introduction to medicines, poisons and pharmacy calls ruth cheema medicines information pharmacist...
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![Page 1: Introduction to Medicines, Poisons and Pharmacy Calls Ruth Cheema Medicines Information Pharmacist Trent Medicines Information Service For Health Advisors,](https://reader036.vdocuments.us/reader036/viewer/2022062304/56649ef35503460f94c05c3a/html5/thumbnails/1.jpg)
Introduction to Medicines, Poisons and Pharmacy Calls
Ruth Cheema
Medicines Information Pharmacist
Trent Medicines Information Service
For Health Advisors, Health Information Staff and Nurse Advisors
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Introduction to Medicines, Poisons and Pharmacy Calls
Aim
To enable all staff answering Medicines, Poisons and Pharmacy calls to work within role competencies and fulfil them safely, reliably and effectively in this area of care.
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Introduction to Medicines, Poisons and Pharmacy Calls
Learning Outcomes
1. Have an overview of NHS Direct’s Pharmacy and Medicines Services
2. Have an overview of UK Medicines Information Services, National Poisons Information Service and Community Pharmacy Services
3. Have a baseline knowledge for handling Medicines and Poisons Calls
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
![Page 5: Introduction to Medicines, Poisons and Pharmacy Calls Ruth Cheema Medicines Information Pharmacist Trent Medicines Information Service For Health Advisors,](https://reader036.vdocuments.us/reader036/viewer/2022062304/56649ef35503460f94c05c3a/html5/thumbnails/5.jpg)
Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Call
Workshop 2 What is a Medicine? What Next?
![Page 6: Introduction to Medicines, Poisons and Pharmacy Calls Ruth Cheema Medicines Information Pharmacist Trent Medicines Information Service For Health Advisors,](https://reader036.vdocuments.us/reader036/viewer/2022062304/56649ef35503460f94c05c3a/html5/thumbnails/6.jpg)
Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Why learn about Pharmacy and Medicines?
Research from 2000 showed
6% of all calls to NHSD are for advice about medicines40% of calls include advice about medicines
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Medicine Calls may involve
Prescription-only Medicines (POM)
Homeopathic preparations
Pharmacy Medicines (P)
Food supplements and vitamins
General Sales List Medicines (GSL)
Recreational drugs and drugs of abuse
Herbal remedies Steroids in sport
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Is there a Policy?
Look inNHS Direct National
Policy for Handling
Medicines Calls NP005
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Definition of Medicine Calls
Approved Reference Sources
Principles for Handling Medicines calls
Record keeping and Documentation
(Poisons calls) Quality Assurance
Guidance for specific types of calls
Training and Development
NP005 covers
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
NP005 Definition of Medicines Any substance or article which is manufactured, sold, supplied, imported or exported for use wholly or mainly in
Treating or preventing disease
Diagnosing disease or status of a physiological condition
Contraception
Inducing anaesthesia
Temporarily or permanently affecting a physiological function in any way
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Overview of the roles of different staff in handling medicines calls: role competencies and limitations
Call Handlers/Health Advisors
Information on access to medicines, repeat prescriptions, P4Q calls
Health information staff
Medicines Information when no new or worsening symptoms
Nurse Advisors Medicines advice when new or worsening symptoms present
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
P4Quick CallP4 Priority Quick Calls on access to pharmacy
services and medicines e.g.
Emergency Hormonal Contraception
Information on missed contraceptive pills
Repeat medication
Access to medicines
do not need to be referred to Health Information.
Details in the Medicines handling Policy NP005
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Other NHS Direct PoliciesNP001 – National Guidance for the Management of Frequent Callers
NP002 – National Policy for the Referral of Callers with Mental Health Issues to Mental Health Helplines
NHS Direct FAQs regarding Protecting and Using Patient Information
NHS Direct Child Protection Policy
NHS Direct Adverse Incident Management Policy
NHS Direct Complaints and Feedback Policy
NHS Direct Third Party Calls Policy
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Compulsory checks for new/active or recurrent symptoms
“Are you calling about an injury or a new or worsening health
problem?”
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Direct’s Pharmacy and Medicines Services
Risk Factors in taking medicines calls
Misunderstanding what the caller said
Omitting relevant information sources
Missed symptoms Working outside level of competency
Incomplete background information
Caller doesn’t understand the answer
Incomplete documentation Inaccurate documentation
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
![Page 17: Introduction to Medicines, Poisons and Pharmacy Calls Ruth Cheema Medicines Information Pharmacist Trent Medicines Information Service For Health Advisors,](https://reader036.vdocuments.us/reader036/viewer/2022062304/56649ef35503460f94c05c3a/html5/thumbnails/17.jpg)
Introduction to Medicines, Poisons and Pharmacy Calls
Ethical Dilemmas
Medicines calls that may lead to ethical dilemmas Age of caller Third party calls Refusal of another HCP to supply a medicine Caller not wishing to disclose information to Dr Wrong information given to caller by HCP Caller taking a higher dose than prescribed Caller wants information about how to obtain a medicine
that is of dubious worth Caller prescribed two interacting medicines
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Introduction to Medicines, Poisons and Pharmacy Calls
Ethical Dilemmas
I found a tablet….My G.P. says this…. but I’ve read the other….Does heroin interact with…..?Could my partner’s tablets cause……?
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Introduction to Medicines, Poisons and Pharmacy Calls
Ethical Dilemmas – General Guidance
All the published information sources that you use are in the public domain.
Instinct: You may have to do what seems right to you.
You do not have to answer everything that you are asked!
Document carefully everything that you do
There are often no “right answers” .Give yourself thinking timeSecond opinion: try to speak to a colleague or to the Medicines Information Centre.Conflicts: try not to get caught up in patient conflicts with other professionals.
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Introduction to Medicines, Poisons and Pharmacy Calls
Workshop 1 – Ethical Dilemmas
A man asks how long cocaine stays in the body. He used some cocaine at the weekend but is due to have a drug test tomorrow.
What advice would you give?
A woman says she has found some medicines in her son’s room. She reads the labels - lamivudine, zidovudine & saquinavir.
Can you tell her what they are for? Would your answer be different if the call was from his wife?
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
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Introduction to Medicines, Poisons and Pharmacy Calls
Overview of UK Medicines Information
UKMi - supports MI needs of NHS health professionals
>½ million enquiries 2005
16 regional & 260 local centres
Specialist services - pregnancy, breastfeeding, liver disease
Training, websites, QA, drug reviews
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Introduction to Medicines, Poisons and Pharmacy Calls
Overview of UK Medicines Information
Your Medicines Information Service
Your team photo
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Introduction to Medicines, Poisons and Pharmacy Calls
Overview of UK Medicines Information
Staff Pharmacists Pre-registration students Secretarial support
Service to NHS Direct Complex medicines calls MI skills training Quality Assurance National work
9am - 5.00pmYour MI phone
number
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Introduction to Medicines, Poisons and Pharmacy Calls
Refer to the UKMi Service if You need interpretation of call You have no information or it is unclear It is a complex call Not within your competency
Name, hours and contact details of your Regional MI
Service
Overview of UK Medicines Information
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Introduction to Medicines, Poisons and Pharmacy Calls
Caller taking 3 or more prescription medicines
Dose(s) outside the normal range
Unlicensed use of medicine or use of unlicensed medicine
High risk medicines e.g. aminophylline, carbamazepine, digoxin, lithium, methotrexate, phenytoin, theophylline, warfarin
Medicines in pregnancy or breastfeeding
Complex Calls
Overview of UK Medicines Information
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable NHS Direct’s Pharmacy and Medicines Services
Workshop 1 Ethical Dilemmas Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
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Introduction to Medicines, Poisons and Pharmacy Calls
24 hour, UK wide clinical toxicology service for healthcare professionals
Staffed by Poisons Information Specialists, Nurses, Pharmacists, Physicians
Provide information & advice on diagnosis, treatment and management of poisoning
Overview of National Poisons Information Service
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Introduction to Medicines, Poisons and Pharmacy Calls
Overview of National Poisons Information Service
Five poisons centres
Belfast, Cardiff, Birmingham, Edinburgh, Newcastle
One national number 24/7
0870 600 6266
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Introduction to Medicines, Poisons and Pharmacy Calls
Overview of National Poisons Information Service
TOXBASE®
Primary Clinical Toxicology database of NPIS
Available to healthcare professionals only
Contains colour-coded NHS Direct advice boxes
Updated daily
Low Toxicity Poster – substances safe if ingested
At NHS Direct used by NAs only
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Introduction to Medicines, Poisons and Pharmacy Calls
Provides information on toxicity and management of acute poisoning for over 14,000 products – search by brand name or type of product
TOXBASE®
Overview of National Poisons Information Service
Pharmaceuticals Household & other Commercial Products
Industrial Chemicals Plants
Agricultural Chemicals Snakes
Veterinary Products Insect Bites
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
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Introduction to Medicines, Poisons and Pharmacy Calls
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
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Introduction to Medicines, Poisons and Pharmacy Calls
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
10 facts about Community Pharmacy6 million people visit a community pharmacy every day.
94% population use the local pharmacies at least once a year.
Community pharmacy could manage up to 8% of adult attendances to A&E.80% repeat prescriptions could be handled by community pharmacists, saving 2.7 million hours of GP/practice time.
NHS could save £380 million/year if 1 in 4 people consulted their pharmacist about minor ailments instead of the GP.
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
10 facts about Community Pharmacy30% PCTs developing schemes to provide patients treatment for minor ailments through pharmacies.
In 2002, the NHS medicines bill was £8 billion, 250% more than in 1990.
In 2002, 712 million prescription items were dispensed, 50% more than 1990.
75% GPs say pharmacists should be able to prescribe certain medicines and offer extended advisory services.
In one study, 66% of patients did not require all prescription items to be dispensed.
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Started 1st Apr 2005, monitoring delayed until Oct
Benefits Improve access to community pharmacy Expand range of services provided Make better use of pharmacist skills Help reduce workload pressures on GPs
3 levels of service: Essential, Advanced, Enhanced
New Contract
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Dispensing Patient records Compliance support Electronic transfer
of prescriptions
Repeat dispensing Pharmacist
managed repeats
Disposal of unwanted medicines
Health promotion 6 campaigns / year
Signposting
Support for self care
Clinical Governance
Essential services
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Optional
Accreditation to provide
Medicines Use Review Long-term conditions Identified by PCT Report to patient and GP
Prescription Intervention Response to specific issue Report to patient and GP
Advanced Services
Accreditation
Pharmacist has passed a competency test
Patient and pharmacist can sit down together
Talk normally without being overheard
Private consultation area
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
PCTs may commission to meet local need
May implement recognised services or develop own initiatives
Enhanced Services
Suggested Enhanced Services
Minor Ailments
Smoking Cessation
Supervised Administration of
Medicines
Anticoagulant Monitoring
Needle Exchange Schemes
Care Home Support
Emergency Hormonal Contraception Schemes
Medicines Review
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Staff in a community pharmacySales assistants Trained to work in shop
but not to sell or advise on medicines
Counter assistants Trained to sell and advise on medicines – supervision by pharmacist
Dispensing technicians Trained to dispense Rx – all checked by pharmacist
Pharmacist Responsible for all sales and Rx of medicines
By law a pharmacy is not a pharmacy if pharmacist not present
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Access hours
Monday – Saturday standard ‘shop hours’
OOH system to cover evenings and Sunday by local agreement
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Out of Hours (OOH) Provision
Check NHS.uk for details of local arrangements for OOH service
Look on NHS Direct online under Common Health Problems for
Emergency Supply of medicines from a community pharmacy
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Emergency Supply by a pharmacist – £ charge to patientPharmacist must interview the person
Immediate need and impractical to obtain a prescriptionPreviously prescribed for the personDose appropriate for the person
Supply up to 5 days except Insulin, ointment, cream, drops, inhaler – smallest pack Oral contraceptive - a full cycle Antibiotic - a full course of treatment
Do not supply a Controlled Drug Except phenobarbitone for epilepsy
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Prescription Charges£6.65 for each NHS Prescription
Irrespective of cost to NHS of medicine
Irrespective of quantity
Same drug and form is one charge
Various charges for combination products
Pre-payment certificates – forms from community pharmacies
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Aged under 16 Aged 16, 17 or 18 years in full time education. Aged 60 or over. Has a Maternity Exemption certificate. Has a Medical Exemption certificate. Has a War Pension exemption certificate. Has a Prescription Prepayment certificate. Named on a NHS Charge certificate (HC2). Prescribed free of charge oral contraceptives. Gets Income Support or Income Based Jobseekers
Allowance. Entitled to / named on, NHS Tax Credit
Exemption certificate. Partner gets Pension Credit Guarantee Credit.
Exemptions from prescription charge
Overview of Community Pharmacy Services
.
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Introduction to Medicines, Poisons and Pharmacy Calls
ConfidentialityCode of Ethics – Pharmacist must treat patients with confidentiality
Data Protection Act – Includes paper and computerised patient medication records
Caldicott Principles – Good practice for using patient information in the NHS
Advanced Services – Private consultation area
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Patient demographics Medication dispensed
Drug – brand/formulation Strength Quantity Date
Special Notes Counselling given No clic-locks Allergies
Patient Medication Records
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
NHS Rxs on PMR Private Rxs - in bound book
or on PMR Controlled drugs obtained or
supplied - in bound book
Record Keeping
Checks by
RPSGB inspector
Superintendent Pharmacists
Police
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Emergency Hormonal Contraception (EHC)
Pharmacists may
Sell EHC (cost to patient) subject to certain restrictions e.g.age of patient
Supply EHC (free to patient) subject to pharmacist training and according to local guidelines (PGDs)
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Existing arrangements - prescriptions for oxygen dispensed at community pharmacy
From 2006 new arrangements in place
Patients will receive oxygen directly from supplier
Oxygen
Overview of Community Pharmacy Services
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
What is a Medicine?
Active Ingredient or Drug
Excipients – vehicle, bulking agent, tablet coating, capsule shell, colours, flavouring, stabiliser, pH adjuster ……
Form – tablet, capsule, suppository, eye drops, cream, patch, inhaler, injection ……..
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Naming medicines
Generic Brand
Amoxicillin Amoxil ®
Salbutamol Ventolin ®
Fluoxetine Prozac ®
Omeprazole Losec ®
Mefloquine Lariam ®
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Naming medicinesrINN - Internationally used naming system
introduced in June 2004
British Approved Name (BAN)
Recommended International Non-proprietary Name (rINN)
Amoxycillin Amoxicillin
Dothiepin Dosulepin
Frusemide Furosemide
Lignocaine Lidocaine
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Legal classification of medicines
General Sales List GSL
May be sold in general shops e.g. Paracetamol
Pharmacy OnlyP
May be sold in a pharmacy but not a general shop e.g. Zantac
Prescription OnlyPOM
May only be supplied on prescription e.g. Amoxicillin
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Controlled Drugs (CDs)
Class A Heroin, LSD, ecstasy, morphine, remifentanil, Class B if injections
Class B Amphetamines, barbiturates, codeine, pentazocine, pholcodine
Class C Anabolic steroids, cannabis, growth hormone, clenbuterol
Misuse of Drugs Act 1971 – Controlled Drugs harmful when misused. Act prohibits production, supply or possession
Post Shipman - CD regulations strengthened eg returning CDs
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines CallsMarketing Authorisation “Product Licence”
www.mhra.gov.uk
Issued by Medicines & Healthcare Products Regulatory Agency
Product licenses granted if three questions have been fully answered by manufacturer - Safety, Quality, Efficacy
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Key aspects in Summary of Product Characteristics (SPC) and Patient information leaflet (PIL) www.medicines.org.uk Large print and Braille PILs to be available
Prescribing within the product licence is the responsibility of the doctor
Patient must give informed consent if medicine is unlicensed or used “off label”
Marketing Authorisation “Product Licence”
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Introduction to Medicines, Poisons and Pharmacy Calls
Workshop 2 What is a Medicine?
The brand name of the product
The name of the active ingredient
The strength of the active ingredient
The Product Licence number
Look at the sample packs of medicines. Can you find….?
The expiry date
The name of the manufacturer
The legal category
The batch number
The dosage form
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Off LabelUK product licence but
being used for an indication / at a dose / by a route not in the licence
No LicenceNo UK product licence
Methotrexate for asthma and lupus
Sodium valproate for prevention of migraine
Thalidomide
Melatonin
Most herbal products
Unlicensed Medicines
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Newly licensed
Monitored intensively by Commission for Human Medicines (CHM) which reports to MHRA
Black triangle status usually reviewed after 2 years
Black Triangle medicines
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
NEWER DRUGS & VACCINES ()
All ADRs even if
Not certain that drug has caused it
Reaction well known
Other drugs at same time
ESTABLISHED DRUGS& VACCINES
All serious ADRs
Fatal, life threatening or disabling
Prolonged hospital stay
Even if well known
Yellow Card Reporting Scheme
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Pilot scheme launched Jan 2005
Patients can report suspected adverse effects www.yellowcard.gov.uk Patient report forms from 4000 GPs in pilot or MHRA
Help MHRA understand the patient experience and perspective of suspected adverse effects
Patients can view anonymous data on website
Patient reporting to Yellow Card Scheme
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Known as the ‘Black List’
Pricing Prescription Authority (PPA) will not reimburse dispensing cost.
NHS
Medicines that may not be prescribed in the NHS
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Certain foods considered medicines in specific conditions.
Cost of dispensing reimbursed only if GP has endorsed script “ACBS
ACBSe.g.Wysoy for milk protein
sensitivity
Borderline substances
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Homeopathy
Complementary Medicines
Herbal Medicine
Safe to use with conventional
medicines
May interact with conventional
medicines
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
In the UK, herbal products are either foods or medicines.
New legislation from August 2005 placing stricter controls on the levels of vitamins and minerals in food supplements.
Food supplements
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Doctor BNF
Dentist Dental Formulary
District Nurse / Health Visitor qualified as a Nurse Prescriber
Nurse Prescribers’ Formulary
Nurse / Midwife qualified as an Extended Formulary Nurse Prescriber
Nurse Prescribers’ Extended Formulary
Who can prescribe medicines?
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Voluntary partnership between doctor/dentist and supplementary prescriber to implement a clinical management plan with the patient’s agreement.
Prescribe all GSL, POM and CDs within the clinical management plan.
Pass approved training. Currently Authorised Proposed
NurseMidwife
Pharmacist
PhysiotherapistsRadiographers
Chiropodists, Optometrists
Supplementary Prescribing
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
New legislation to improve access to medicines
No individual prescription but Dr signs instructions for Specific Patient Group
Named health professional authorised to:
Supply a pre-labelled, fixed quantity medicine or
Administer fixed quantity medicine
Supply by PGD
Casualty
Minor Injuries Clinic
Walk-In Centre
Family Planning Clinic
Genito-Urinary Clinic
Ante-Natal Clinic
Diabetic Clinic
and more…
Patient Group Direction (PGD)
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
Pregnancy Breastfeeding Infants/children Elderly Patients on ‘high
risk’ medicines Renal problems Liver problems
Adverse Drug Reactions - at risk patient groups
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Introduction to Medicines, Poisons and Pharmacy Calls
Baseline Knowledge for handling Medicines Calls
More likely if taking several medicines Interactions can occur between conventional
medicines and
Drug Interactions
One drug modifies the effect of a second drug
Other conventional medicines
Foods
Herbal medicines Alcohol
Illicit/street drugs Food supplements
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Introduction to Medicines, Poisons and Pharmacy Calls
Primary resources for Medicines Calls – not in CAS system
Baseline Knowledge for handling Medicines Calls
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Introduction to Medicines, Poisons and Pharmacy Calls
Other support for medicines calls
NHS Direct in-house resources Health Information Specialists Health Information library
UK Medicines Information.
Your local centre is
Name…
Phone number….
Baseline Knowledge for handling Medicines Calls
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Introduction to Medicines, Poisons and Pharmacy Calls
Session Timetable
NHS Direct’s Pharmacy and Medicines Services Workshop 1 Ethical Dilemmas
Overview of UK Medicines Information Overview on National Poisons Information Service
Break Overview of Community Pharmacy Services Baseline Knowledge for handling Medicines Calls
Workshop 2 What is a Medicine? What Next?
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Introduction to Medicines, Poisons and Pharmacy Calls
What Next?
More practice and hands-on training
All Nurse Advisors
6 hours – Handling Medicines Calls
All Health Information staff
6 Hours – Handling Medicines Calls
3 Hours – Oral contraception
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Introduction to Medicines, Poisons and Pharmacy Calls
What Next?
…..and More
Further skills sessions for HIAs and NAs• Medicines in Pregnancy and Breastfeeding• Oral Contraception and EHC• Travel Medicines• Complementary and Alternative Medicines• eBNF and eMC – further skills• Immunisation
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Introduction to Medicines, Poisons and Pharmacy Calls
Learning Outcomes
1. Have an overview of NHS Direct’s Pharmacy and Medicines Services
2. Have an overview of UK Medicines Information Services, National Poisons Information Service and Community Pharmacy Services
3. Have a baseline knowledge for handling Medicines and Poisons Calls