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Hot topics

Here you'll find resources we've developed in response to a number of queries received around a given topic.

As these resources have not been through the full QA process and are designed as an information resource for you to use locally to support decision making, we ask that you do not add these resources to public facing web pages.

Alkindi® Hydrocortisone

Alkindi® has recently been launched as a licenced hydrocortisone for replacement therapy of adrenal insufficiency in children and adolescents (from birth to <18 years old).

The document below summarises some of the associated issues, problems and risks.

Alkindi® - September 2019.pdf

Changing MDS to original packs in care homes

To support community pharmacists during the coronavirus (COVID-19) pandemic care homes may receive medicines for residents in their original packs rather than MDS.

This briefing provides care homes with reassurance on the safety and benefits of using original packs for residents.

Changing from MDS to original packs 2.0.pdf

DOAC safety during COVID-19

This piece of research was done using the OpenSAFELY platform and looked at the safety of prescribing DOACs following the advice from NHS England to switch appropriate patients from Warfarin to a DOAC.

DOAC safety during COVID-19 2.6.pdf

GLP-1 Mimetic Quantities

Hydrogen peroxide 1% cream for impetigo

Implementing the NHS Steroid Emergency Card National Patient Safety Alert (NatPSA)

PLEASE NOTE: This bulletin has been reviewed and updated based on feedback. New clinical system searches are now available. Once identified, patients on these searches will need to be reviewed before deciding whether an NHS Steroid Emergency Card should be issued. 

NHS England and Improvement recently issued a NatPSA about recognising and treating adrenal crisis in adults which included guidance on a new NHS Steroid Emergency Card and who to issue it to.

This Hot topic covers the groups of patients needing an NHS Steroid Emergency Card.

In the zip folders for the clinical system searches you will find:

SystmOne Searches   

  • Searches (just the drugs not the read code for disease / illness) - see guidance on using the searches document for descriptions of searches 
  • Guide on how import searches
  • Guide on how to create a report output to enable prioritising patients

SystmOne Searches set 2 

  • Searches (just the drugs not the read code for disease / illness) - see guidance on using the searches document for descriptions of searches 

SystmOne Protocol

  • Protocol / pop up there are two protocols - one that will trigger when the prescriber starts to write "steroid" into that patient's journal. One linked to when a read code for steroid therapy is added. This will prompt for the prescriber to print the guide and card, and automatically enter the read code Emergency steroid Card issued - if they say yes to the letter. Note - the prescriber will need to consider whether the steroid Emergency card is needed.
  • Guide and card letter template (this will need to be added to the protocol (explained in the guide below)
  • Guide on how to import the protocol and letter (this is all in the same document).

EMIS Web Searches

  • Searches and auto reports to breakdown results ( just the drugs not the read code for disease / illness) - see guidance on using the searches document for descriptions of searches
  • Guide on how to import searches

EMIS Web Searches set 2

  • Searches and auto reports to breakdown results ( just the drugs not the read code for disease / illness) - see guidance on using the searches document for descriptions of searches

EMIS Web protocol

  • Protocol / pop up - linked to when a read code for steroid therapy is added. This will prompt for the prescriber to print the guide / card, and will automatically enter the read code Emergency steroid Card issued - if they select yes to print. Note - the prescriber will need to consider whether the Steroid Emergency Card is needed.
  • Guide on how to import the protocol (there are two files - one is the protocol and one is the letter template).

Implementing the steroid card safety advice v2.4 July 2021.pdf

Patients guide - NHS Steroid Emergency Card.docx

Steroid Emergency Card - Guidance on using the searches.docx

PrescQIPP Steroid Emergency Card Searches - EMIS Web.zip

PrescQIPP Steroid Emergency Card Searches (set 2) - EMIS Web.zip

PrescQIPP Steroid Emergency Card Protocols - EMIS Web.zip

PrescQIPP Steroid Emergency Card Searches - SystmOne.zip

PrescQIPP Steroid Emergency Card Searches (set 2) - SystmOne.zip

PrescQIPP Steroid Emergency Card Protocols - SystmOne.zip

Iopidine® (apraclonidine) eye drops

We have received reports that some GP practices are adding Iopidine® eye drops onto repeat prescription despite the maximum treatment duration recommended is one month.

There has been an increase in the use of the preservative free higher strength Iopidine® 1% eye drops compared to the lower strength Iopidine® 0.5% eye drops in England. This raises potential patient safety concerns if the higher strength formulation is being used as a preservative free alternative to Iopidine® 0.5% eye drops.

We have summarised the issues and suggest medicine optimisation solutions to improve patient safety and avoid unnecessary costs.

Iopidine® (apraclonidine) eye drops - October 2019.pdf

Namuscla (mexiletine)

A licensed version of mexiletine, Namuscla® 167mg capsules was launched earlier this year.

There is likely to be a significant cost pressure in primary and secondary care if this is introduced without consideration given to medicine optimisation.

We have summarised the issues and suggest medicine optimisation solutions to reduce cost pressures.

Namuscla (mexiletine) - August 2019.pdf

National MO priorities 23/24 PrescQIPP resources

Right to Choose

Patient choice is at the heart of the NHS.

Under Right to choose, patients can now request a referral for their 1st outpatient appointment from the provider of their choice.

This Hot Topic Bulletin summarises the key points in relation to a patient’s legal right to choose and highlights the current issues which Integrated Care Systems need to consider in relation to patient choice .

The Frequently asked questions (FAQ) document, provides answers to the most asked commissioning questions in relation to Right to Choose

Right to Choose - November 2023.pdf

Right to Choose - FAQs - November 2023.pdf

Switching ICS/LABA inhalers cost and carbon implications

Under-recognised risk of harm from propranolol

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