Medicines information

Medicines supply notifications – 29 June 2020

The following outlines supply issues with lodoxamide, mirtazapine, imipramine, lacosamide and includes an update on ranitidine

Emergency Supply of Medicines Transfer of Information Project – 1 June 2020

To support the national COVID-19 response, NHS England and NHSX have requested the acceleration of the Community Pharmacy Consultation Service (CPCS) Emergency Supply of Medicines  (referral made by NHS 111 to community pharmacy to make an emergency supply of a medicine/appliance) Transfer of Information project.

This is an improved method of information being received by practice to make them aware of an emergency supply of medication through the above scheme and incorporate the information within the patients records.

Testing has been carried out in the Leeds area, and therefore the pilot will be rolled out to the TPP sites in Leeds, expected w/c 15/06/2020. Dates may still vary subject to testing / other circumstances.

Please see the guide from TPP showing the new functionality, and view the three minute training video .

COVID-19 adjusted heart failure pathway – 12 May 2020

Vitamin B12 injections – 11 May 2020

Amber drugs – 11 May 2020

This guidance has been produced to support general practices on the prioritisation of amber drug monitoring during the current emergency.

Anticipatory / End of Life Medicines

Please continue to access anticipatory medicines in the usual way. Community pharmacies generally hold small stocks of these drugs and can order from wholesalers for daily delivery. A number of pharmacies in Leeds are commissioned by NHS England to hold larger stocks which are available for more urgent need. At the time of writing, it is not legal for care homes to maintain stocks of these medicines. Please read the briefing below which includes links to further clinical guidance.

Valproate pregnancy prevention programme: temporary advice for management during Covid-19 – 6 May 2020

Guidance for specialists for initiation of valproate in female patients and for annual review and pregnancy testing to support adherence to pregnancy prevention requirements during the pandemic. The contents of the guidance include:

• Initiation of valproate
• Annual review of existing patients
• Arrangements for annual review
• Pregnancy testing
• Call for reporting

See detailed guidance

Updated information regarding anti-inflammatory medications – 15 April 2020

Expert working Group concludes there is currently insufficient evidence to establish a link between use of ibuprofen and susceptibility to contracting COVID-19 or the worsening of its symptoms. Further information can be found below.

updated anti-inflammatory medicines information

Guide for alternative inhalers during stock shortages

Supply of some inhalers is becoming limited in primary care and alternative inhalers may need to be used. Guidance has been produced to support prescribers with this. You can view the guidance below:

• Guide for alternative inhalers during stock shortages

Online Medicines Support Resources for Leeds GP practices and Community Pharmacies – 7 April 2020

NHS Leeds CCG have subscribed to a 3 month trial of the MaPPs2 system (Medicines – A Patient Profile Summary), It is a fully indemnified web-based medicines management system, to provide support for patients and improve adherence and medicines taking behaviour particularly during the Covid-19 pandemic. The service will be free from 1 April 2020 until the 30 June 2020 to help our colleagues, Full details of how to access and examples of the charts/leaflets can be found below:

Drug shortage website – 7 April 2020

MIMS provide a live drug shortage tracker that practice staff can now access. You will need to register for this service with GP Online, the provider of MIMS.  The tracker is based on national stock shortages and may not necessarily reflect local stock levels – please confirm with the patient’s community pharmacy if there is a local shortage before switching a patient’s medicines to an alternative based on the data from MIMS.

Drug shortage website

Guidance on depot antipsychotics – 6 April 2020

The Leeds and  York Partnership NHS Foundation Trust have produced some guidance to support primary care in managing patients on depot antipsychotics.

Mental health medicines optimisation liaison service – 6 April 2020

During the COVID 19 outbreak there may be an increase in demand for mental health support from patients. Please contact the MOLS team for support about any mental health medication enquiries.

New rapid NICE guidelines – 6 April 2020

On Saturday 4 April, NICE published four new Rapid Guidelines regarding management of certain cohorts of patients during COVID-19.  These are:

1) Severe asthma
2) Managing suspected or confirmed pneumonia in adults in the community
3) Rheumatological autoimmune, inflammatory and metabolic bone disorders
4) Managing symptoms (including at the end of life) in the community

Please note: if you are prescribing medicines for a possible COVID-19 positive patient, please remind them they must not attend the community pharmacy themselves, but must send a representative to collect

Diabetes and coronavirus – 6 April 2020

Coronavirus can cause more severe symptoms and complications in people with diabetes. In addition, some patients with diabetes may be at higher risk of developing diabetic ketoacidosis (DKA) which could put extra strain on the healthcare system. Diabetes specialists in Leeds and the Medicines Optimisation team have produced advice and resources for GPs and patients. This contains a list of locations of emergency stocks of blood ketone meters for primary care teams to access for patients who are unwell.

Diabetes & coronavirus resources

Safe management of patients on Warfarin for the management of non valvular AF – 6 April 2020

More than ever before the system needs to work together to optimise care and management for people receiving anticoagulation. To facilitate this we are proposing a collaborative approach between LTHT, LCH and Primary Care to ensure that identified patients suitable for switching from Warfarin to DOAC are reviewed and managed in a timely manner.

Our approach has resulted in the identification of key priorities, aims and next steps – please download the documents below for more information.

Electronic repeat dispensing – 3 April 2020

Guides to support practices setting up or changing electronic repeat dispensing.

Community Pharmacy: changes to services – 27 March 2020

Information on changes to Pharmacy opening hours and ways of working.

Medicines briefing – 18 March 2020

Briefing includes: Myths – ACE Inhibitors/ibuprofen, clinics run from GP Practices, community pharmacy deliveries, Mowbray Square – other clinics, data protection, supply issues: PPE/Hand Sanitiser.

Information regarding expedited discharge from LTHT

During the COVID-19 pandemic, Leeds Teaching Hospitals NHS Trust (LTHT) are rapidly discharging patients, often with shorter inpatient stays than they would normally have. This means patients will have a change to the normal discharge process. To maintain patient safety from a pharmacy perspective, a system has been developed to support patients with their medication post discharge and into primary care. The document shows the pathway through which patients will be referred by LTHT for pharmacy review and medicines reconciliation in the community post discharge from LTHT with supporting notes on how that will be managed and escalated if necessary.