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Standard Drug List PHC Remote Guideline
Target Audience
All Clinical Employees
Jurisdiction
Primary Health Care Remote CAHS; Primary Health Care Remote TEHS
Jurisdiction Exclusions
N/A
Document Owner
Nicola Morris
Senior Pharmacist Primary Health Care TEHS
Approval Authority
Chair
Remote Health Pharmacy Group
Author
Quality & Safety Team Remote Health; Remote Health Pharmacy Group
The attributes in the above table will be auto-filled from the PGC System. Do not update in this document.
Purpose
To provide guidance to Primary Health Care staff on the agreed list of medicines for use in Department of
Health (DoH) Primary Health Care (PHC) Remote health centres throughout the Northern Territory (NT).
Guideline
1.
General Information
The Standard Drug List (SDL) is an agreed list of medicines for use in Department of Health (DoH)
Primary Health Care (PHC) Remote health centres throughout the Northern Territory (NT), and is
standardised to assure the availability of all commonly required medicines used in the NT remote context.
It supports the consistent use of approved Scheduled Substance Treatment Protocols (SSTPs) under
Section 254 of NT Medicines, Poisons and Therapeutic Goods Act (MPTGA), providing a comprehensive
inventory of medicines required for the best practice management of most acute and chronic conditions
encountered in remote NT locations. Availability of all items on the SDL will support effective Medical
Practitioner consultations, and enhance quality use of medicines and compliance with the overarching NT
Hospital Formulary endorsed by the NT Drugs and Therapeutics Committee.
The SDL includes both Pharmaceutical Benefits Scheme (PBS) and non PBS listed substances.
The SDL applies to all DoH PHC Remote health centres, and has the following basic features in its
application:
1. Mandatory items – must be stocked in all health centres
2. Non mandatory items – health centres may opt to hold or not hold on site
Some capacity also exists for local inclusions to be approved for use for a particular local health centre, as
additional items See 4.5
Section 4 details how the SDL is maintained and applied. It is important to note that while the SDL is an
official document and governs which medicines are available in PHC Remote, there are mechanisms that
allow any practitioner to contribute to maintenance and ongoing suitability of the List.
Medical Practitioners may prescribe medicines not included on the SDL; however prescribing patterns
must consider best practice in regard to standard protocols, PBS inclusions, cost efficiencies and
Title: Standard Drug List PHC Remote Guideline
HPRM Approval No: DD2017/3572 | Version: 2.0 | Doc ID: HEALTHINTRA-1880-11367 | Approved: 30/07/2015 | Last Updated: 3/05/2017
Page 1 of 6
DEPARTMENT OF HEALTH
suitability of regimes for remote clients. Prescriptions may only be written for individual clients against
specific clinical conditions.
PHC Remote employed Medical Practitioners are able to apply for and hold additional items utilising the
RMP Specific Medicines Request process, in addition to the Standard Drug List items. See Section 4.6 for
detailed information.
2.
Definitions
Remote Health Pharmacy Group: a Group of the Remote Health Best Practice Group. It is a
multidisciplinary and inter-sectoral forum for the systematic management, monitoring and review of
medicines utilised by DoH remote health centres in the NT.
Pharmaceutical Benefits Scheme (PBS): a scheme through which the Australian Government subsidises
the cost of prescription medicines.
Scheduled Substance Treatment Protocol (SSTP): is a protocol for possessing, supplying or administering
a scheduled substance as approved by the Chief Health Officer under Section 254 of the NT MPTGA.
Section 100 (S100): a section of the National Health Act 1953 which allows for special supply
arrangements to be made by the Minister for Health to ensure availability of a pharmaceutical service to
all Australians where general provisions of the PBS scheme cannot be easily applied. See Section 100
Pharmacy Arrangements.
RMP Specific Medicines: for the purpose of this document refers to medicines which PHC RMPs may
request to complement their area of advanced clinical practice (advanced skill).
3.
Responsibilities
3.1
Remote Health Pharmacy Committee
As per Remote Health Best Practice Group - Terms of Reference
3.2


3.3



3.4


3.5




Clinical Staff
Ensure familiarity with the SDL and related protocols
Adhere to approved SSTPs when administering medicines
Primary Health Care Manager (PHCM)
Ensure staff are aware of and have access to the SDL
Ensure that clinical staff are familiar with the significance of the SDL
Reinforce to nurses, midwives and Aboriginal and Torres Strait Islander Health Practitioners
(ATSIHPs) their responsibility to adhere to approved SSTPs when administering medicines
Medical Practitioner
Be guided by the Standard Drug List
Adhere to the endorsed request process for access to RMP Specific Medicines. See Section 4.6 for
details.
Pharmacist
Routinely supply only those medicines on the SDL, approved non-standard local additions and RMP
Specific Medicine Requests
Provide other medicines only where prescribed by a Medical Practitioner
Assist individual health centres in establishing and maintaining medicine stock levels
Where appropriate, advise clinical staff of the process to suggest changes to the SDL
Title: Standard Drug List PHC Remote Guideline
TRIM: DD2017/3572 | Version: 2.0 | Doc ID: HEALTHINTRA-1880-11367 | Approved: 30/07/2015 | Last Updated: 3/05/2017
Page 2 of 6
DEPARTMENT OF HEALTH
4.
Procedure
4.1
Features of the Standard Drug List
The master SDL details a number of categories of information to cater for various purposes. These
include:
- Name (generic)
Listed alphabetically
- Form
- Strength
- Usual Pack Size
- S100 listed
- Approved SSTP Meds1
“S250 or BPG”
- S8 / RS4
“S8” or “RS4”
- Mandatory / Optional items
Bold text + “Mandatory”
- Category
- Comment
The Standard Drug List is available on the Atlas website as excel document. This allows staff to sort or
filter the SDL according to information required. Staff may find it useful to sort the SDL by:
-
4.2
Approved SSTP Meds
S100 items only
-
Non S100 items only
Category
Maintenance of the Standard Drug List
The SDL is managed by the Remote Health Pharmacy Group; a subgroup of the Remote Health Best
Practice Group. This Group provides a formal avenue for investigation and decision making of medicine
related issues arising in PHC Remote, and is chartered with maintaining the currency of the SDL. See
Terms of Reference.
The Remote Health Pharmacy Group periodically undertakes comprehensive review of the overall List,
but will address ad hoc review of particular items as they arise in the course of business.
Any staff member may make suggestions regarding recommended additions or deletions on the List.
Submission of a Best Practice Referral form is recommended for this purpose.
Any edits to the List are posted to the Atlas website and are regarded as official once posted. All relevant
parties will be notified of edits by broadcast e-mail.
4.3
Ordering Medicines from the Standard Drug List
There are three order forms required for ordering items from the SDL, including:
- S100 order forms (supplied by the S100 contractor to each health centre)
- Non S100 Remote Health Hospital Pharmacy Order Form
- S8 & RS4 Medicines from Hospital Pharmacy Order Form
The SDL dictates the content of ordering forms for both S100 and non S100 supplied medicines. As
noted above, changes to the SDL are notified to relevant suppliers to allow order forms to be updated.
See Pharmacy - Ordering for details.
1
Medicines that may be supplied or administered by a nurse, midwife or ATSIHP according to an approved SSTP:
-
S250 = S4 & S8 medicines approved by the NT CHO under Section 250 NT MPTGA
-
BPG = Unscheduled, S2, S3 and S5 medicines approved by PHC remote Best Practice Group
Title: Standard Drug List PHC Remote Guideline
TRIM: DD2017/3572 | Version: 2.0 | Doc ID: HEALTHINTRA-1880-11367 | Approved: 30/07/2015 | Last Updated: 3/05/2017
Page 3 of 6
DEPARTMENT OF HEALTH
4.4
Medicine Stock Levels
There are no mandated stock levels for the SDL due to the varied requirements of different health
centres. Variables include differing client groups, size and profile, visiting Medical Practitioner prescribing
patterns and other distinctions. Nonetheless, a standard order sheet, detailing stock levels can provide a
valuable tool for pharmacy stock control. For this reason individual health centres may wish to develop
medicine ordering sheets and this is best done in consultation with the contracted pharmacist.
4.5
Additional Items based on Local Requirements
While not technically part of the generic SDL, PHC Remote supports individual health centres having
opportunity to carry certain additional medicines which may be justified in a particular location. These
additional items are subject to approval by the regional PHC Director of Medical Services (PHC DMS) and
approval is based on merit factors including consideration of pre-existing alternatives on the SDL, clinical
conditions encountered locally, best practice clinical management and cost. A request for local additions
should not be initiated lightly, particularly for clients who may be highly mobile as this may lead to
difficulties in providing medicines at other health centres.
Health centres wishing to initiate local additions to the SDL may do so by submitting a request to the
PHC DMS who may authorise or reject the proposal. Where the PHC DMS believes a request warrants
wider consultation this will be referred to the Remote Health Pharmacy Group.
Following approval or otherwise, the PHC DMS forwards all requests to the PHC Remote Pharmacist to
ensure master lists are updated, and to advise the relevant pharmacy of the authorised addition to a local
list. Where this process triggers an issue for consideration by the Remote Health Pharmacy Group, the
Remote Pharmacist will channel this accordingly.
It is anticipated that there would be few circumstances where items additional to the standard list would
be routinely required. In the event of numerous requests for a similar item this will more likely indicate an
item that warrants consideration for inclusion on the SDL as either a mandatory or optional item.
4.6
RMP Specific Medicine Requests
Primary Health Care – RMPs may request approval for specific medicines not routinely held at a given
health centre. These medicines may be requested to complement the practitioner’s area of advanced
clinical practice (advanced skill or competency).
The RMP Specific Medicine Request Form must be completed by the requesting RMP and forwarded to
the regional PHC DMS for consideration. Evidence of the RMP’s current advanced skill or competency
must be provided with each request. The standard drug list and any non-standard local additions must be
reviewed prior to requesting to hold RMP Specific Medicines.
Please note that RMP Specific Medicines are authorised only for use by, or under the direct supervision
of, the approved RMP. The approved RMP is responsible for ordering and maintaining stock of their
approved medicines. Authorisations are valid for 12 months only. The request to hold RMP Specific
Medicines must be resubmitted annually, providing evidence of the currency of the practitioners
advanced skill or competency.
RMP Specific Medicines must be clearly labelled as being for use by the approved RMP only. Schedule 8
and Restricted Schedule 4 medicines must be stored and managed according to policies outlined in those
documents. Additionally RMP Specific S8 and RS4 Medicines must be documented as such in the S8 &
RS4 Drug Register. All RMP Specific Medicines must be returned / disposed of once the approved RMP
ceases to practice at that health centre. Also see Pharmacy Ordering, section 4.4.7.
Title: Standard Drug List PHC Remote Guideline
TRIM: DD2017/3572 | Version: 2.0 | Doc ID: HEALTHINTRA-1880-11367 | Approved: 30/07/2015 | Last Updated: 3/05/2017
Page 4 of 6
DEPARTMENT OF HEALTH
Implementation, Review & Evaluation Responsibilities
Method
Implementation
Responsibility
Document will be accessible via the Policy Guidelines
Centre and Remote Health Atlas
Health Policy Guidelines Program
Review
Document is to be reviewed within three years, or as
changes in practice occur
Atlas Development Officer,
Primary Health Care CAHS
Evaluation
Evaluation will be ongoing and informal, based on
feedback.
Atlas Development Officer,
Primary Health Care CAHS
Atlas Development Officer,
Primary Health Care CAHS
Key Associated Documents
Forms
Best Practice Referral
Remote Health Hospital Pharmacy Order
Request for Non Standard Medicine Local Addition
RMP Specific Medicine Request Form
S8 & RS4 Medicines from Hospital Pharmacy Order Form
S100 Medicine Order forms – available from relevant contracted pharmacy
Key Legislation, By-Laws, Standards,
Delegations, Aligned & Supporting Documents
Additional Clinical Protocols
Pharmacy Ordering
Prescriptions
Regional Hospital Pharmacies
Restricted Schedule 4
Return of Unwanted Medicines
Schedule 8
S100 Pharmacy Arrangements
Section 250 NT MPTGA
Standard Drug List - Master
NT Medicines Poisons and Therapeutic Goods Act (MPTGA) and Regulations
Medicines and Poisons Control website
Gazette Notices (Section 250, 252, 254)
NT Hospital Formulary
Pharmaceutical Benefits Scheme (PBS)
PBS Explanatory Notes
Remote Primary Health Care Manuals website:
Central Australian Rural Practitioners Association (CARPA) Standard
Treatment Manual
Minymaku Kutju Tjukurpa - Women’s Business Manual
References
As above
Title: Standard Drug List PHC Remote Guideline
TRIM: DD2017/3572 | Version: 2.0 | Doc ID: HEALTHINTRA-1880-11367 | Approved: 30/07/2015 | Last Updated: 3/05/2017
Page 5 of 6
DEPARTMENT OF HEALTH
Evidence Table
Reference
N/A
Method
N/A
Evidence level
(I-V)
N/A
Summary of recommendation from this reference
N/A
Title: Standard Drug List PHC Remote Guideline
TRIM: DD2017/3572 | Version: 2.0 | Doc ID: HEALTHINTRA-1880-11367 | Approved: 30/07/2015 | Last Updated: 3/05/2017
Page 6 of 6
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