10/12/2020: New ESCAs in North Staffordshire

Two ESCAs were approved by the Area Prescribing Committee (North) in September 2020 for use in North Staffordshire. They are:

• Methotrexate for the treatment of Autoimmune Rheumatic diseases (Version 4.1)- This was updated to include additional monitoring information if prescribed concurrently with Leflunomide.
• Tizanidine for the treatment of spasticity associated with brain injuries, multiple sclerosis or spinal cord injury or disease (Version 1.0)- This is a new ESCA developed by MPFT.

Note that both drugs have an ‘Amber-E’ status on the North Staffs formulary for the relevant indications, thus transfer of prescribing into primary care MUST be accompanied by an agreed ESCA form.

All APC approved ESCAs are available on netFormulary via the link: http://www.northstaffordshirejointformulary.nhs.uk/docs/esca/

For any prescribing-related issues, please contact the respective medicines optimisation team.

3/11/2020 PRODUCT DISCONTINUATION:

Bydureon 2 mg powder and solvent for prolonged-release suspension for injection in pre-filled pen (exenatide once-weekly) will be discontinued from 31/12/2020. Clinicians should note that the old device is being replaced by the Bydureon BCise pen (exenatide 2mg prolonged-release injectable suspension); a once weekly, single use, fixed dose pen with a hidden needle that automatically injects the required dose, allowing for simpler administration compared to the old Bydureon device. Prior to prescribing and administration of this new device, patient and caregivers training must be undertaken by a healthcare professional

Everyone Health, the service provider for smoking cessation service confirms it is now open to all tobacco smokers, living anywhere in Staffordshire, aged 40 years and over. Referrals can still be made by calling the contact centre on 0333 005 0095, or via email: eh.staffs@nhs.net

4/8/20 Updated Gluten-Free Prescribing policy 2020

The updated Gluten-Free Prescribing policy 2020 can be found on the Homepage, Guidelines and Clinical Pathways link on the North Staffordshire Joint Formulary.

24/7/2020 - Updated Rheumatology ESCA’s

Midlands Partnership NHS Foundation Trust (MPFT) have updated their contact details for their Rheumatology ESCA’s to reflect their dedicated email address: haywoodrheumatology@esca.nhs.net

The updated documents can be found on the ESCA’s link on the North Staffordshire Joint Formulary Home page.

07/05/2020 - New Covid-19 information link

The North Staffordshire Joint Formulary has a new COVID 19 link titled Interim Clinical Information. Please use this link to access local and national documents recommending advice and guidance during this time. If you have any queries relating to this please use the Feedback tab on the formulary front page.

Medicines Information Team

19/03/20 Esmya: Urgent patient level recall

Gedeon Richter (UK) Ltd is recalling all unexpired stock of Ulipristal acetate (Esmya) from patients, pharmacies and wholesalers following a new case of liver failure requiring liver transplant in a patient taking the medicine. To protect patients while a safety review is conducted, the European Medicines Agency's safety committee, Pharmacovigilance Risk Assessment Committee, (PRAC) has recommended that women stop taking 5mg ulipristal acetate (Esmya and generic medicines) for uterine fibroids.

Clinicians must contact patients who have been supplied Esmya and ask them to stop taking their medication as soon as possible and return any unused medicine to their pharmacy. All patients currently being treated with Esmya/ulipristal acetate for uterine fibroids should be provided advice about other possible treatments for uterine fibroids.  

24/02/20: Three Insuman preparations to be discontinued.

Three presentations of Insuman Basal and Insuman Comb are to be discontinued owing to limited capacity at the manufacturing site. The manufacturer says the discontinuations are not due to any safety issue.

The presentations being discontinued are:

• Insuman Comb 15 100IU/mL suspension for injection in a cartridge (expected end of supply June 2020). This is the only presentation of Insuman Comb 15.
• Insuman Basal 100IU/mL suspension for injection in a vial (expected end of supply May 2020).
• Insuman Comb 25 100IU/mL suspension for injection in a vial (expected end of supply June 2020).

No new patients should be started on these presentations, and existing patients should be switched to a suitable alternative. See individual entries on the formulary for alternatives.

24/12/19: Antimicrobial guidelines for Staffordshire and Stoke CCGs

The Staffordshire and SOT Antimicrobial prescribing guidelines for managing common infections in primary care have been updated. This document is now available on netFormulary. Clinicians should familiarise themselves with the document and employ its use in clinical practice. Any queries can be directed to the Medicines Optimisation Team.

21/11/19: Asthma guidelines for Staffordshire and SOT CCGs

The APC/APG has approved the Staffordshire and SOT CCGs Asthma Guidelines. This document is now available on netFormulary. Clinicians should familiarise themselves with the document and employ its use in clinical practice. Any queries can be directed to the Medicines Optimisation Team. 

14/11/19: Updated Renal ESCAs in North Staffs (approved by APC)

Clinicians should take note of the updated ESCAs for Lanthanum and Sevelamer, both used for the treatment of hyperphosphatemia in pre-dialysis CKD patients in North Staffordshire. Any questions relating to these documents can be sent to the Medicines Optimisation team.

14/10/19: Update on current supply issue of all brands of adrenaline auto-injectors

Clinicians should note the latest stock availability update from DHSC concerning adrenaline auto-injectors (see table below). Due to the supply issues with some brands, it may be necessary to switch patients to an alternative brand that they are unfamiliar with. Clinicians should support switching and ensure patients know how to use the alternative product that is supplied. 

Specific training and advice are required for each of the devices. Please follow the links to the relevant training videos below:

EpiPen:            http://www.epipen.co.uk/demonstrationvideo/

Jext:                 https://hcp.jext.co.uk/

Emerade:          https://www.emerade-bausch.co.uk/patient/how-to-use-emerade

01/08/2019:  Emerade® adrenaline auto-injectors supply issues

There is a short-term supply issue affecting Emerade® 500 microgram and 300 microgram adrenaline auto-injectors (AAIs). Bausch & Lomb are the sole UK supplier of Emerade® devices in the UK. New supplies of Emerade® 500 microgram are expected by the end of August 2019. Limited stock of Emerade® 300 microgram is available. Currently, new supplies are expected by the end of September 2019.

Two alternative AAI devices are available in the UK- EpiPen® and Jext®. Both Jext® and EpiPen® AAIs are currently available, however, supplies of Jext® are unlikely to be sufficient to support a significant switch to this product and therefore where there is no patient / clinician preference, EpiPen® should be considered as the first line alternative. The devices differ slightly in the administration technique and specific training is required for each device.

16/07/19: Diamorphine 5mg injection supply issue

There is currently supply issues with Diamorphine 5mg injections. The national Medicines Shortage Response Group (MSRG) have recommended the following:

Primary care, private hospitals, hospices & substance misuse treatment centres: There is sufficient diamorphine 10mg injection to support the forecasted use of the diamorphine 5mg strength. Order stock from usual wholesalers.

Secondary care NHS Trusts: Hameln's morphine 10mg injection (p/free) is the first line alternative. Trusts should order in line with historical demand. Do not stockpile which may potentiate supply issues of this product.

05/06/2019: HRT Supply Issues

There are currently stock availability issues for a number of hormonal replacement therapy preparations. Please establish local availability prior to issuing prescriptions. For further information and guidance, please contact the Medicines Optimisation Team at medopsqueries@stoke.nhs.uk 

10/05/19: Epanutin 50mg Infatabs Supply Issue

Clinicians should read the attached information from the Department of Health and Social Care (DHSC) concerning global supply issues of Epanutin 50mg Infatabs until November 2019. Prescribers must exercise caution and increase patient monitoring if prescribing a product from a different manufacturer as this is a Category 1 antiepileptic drug.

08/04/2019 New How To Guide for the North Staffordshire Joint Formulary

A newer updated version of the How To Guide has been uploaded to the front page of the Formulary

25/03/19: North Staffordshire CCGs move from pdf version to netFormulary

Welcome to the new North Staffordshire Joint Formulary hosted on netFormulary. This replaces the previous .pdf version of the Joint Formulary. Healthcare professionals across North Staffordshire are hereby required to only access the online version of this Joint Formulary. The North Staffordshire Joint Formulary is the preferred prescribing list for North Staffordshire CCGs including University Hospital of North Midlands NHS Trust (UHNM), North Staffs Combined Healthcare NHS Trust and Midlands Partnership NHS Foundation Trust (MPFT).

Please note that the South Staffordshire Joint Formulary (which is also hosted on netFormulary) remains the preferred Prescribing list for South Staffordshire CCGs, including Burton Hospital NHS Foundation Trust and Cannock and Stafford Hospitals Foundation Trust.

For any formulary related questions or support, please contact representatives of your relevant organisation:

- For Primary Care: Denis Kanu (CCGs Interface Pharmacist) - medopsqueries@stoke.nhs.uk 
- For Secondary Care: Xin Wei Tan (Secondary/Primary Care Interface Pharmacist, UHNM) -  Xinwei.Tan@uhnm.nhs.uk

Thank you