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Prescribing Oversight Ccommittee - Consultation Papers for the meeting on 4th March 2020

 

As part of the Prescribing Oversight Committee’s (POC, formerly APC) new consultation process, we are broadening the consultation to allow more clinicians to engage with this process, by making it available via an online survey. Consultation papers will be circulated every two months in line with the meeting. Your input is valued, as you are considered a stakeholder in the Berkshire West Integrated Care Partnership.

Decisions made at this committee are likely to have a direct or indirect impact on your practice. 

This consultation is your opportunity to feed into the POC decision-making process.

**The deadline for comments is 5pm on 19th February 2020**

The following papers are to be considered at the meeting on 4th March 2020

  

GP and SALT PRESCRIBING GUIDE: Thickeners for adult patients with dysphagia

A new document to support the appropriate prescribing of thickener products and their quantities.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

Berkshire Infant Feeding Guidelines & Appropriate Prescribing of Infant Formulae

This document is to support clinicians in the appropriate prescribing of infant formulas and managing infant feeding dilemmas.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

Berkshire Adult Nutritional Supplement and Tube Feed Formulary

The Renal Dietitians have requested for Fortisip Compact Protein and Fresubin to be added to the formulary as they felt they met their patient’s specialist needs better than some of the current products due to their micronutrient status, cost and/or volume.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

COPD Guidelines

Due to the current differences in NICE Guidelines and GOLD, local respiratory specialists have approved the use of the Primary Care Respiratory Society treatment algorithm for the use of inhaled therapies in COPD. The treatment algorithm is intended for use when initiating new treatments due to disease progression and not intended to be used for switching patients from their existing treatment, unless the patient is uncontrolled or struggling to use their current treatment/device.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

Adult Palliative Care Guidelines 

These guidelines cover all services in Berkshire including Wexham Park Hospital, Royal Berks Hospital, BHFT, East Berkshire CCGs, Sue Ryder Hospices & Thames Hospice. They are to be read in conjunction with Organisational Policies on Medicines Management, Prescribing and administration of medicines and use of Oxygen appropriate to each organization.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

Adult ADHD Guidelines 

These guidelines have been reviewed following NICE guidance issued in 2018 on the diagnosis and management of ADHD in children, young people and adults (1), which states; ‘After titration and dose stabilisation, prescribing and monitoring of ADHD medication should be carried out under Shared Care Protocol arrangements with primary care’. Clear guidelines are therefore necessary to clarify the roles of primary and secondary care providers when using more specialist medicines that are categorised as amber drugs in the NHS Berkshire traffic light system. This document sets out these responsibilities from initial referral to the adult ADHD service through to on-going treatment maintenance and support.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

Children's ADHD Guidelines 

NICE Clinical Guideline 87 states that ‘Healthcare providers should ensure continuity of care for people with ADHD’. Also, that after titration and dose stabilisation, prescribing and monitoring of ADHD medication should be carried out under Shared Care Protocol arrangements with primary care. The BHFT CAMH Service is commissioned to provide a service to children aged up to and including 18 years of age. Clear guidelines are necessary to clarify the roles of primary and secondary care providers when using more specialist medicines that are categorised as amber, red, green, brown or non-formulary drugs in the NHS Berkshire traffic light system. This document sets out these responsibilities from initial referral to the Child and Adolescent Mental Health Service (CAMHS) ADHD Pathway through to on-going treatment maintenance, support and ultimately, referral to Adult ADHD services if necessary.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

Prescribing and Monitoring of Oral Antipsychotics

This shared care protocol covers the use of oral antipsychotics prescribed for the treatment of:

- Schizophrenia / schizoaffective disorder

- Bipolar affective disorder

- Psychotic symptoms i.e. hallucinations, thought disorder, paranoia, delusions, conceptual disorganisation, grandiosity and psychomotor agitation for those patients who do not have a diagnosis of schizophrenia/ schizoaffective disorder or bipolar disorder.

- Unlicensed indications approved by NICE; psychotic depression, severe and distressing anxiety in bipolar disorder where psychological treatment has failed.

- Major depression – adjunctive treatment (Quetiapine XL is licensed, however, other atypical antipsychotics are used off-label.

Please click here to read this paper

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

Berkshire Dementia Pathway

The BHFT Older Adults Service Lead has worked in collaboration with Dr Katie Simpson and Dr Angus Tallini to review the Dementia Care Pathway in light of recent updates to NICE Guidelines for Dementia (NG97). The aim is to move away from shared care to a system of discharging patients back to their GP with the provision for improved communication and referral back to the service if problems arise. This will ultimately improve patient safety and experience by:

  • Improve early diagnosis for people with dementia because resources can be moved to deal with initial assessments. This will reduce the waiting time for Memory Clinics.
  • Improve patients and carers experience of living with dementia and improve access to help to prevent and manage crises
  • Access to a named Dementia Care Advisor for each patient with dementia who does not already have a named social worker or mental health practitioner Integrated services with effective joint working

Reduce risk of different pharmacies sending medicines

Please click below for the respective papers

 

If you wish to comment on this specific paper, as part of the consultation, please click here.

 

 

Expiring Green/Amber/Red Policies

These papers are all POC (previously APC) policies due for review. In line with the updated process, POC policies for Green, Amber or Red drugs will be removed if approved. There has been no change in the CCG’s position on these policies and no new evidence or change in practice to warrant a change in their traffic light status (TLS) and so they have been submitted to the POC for review to agree this position.

If you wish to read any of the policies below, please click on their individual links. 

Green Policies

Amber Policies

Red Policies

If you wish to comment on any of these, please click here, where comments can be submitted for any of the policies below (multiple submissions permitted).

 

Expiring Brown Policies

These papers are all POC (previously APC) policies due for review. There has been no change in the CCG’s position on these policies and no new evidence or change in practice to warrant a change in their traffic light status (TLS) and so they have be submitted to the POC for review to agree this position.

If you wish to read any of the policies below, please click on their individual links. 

 If you wish to comment on any of these, please click here, where comments can be submitted for any of the policies below (multiple submissions permitted).

If you need medical help and are unsure what to do, call NHS 111 for help and advice. They are available 24 hours a day.