PAD - Prescribing Advisory Database
Surrey
Prescribing Advisory Database

Committee Decisions

Decisions : Surrey Medicines Commissioners Group

Records returned : 51.

Date
Drug Profile
Narrative
Traffic Light Status
Wednesday, February 5, 2020

Community Pharmacy Surrey & Sussex (CPSS) have produced a briefing to explain the changes to the pharmacy home delivery services - see briefing paper below

Additional information relating to community pharmacy services across Surrey and Sussex can be found on the CPSS website

https://communitypharmacyss.co.uk/

 

 
N/A
Wednesday, April 3, 2019

Hepatitis B for the AT RISK group - Public Health England have provided advice about the management and prioritisation of Hepatitis B vaccines during periods of short supply and a plan for the phased re-introduction of hepatitis B vaccine for the lower priority groups.

NOTE - Hepatitis B has a BLACK traffic light status for use in travel - see "Travelling abroad" link on the right of the screen for further information

 
N/A
Wednesday, April 3, 2019

Combined Hepatitis A/B for the AT RISK group - Public Health England have provided advice about the management and prioritisation of Hepatitis vaccines during periods of short supply and a plan for the phased re-introduction of hepatitis vaccine for the lower priority groups.

NOTE - Hepatitis A/B has a BLACK traffic light status for use in travel - see "Travelling abroad" link on the right of the screen for further information

 
N/A
Wednesday, March 6, 2019

From 1st April 2019 both pregabalin and gabapentin will be classified as a schedule 3 Controlled Drug. As such, the arrangements through which patients obtain these medicines will change.
The Surrey Medicines Commissioners Group have developed a patient template letter for local adaption - see below.

In addition, NHSE have produced a patient hand-out that is also available below

 
Black
Wednesday, March 6, 2019

From 1st April 2019 both pregabalin and gabapentin will be classified as a schedule 3 Controlled Drug. As such, the arrangements through which patients obtain these medicines will change.
The Surrey Medicines Commissioners Group have developed a patient template letter for local adaption - see below.

In addition, NHSE have produced a patient hand-out that is also available below

 
See Below
Wednesday, March 6, 2019

From 1st April 2019 both pregabalin and gabapentin will be classified as a schedule 3 Controlled Drug. As such, the arrangements through which patients obtain these medicines will change.
The Surrey Medicines Commissioners Group have developed a patient template letter for local adaption - see below.

In addition, NHSE have produced a patient hand-out that is also available below

 
See Below
Wednesday, March 6, 2019

From 1st April 2019 both pregabalin and gabapentin will be classified as a schedule 3 Controlled Drug. As such, the arrangements through which patients obtain these medicines will change.
The Surrey Medicines Commissioners Group have developed a patient template letter for local adaption - see below.

In addition, NHSE have produced a patient hand-out that is also available below

 

 
Black
Wednesday, September 5, 2018

The Surrey Medicines Commissioners Group agreed that the Surrey Heartlands Managing Diabetes in Care Homes resource was appropriate for local adoption.

See CCG specific documents below

 
N/A
Wednesday, June 6, 2018
Immediate release (IR) quetiapine should be used in preference to the XL formulations as recommended by the PCN in May 2012.

Quetiapine IR should be prescribed generically. The Seroquel brand was assigned a BLACK traffic light status by the PCN in May 2017

SABP have updated (Jan 2018) a number of resources aimed at supporting the use of IR quetiapine in preference to the XL formulations - see below

A shared-care Information Sheet for prescribers can also be found below.

Where quetiapine is used in Behavioural and Psychological Symptoms of Dementia (BPSD), please see PAD page for this indication (search BPSD or see link below)
 
Blue
Wednesday, March 7, 2018

It is recommended that tramadol modified release preparations are prescribed by BRAND - see UKMI Branded Prescribing Recommendations document below. The locally preferred brand for modified-release, TWICE DAILY dosing is Marol® Marol® is available across all of the twice-daily dose ranges, already represents the most commonly prescribed tramadol brand locally and nationally and remains one of the most cost-effective tramadol MR choices. Patients currently receiving generically written prescriptions should be reviewed with a view to change the prescribing to a cost-effective brand.

 
N/A
Wednesday, March 7, 2018

It is recommended that buprenorphine patches are prescribed by BRAND - see UKMI Branded Prescribing Recommendations document below. The locally preferred brand for buprenorphine 7-day patches is Butec® Butec® is available across all of the dose ranges, already represents the most commonly prescribed brand nationally (>50%), and is considerably less costly than the originator brand BuTrans. Patients currently receiving generically written prescriptions should be reviewed with a view to change the prescribing to a cost-effective brand.

 
N/A
Wednesday, November 1, 2017
Patient Specific Directions (PSDs) are often used to enable non-medical practitioners (practice nurses, health care assistants) to administer specific medicines for specific conditions.
A PSD tempate for EMIS system users has been developed by a local GP practice to improve the consistency and content of their salbutamol PSDs.
This PSD template (among others) is available from your local Medicines Management Team should your practice wish to adopt / adapt it.

Please contact your local Medicines Management Team for assistance
 
N/A
Wednesday, November 1, 2017

Patient Specific Directions (PSDs) are often used to enable non-medical practitioners (practice nurses, health care assistants) to administer specific medicines for specific conditions. A PSD tempate for EMIS system users has been developed by a local GP practice to improve the consistency and content of their Denosumab PSDs. This PSD template (among others) is available from your local Medicines Management Team should your practice wish to adopt / adapt it. Please contact your local Medicines Management Team for assistance

 
Green (see narrative)
Wednesday, November 1, 2017
Patient Specific Directions (PSDs) are often used to enable non-medical practitioners (practice nurses, health care assistants) to administer specific medicines for specific conditions.
A PSD tempate for EMIS system users has been developed by a local GP practice to improve the consistency and content of their testosterone injection (Nebido) PSDs.
This PSD template (among others) is available from your local Medicines Management Team should your practice wish to adopt / adapt it.

Please contact your local Medicines Management Team for assistance
 
N/A
Wednesday, November 1, 2017
Patient Specific Directions (PSDs) are often used to enable non-medical practitioners (practice nurses, health care assistants) to administer specific medicines for specific conditions.
A PSD tempate for EMIS system users has been developed by a local GP practice to improve the consistency and content of their Zoladex PSDs.
This PSD template (among others) is available from your local Medicines Management Team should your practice wish to adopt / adapt it.

Please contact your local Medicines Management Team for assistance
 
N/A
Wednesday, November 1, 2017
Patient Specific Directions (PSDs) are often used to enable non-medical practitioners (practice nurses, health care assistants) to administer specific medicines for specific conditions.
A PSD tempate for EMIS system users has been developed by a local GP practice to improve the consistency and content of their Prostap PSDs.
This PSD template (among others) is available from your local Medicines Management Team should your practice wish to adopt / adapt it.

Please contact your local Medicines Management Team for assistance
 
N/A
Wednesday, November 1, 2017
Patient Specific Directions (PSDs) are often used to enable non-medical practitioners (practice nurses, health care assistants) to administer specific medicines for specific conditions.
A PSD tempate for EMIS system users has been developed by a local GP practice to improve the consistency and content of their Vitamin B12 PSDs.
This PSD template (among others) is available from your local Medicines Management Team should your practice wish to adopt / adapt it.

Please contact your local Medicines Management Team for assistance
 
N/A
Wednesday, April 5, 2017
Combined hepatitis A & B vaccines (Twinrix and Ambrix) are NOT recommended for routine prescribing for travel purposes and are considered BLACK on the traffic light system

In the small cohort of patients who require BOTH the hepatitis A and B for travel purposes, the vaccines should be supplied separately with the hepatitis A on FP10 prescription and the hepatitis B as a private supply.

Hepatitis B vaccination for TRAVEL purposes is not commissioned under the NHS and should be prescribed / supplied privately for this indication
 
Black
Wednesday, November 2, 2016
The MCG agreed the use of the In-Check Dial device for use in general practice to support the improvement of patient inhaler technique
See guide below
 
Green
Wednesday, November 2, 2016
A number of Surrey CCGs have subscribed to an NHS programme called PrescQIPP, which produces a range of
evidence-based, application-in-practice oriented resources to support quality prescribing in the NHS - see "overview for clinicians" document below.
Where agreed as appropriate and supportive of local initiatives, PrescQIPP resources will be made available on the PAD and will be used / implemented by local Medicines Management Teams. CCG NHS logos will be added to locally endorsed PrescQIPP documents.
For non-PrescQIPP subscribers there are numerous resources available on the PrescQIPP website that have been released for use by all.
For more information about PrescQIPP and to access a variety of resources, visit the PrescQIPP website https://www.prescqipp.info/
 
N/A
Wednesday, September 7, 2016
There have been a number of reported severe skin reactions in children treated with an NSAID for chickenpox.
UKMI have produced a Q&A document to highlight these reports and have recommended that NDAIDs are avoided in children suffering from this infection.
Paracetamol is the recommended alternative for symptomatic management.

Please see Q&A document for full information
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below.
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below.
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, June 1, 2016
Surrey Medicines Commissioning Group recommend that patients prescribed all types of anticoagulants (warfarin and NOACs) should be given an anticoagulant alert card to carry with them. For patients taking NOACs, the card should be annotated on the reverse in the “Therapeutic range (INR)” box with the words “not applicable” or “not required for this drug”.
The cards are available for practices to order through usual NHS stationery supply routes.
See an example of the Anticoagulant Alert Card in the document below
 
N/A
Wednesday, November 4, 2015

UKMI Q&A for branded prescribing recommendations states that fentanyl patches are available as matrix and reservoir formulations; Patient familiarity with one brand is important. Generic prescribing is therefore not recommended and is considerably more costly. Matrifen (matrix) was agreed as a cost effective brand for primary care prescribing and is currently the most commonly prescribed brand of fentanyl patch amongst the Surrey CCGs. Mezolar matrix patches and Mylafent patches are similarly lower cost. Note: patches must not be cut because damage to the rate-limiting membrane can lead to a rapid release of fentanyl resulting in overdose. If the prescriber intends the patch to be cut (NB: unlicensed and not recommended by the MHRA) then the prescription must specify a brand of matrix formulation patch.

 
N/A
Wednesday, September 2, 2015

It is recommended that slow-release and longer-acting diltiazem products are prescribed by brand.

Following consideration of product price and current prescribing levels, the following were agreed as cost-effective preferred diltiazem brands for primary care:

  • Twice daily – Angitil SR capsules (available in all three strengths)
  • OR Tildiem Retard for patients preferring a tablet (although not available as 180mg strength)
  • Once daily – Zemtard XL 
 
Green
Wednesday, September 2, 2015

It is recommended that slow-release and longer-acting diltiazem products are prescribed by brand.

Following consideration of product price and current prescribing levels, the following were agreed as cost-effective preferred diltiazem brands for primary care:

  • Twice daily – Angitil SR capsules (available in all three strengths)
  • OR Tildiem Retard for patients preferring a tablet (although not available as 180mg strength)
  • Once daily – Zemtard XL
 
Green
Wednesday, October 30, 2013
The group agreed that, despite being licensed for this indication, the prescribing of naltrexone for opioid dependence should remain with the specialist and that shared care was not appropriate.
This discussion follows a number of requests received by GPs to prescribe
 
Red
Wednesday, October 30, 2013
GPs are advised not to provide prophylactic treatment on NHS prescriptions for conditions that may arise while travelling e.g. travel sickness, diarrhoea. Patients should be advised to purchase these items prior to travel. Advice is available from community pharmacists if required. Patients should be advised to seek medical attention abroad for conditions that arise at that time and are unresponsive to self medication. For further information please refer to the medicines management guide to prescribing.
 
N/A
Wednesday, February 22, 2012
Committee were asked to consider the issues associated with the prescribing of linezolid in primary care for mild to moderate skin/soft tissue infections (SSTIs) in patients: Linezolid prescribing for mild to moderate SSTI in line with HPA recommendations is an option for primary care prescribing especially where referral/admission to secondary care is to be avoided. Primary/secondary care interface: Treatment courses that are initiated in secondary care should be supplied by the Trust in their entirety. GPs should not be asked to prescribe the remainder of linezolid courses. Shared care is therefore not considered appropriate for this drug. Information sheet [linezolid]to support GPs to be developed.
 
N/A
Wednesday, February 22, 2012
Linezolid is considered a red drug for complicated skin and soft tissue infections - refer back to Acute Trust
 
Red
Wednesday, February 22, 2012
Linezolid is considered a red drug for the treatment of pneumonia - refer back to Acute Trust
 
Red
Wednesday, March 3, 2010
Dr Tina Peers (consultant in family planning) provided the opinion that EllaOne is a useful treatment option in patients who are seeking emergency contraception between 72 and 120 hours after unprotected intercourse or contraceptive failure. Family planning clinics have been issuing FP10 prescriptions for a small number of patients but have been experiencing supply problems through community pharmacy since this is a drug not routinely stocked. As a result of this, the family planning service have themselves arranged a small stock holding at some of their clinics and follow a protocol for use of this drug. The committee agreed that, considering the tri-fold in cost compared to other available EHC products, this product should only be used in patients who are seeking such treatment post 72 hours
 
Green
Friday, September 25, 2009
Zoledronic acid (Aclasta) - To use only on the recommendation of a Consultant Rheumatologist or Geriatrician in patients with osteoporosis for whom a bisphosphonate is the most appropriate line of treatment and who are unsuitable for or unable to tolerate oral bisphosphonates for osteoporosis or who are unable to comply with them and for patients with fractures despite oral bisphosphonates. It should be administered only in a place with the required clinical governance systems in place (training of staff, IV administration protocols etc).
 
Red
Wednesday, September 16, 2009
NICE TA177 'Alitretinoin for the treatment of severe chronic hand eczema' was noted. The committee agreed that alitretinoin licensed for hand eczema should be for hospital use only (RED status).
 
Red
Wednesday, May 20, 2009
The committee agreed that it should be a RED drug on the traffic light system if initiated following an out-patient appointment by a secondary care specialist / GPSI as the cost of the drug is included within PbR tariff. However, it was agreed that GPs may make an individual clinical decision to prescribe for recurrent skin lesions after initial diagnosis
 
Red
Wednesday, May 20, 2009
The committee confirmed that rivaroxaban should be considered a hospital only RED drug for the prevention of venous thromboembolism after total hip or total knee replacement in adults - the full treatment course should be given by the acute trust provider
 
Red
Wednesday, May 20, 2009
Following the presentation of further information since the last meeting the committee agreed with the use of Nebido in line with the SMC recommendation and agreed that it should be made available as an option for the treatment of male hypogonadism in Surrey PCT when testosterone deficiency has been confirmed by clinical features and biochemical tests
 
Amber Star
Wednesday, November 19, 2008

Local acute Trusts requested that ursodeoxycholic acid, used in the treatment of gall stones, is changed from Amber* to green. It was agreed that it should remain Amber* as initiation would still need to be carried out by the hospital Prescribe generically. Note - the branded product Ursofalk 250mg capsules were considered BLACK at the May 2017 PCN

 
Blue
Wednesday, October 29, 2008
Following safety advice the use of methotrexate 10mg tablets is not supported. Prescriptions should be for the 2.5mg tablets only
 
Black
Wednesday, September 26, 2007
September 2007 – The DH changed the regulations and advice relating to the treatment of TB. Patients requiring TB medication should be treated in specialist TB clinics where they will not be subject to prescription charges. FP10 prescriptions are not exempt from charges and should not be used.
 
Red