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Nottingham West CCG Prescribing Team Beth Carney/ Dawn Gajree / David Sharpe September 2014.

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Presentation on theme: "Nottingham West CCG Prescribing Team Beth Carney/ Dawn Gajree / David Sharpe September 2014."— Presentation transcript:

1 Nottingham West CCG Prescribing Team Beth Carney/ Dawn Gajree / David Sharpe September 2014

2 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

3 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

4 What do we do? “Promote evidence based cost effective prescribing” £12 million prescribing budget £323,000 QIPP

5 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

6 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

7 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

8 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

9 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.


11 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

12 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

13 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

14 Generic Drug Tariff CostOriginal BrandCostAlternative BrandsCost Ethinylestradiol 20 micrograms/Desogestrel 150 microgramsn/aMercilon®£7.67Gedarel® 20/150£5.98 Ethinylestradiol 20 micrograms/Gestodene 75 microgramsn/aFemodette®£8.85Millinette® 20/75£6.37 Sunya 20/75®£6.62 Ethinylestradiol 30 micrograms/Desogestrel 150 microgramsn/aMarvelon®£6.45Gedarel® 30/150£4.93 Ethinylestradiol 30 micrograms/Gestodene 75 microgramsn/aFemodene®£6.73Millinette® 30/75£4.85 Katya 30/75®£5.03 Ethinylestradiol 30 micrograms/Levonorgestrel 150 micrograms£2.82Microgynon 30®£2.82Levest®£1.80 Rigevidon®£1.89 Ovranette®£2.20 Ethinylestradiol 30/40/30 micrograms Levonorgestrel 50/75/125microgramsn/aLogynon®£3.82TriRegol®£2.87 Ethinylestradiol 35 mcg / norgestimate 250 mcg Cilest®£7.16Lizzina®£5.37 Desogestrel 75 micrograms£3.51Cerazette®£8.68Cerelle®£3.50 Zelleta®£3.51

15 Where to find local guidelines and formulary


17 Practices and Pharmacists Dawn Gajree: – Church Street Medical Centre – Hama Medical Centre – Hickings Lane Medical Centre – Linden Medical Centre – Saxon Cross Surgery – Abbey Medical Centre

18 Practices and Pharmacists Kate Morris – The Valley Surgery – Manor Surgery – The Oaks Medical Centre – Bramcote David Sharpe – West End Surgery – Church Walk Surgery

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