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Southampton Joint Formulary
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 Introduction


Southampton Joint Medicines Formulary

Background

University Hospital Southampton NHS Foundation Trust (UHS) is one of seven local trusts (primary, community and secondary care) that work collaboratively via the Basingstoke, Southampton and Winchester District Prescribing Committee (DPC). The collaboration has been formally endorsed by the Executive Forums of these trusts. The main aim of the DPC is to ensure that there is a consistent approach to prescribing the most safe, efficacious and cost effective medications across the local health care community.

The Southampton Joint Formulary includes medications available for routine prescribing within UHS Trust and Southampton City CCG. It is managed by UHS's Drugs Committee, following recommendations and guidance from the DPC. The formulary process is fully supported by UHS's Trust Board.

Using the formulary

This formulary provides a list of medicines available for routine prescribing or those available within certain criteria. Unless otherwise stated, the medicines selected are recommended as first choice, particularly for new patients. Those patients stabilised on other therapies may be switched to a formulary drug if and when clinically appropriate. The formulary states if a NICE Technology Appraisal is available for a particular medicine. NICE guidance is available from www.nice.org.uk/. Patients have the right to medicines and treatments that are included in Technology Appraisals from NICE, if their doctor says they are clinically appropriate for them. The NHS usually has 3 months between new Technology Appraisals being published and medicines being included in the formulary.

Unlicensed medicines are denoted and these do not hold a marketing authorisation (product licence) in the UK.

Hampshire Hospitals NHS Foundation Trust and West Hampshire CCG have separate Medicines Formularies published on their respective websites. 

There are also separate formularies for wound care products, incontinence appliances, stoma products and nutritional supplements. Links to these can be found in the relevant chapters.

The formulary is not intended to replace the British National Formulary (BNF) and this or another suitable reference should be referred to for information on licensed indications, contraindications, cautions, side-effects, interactions and dosage etc. (BNF is available online at https://www.medicinescomplete.com/mc/).

Red/Amber/Green (RAG) status

The DPC recommends a colour status to medicines to be included in formularies to denote the setting in which the medicines should be used or prescribed.

Details of each colour status are given below

Green

Suitable for prescribing by all in both primary and secondary care.  

Amber Recommended

Specialist recommended but suitable for continuation in primary care.  

Amber Initiation

Specialist initiated but suitable for continuation in primary care.  

Amber SCG

Specialist initiated and for continuation in primary care under a locally approved shared care guideline  

Red

Medicines suitable for use in specialist settings only. These should only be prescribed in secondary care  

Red Specialist Centre

Secondary care medicines to be used under specialised commissioning arrangements only  

Blue

For primary care, either via FP10 or supplied through specialist services. These products are stocked by hospital pharmacies only for supply to primary care units and wards, but may be used for continuing supplies for patients admitted on therapy if available.  

Black

Not recommended for use  

High cost drugs

High cost drugs are denoted with a HCD symbol. These medicines are excluded from the national tariff and prescribers and pharmacists must ensure they are used in accordance with an appropriate commissioning policy.

Using non-formulary medicines

It is recognised that, in the best interests of patient care, there will be situations when medicines that are not on the formulary may be required. Within UHS there is a procedure to allow non-formulary prescribing for individual patients if an adequate case is made. If a non-formulary medicine is requested on a wider scale, a formulary application should be made. The application form for evaluation of medicines to be considered for inclusion on the formulary can be found on the formulary homepage.

Does the formulary apply to outpatient prescribing, including referrals to GPs?

In general yes, as it is our aim to promote safe, evidence-based, cost effective prescribing in primary care also. However there are some medicines that are not stocked by the hospital pharmacies and hence are not included in the formulary simply because we would not expect them to be initiated whilst patients are in hospital or in outpatients e.g. topical preparations for acne, drugs for smoking cessation, HRT (only a very limited range of NRT & HRT is stocked).

Questions about the formulary?

If you have questions about the formulary, then get in touch with us at formulary@uhs.nhs.uk

 


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