Prescribing formulary

The Brighton and Hove and High Weald Lewes Haven Joint Formulary is a list of everything which can be prescribed.

Introduction to the joint formulary traffic light system

Green: non-specialist drugs

Suitable for non-specialist initiation.

Blue: specialist initiation WITHOUT shared care guidelines

For drugs that do not require significant drug monitoring or where required monitoring is on-going by the specialist. The drugs are recommended or initiated by a specialist and GPs continue to prescribe on specialist advice without the need for a formal shared care guideline but a shared care information sheet setting out responsibilities may be available. A minimum of one month’s supply of medication will be provided by the consultant if initiating. Information on the initiation process and whether a shared care information sheet will be supplied will be detailed on the Joint Formulary.

Amber: specialist initiation WITH shared care guidelines

For drugs which require specialist initiation and/or dose titration and specific ongoing monitoring. For initiation, dose stabilisation and prescribing (including monitoring) by a specialist until the patient is stabilised (usually for a minimum 3 months but see individual shared care protocols) after which the GP should receive the approved shared care guidance documents to safely continue prescribing the medicine.  Primary care will be expected to undertake some specific drug monitoring under these shared care guidelines.

Red: specialist ONLY drugs

For initiation and continuation (including monitoring) by a specialist only. A specialist is not necessarily a consultant, rather a practitioner with specialist skills e.g. specialist registrar, nurse specialist, GP with specialist interest, community psychiatric nurse, tissue viability nurse.

Black: not routinely supported

Drugs that have been considered by the APC and are not routinely supported for initiation in any health setting for NHS patients.

Non-Formulary: drugs which do not appear in the joint formulary

Any drugs not listed in this formulary have NOT been considered by the Area Prescribing Committee and therefore are NOT routinely supported for initiation in any health setting for NHS patients.

How to use the joint formulary

The Joint Formulary is broken down into chapters, based upon the categories used in the British National Formulary (BNF). It comprises a list of drugs recommended in each section. Each drug is colour-coded in a traffic-light system to facilitate prescribing choice.

Before any treatment is recommended or initiated (in any healthcare setting), a patient centred discussion relating to the risks and benefits of treatment, and patient consent to the treatment plan must have taken place.  This should be documented in all clinic letters and / or patient medical record.

The prescriber should always ensure they have the expertise to prescribe an agent before making a selection. In its guidelines on responsibility for prescribing between hospitals and general practitioners, the Department of Health has advised that legal responsibility for prescribing lies with the doctor who signs the prescription.

If you wish to make a formulary application to the Brighton Area Prescribing Committee, please contact the Brighton and Hove Medicines Management Team.

Formulary chapters

Appendices

  1. Borderline substances
  2. Stoma care accessories
  3. Blacklist drugs not routinely supported
  4. Wound management products and elasticated garments
  5. Continence

Background

The Joint Formulary is overseen by the Brighton Area Prescribing Committee, and is developed and maintained with the collaboration of the following organisations: