of a Primary Care Pharmacist Read/ respond to emails – Data analyst EPACT reports, meeting requests, request for comments. GP practice – read/respond to queries from emails and tasks, MI query, red drugs, alternatives for specials. – run report, identify patients, collect data for each individual, summarise, agree changes, make changes. – Medication reviews, formulary implementation, epact analysis Office/ meeting – CCG service reviews, team meetings, write work streams, next years work, MMF
Helping us with our prescribing plan Pain – Practices have been asked to review of patients taking high dose opioids for non-cancer pain – Locally what is the maximum recommended dose of morphine for non-cancer pain 60mg every 12 hours 100mg every 12 hours 200mg every 12 hours
Helping us with our prescribing plan Pain – Practices are reviewing the prescribing of pregabalin for neuropathic pain – In local guidelines what is 1 st line for neuropathic pain after conventional analgesics? Gabapentin Pregabalin Amitriptyline
Respiratory COPD – Ensure patients who have previously exacerbated are issued with rescue packs (NNT =5) – Patients with an FEV1>50% on an inhaled corticosteroid (ICS) should be reviewed to deem if treatment is appropriate. – Formoterol easyhaler should be used as the 1 st line treatment option for long acting therapy in patients with FEV1>50% – Patients receiving oral steroid courses have the number recorded in the last year and those receiving 3 or more courses are considered for bone protection
Asthma Responding to the National Review of Asthma Deaths 39% of patients who died during the monitoring period had >12 SABA reliever inhalers issued in the year prior to their deaths. 4% of patients had more than 50 inhalers issued in the year prior to their deaths.
Repeat prescribing processes Review of practices repeat prescribing processes Printing of “duplication” on re-printed prescriptions to aid identification of a duplicated prescription to prevent the risk of a patient receiving a double quantity of medicines
The Care Homes Pharmacist Review all care home patients registered with GP practices within CCG. All patients reviewed twice a year Indication, Dose, Quantity, Suitability Recommendations to GP Resolve issues with community pharmacies
Helping us with our prescribing plan Prescribing of Generics / Brands – Promotion of generic prescribing – But some exceptions to the rule….. – Gatalin, sinemet, fenbid, laxido, nystan Prescribing the cost effective formulation – Nitrofurantoin Caps – Azithromycin Caps
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