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 Formulary Chapter 16: Medicines Management Website information - Full Chapter
Notes:

Includes guidelines and advice, PGDs, audit tools, template letters and link to drug tariff specials.

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16.07  Expand sub section  Effective Shared Care Agreements
 note 

Shared care
Certain drugs on the formulary are classified as 'amber' which means they are suitable for shared care prescribing under agreed shared care guidance.

Shared Care Guidance is available for specific drugs where therapy is initiated in the specialist setting but, at an agreed time, prescribing and drug monitoring is taken over by primary care. Shared care agreements have clearly defined areas of responsibility.

The existence of a shared care agreement does not imply that patients will automatically be accepted for shared care. It should be considered on a case-by-case basis for stabilised patients only. A GP has the right to decline shared care on clinical grounds or if he or she does not feel confident in managing the drug or condition.

If you are unable to accept shared care then you should complete this form and send to initiating organisation declining prescribing.

In such cases, you are encouraged to discuss your concerns with the referring consultant and/or the Medicines Management team to explore whether they can be safely resolved.

Melatonin Prescribing

Please note that if you are requested to prescribe Melatonin by Sussex Partnership NHS Foundation Trust, please contact the Medicines Management Team with the details


Information Sheets

Information Sheets for ‘blue’ drugs (which should be initiated by a specialist) are also being developed to facilitate the transfer of prescribing responsibilities.

Specialist should send agreement to GP to request shared care.

Shared Care Agreements for Amber Drugs

Information Sheets for Blue Drugs

See individual drug entries for amber shared care and  blue information sheets

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Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Black

Comment : Not routinely commissioned in any care setting. This may be due to a lack of good clinical evidence, cost effectiveness, concerns over safety or due to the availability of more suitable alternatives. Deviation from this position may be considered by prescribers on an individual basis, where exceptional circumstances exist. Otherwise, funding via Individual Funding Request (IFR) only.   

Red

Initiation : Specialist or hospital only
Repeat Prescribing : Specialist or hospital only
Monitoring : Specialist or hospital only
Comment : These medicines should be prescribed by clinicians in a hospital setting only for the duration of treatment (primary care prescribing is not appropriate). Prescribing and monitoring should be retained within the hospital setting by an appropriate clinician and the medicines supplied by the hospital for the duration of treatment. In exceptional circumstances a GP may be asked to prescribe/administer but the specialist must provide adequate information and support and retain overall clinical responsibility.   

Amber

Initiation : Specialist only
Repeat Prescribing : Any care setting
Monitoring : As defined in Effective Shared Care Agreement (ESCA)
Comment : Monitoring according to Effective Shared Care Agreement (ESCA) for stabilised patients only. GP agreement should be requested by specialist and confirmed/declined by GP on a patient-by-patient basis BEFORE the transfer of prescribing responsibility.   

Blue

Initiation and /or Recommendation : Specialist only
Repeat Prescribing : Any care setting
Monitoring : Any care setting
Comment : Suitability as to whether the medicine should be initiated by the specialist or can be recommended by the specialist for Primary care initiation will be clearly documented in each drug monograph on the formulary. If there is a period of stabilisation before transfer of care this will also be stated. Information sheets to support continued Primary care prescribing will be developed if appropriate. The decision will reflect the agreement of the Area Prescribing Committee.   

Green

Initiation : Any care setting
Repeat Prescribing : Any care setting
Monitoring : Any care setting
Comment : Suitable for non-specialist initiation   

Grey

Prescribing in approved, specialist tertiary care settings only  

OTC

Available to buy Over-The-Counter. Patients should be advised to purchase if appropriate.   

Non Formulary

Non-formulary  

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