Download 9th July 2014 meeting minutes - Gateshead Health NHS Foundation

Gateshead Medicines Management Committee
9th July 2014 0900-1200
Room 4, Education Centre
QEH
Attendees:
Consultant Anaesthetist, Gateshead Health NHS Foundation Trust (Chair)
Prescribing Lead, Gateshead Clinical Commissioning Group (Vice-Chair) (
Consultant, Gateshead Health NHS Foundation Trust
Chief Pharmacist, Gateshead Health NHS Foundation Trust
Medicines Governance Pharmacist, Gateshead Health NHS Foundation Trust
(Secretary)
Regional Drug & Therapeutics Centre (Newcastle) Advisor
Primary Care Medicines Management Provider
Community Pharmacist
Senior Pharmacist NECS
Pharmacist, Gateshead Health NHS Foundation Trust
Apologies: (item 1)
Community Pharmacist
Pharmacist NECS
Item 2
Declaration of Conflict of Interest With Any Agenda
Items
Discussion:
No-one present had any interest to declare with today’s agenda items.
Item 3
Notes of meeting on 14th May 2014 & Decision
Summary
Enc 1+2
Discussion:
Minutes & Decision Summary agreed as a true record.
Item 4
Ongoing Action Points
Enc 3
Discussion:
Circulated for information.
Item 5
Matters Arising
Enc 4
Discussion:
a) Supply of IV antibiotics in the community – the supply situation in the community is still to be resolved, as
are the pathways of care. Meeting has been arranged with all stakeholders for the end of July.
New Drug Requests for July 2014 Meeting
Item 6
Enc
Discussion:
Torasemide
Requested by Dr Barker
Requested for use in Oedema due to congestive heart failure in those patients with end-stage heart failure when
furosemide is not being absorbed enough.
Evidence as per application form.
Reviews:
 NICE – not considered
 SMC – not considered
 AWMSG – not considered
 RDTC – not considered
 NoT APC – not considered
 LNDG – not considered
Colsevelam
Application not yet received.
Jaydess
Requested by Sexual Health Team
Evidence as per application form.
Noted already approved for addition to formulary by South Tyneside Medicines Management Committee.
Conclusion:

Torasemide – approved as Green+ drugs on advice on heart failure team only in those patients with
Oedema due to congestive heart failure with end-stage heart failure when furosemide is not being absorbed
enough.

Jaydess – approved as Green+ drug.
Item 7
New Drug Requests for September 2014 Meeting
Discussion:
None received yet.
Item 8
Antimicrobial Update
Discussion:
Noted there is now an intravenous preparation of azithromycin available and the microbiologist are considering
putting in a formulary application.
Formulary Chapter Updates
Item 9
Enc
Discussion:
The following chapters of the GHFNT formulary have been updated on the internet/intranet sites since the last
meeting:
 1. Gastrointestinal system
 3. Respiratory
 4. CNS
 5. Infections
 7. Obstetric, gynaecology & urinary tract disorders
 12 Ear, nose & oropharynx
Conclusion:
Chapter updates approved.
NHS England Commissioning Circulars
Item 10
Enc
Discussion:
Received for information.

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
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SSC1425 – Macitentan – noted n/a to GHFNT
SSC1426 – Disease modifying therapies for patients with MS – noted n/a to GHFNT
SSC1428 – Duodopa – noted n/a to GHFNT & use not approved by NHS England
SSC1430 – Oncotype DX – noted not currently approved by NHS England
Item 11
Guidelines for Approval
Enc
Discussion:
Following guidelines have been revised & updated:
 None
Following guidelines have been revised & updated:
•
Anaemia pathway
•
Cellulitis pathway
•
DVT pathway
•
PE pathway
The GMMC approved the drug elements of these pathways but noted is now for CCG and Operational Group to
approve the actual pathways with the commissioners.
Conclusion:
The GMMC approved the drug elements of these pathways but noted is now for CCG and Operational Group to
approve the actual pathways with the commissioners.
Shared Care Guidelines for Approval
Item 12
Discussion:
The following shared care guidelines have been revised and updated by NTW Mental Health Trust.
•
Atomoxetine
•
Melatonin
•
Methylphenidate
Conclusion:
The GMMC approved the updated content of these shared care guidelines but noted that they need to be put into
the current CCG template for shared care guidelines.
Item 13
Conclusion:
None received this month.
Primary Care PGDs For Approval
Exceptional Case Requests
Item 14
Discussion:
None received this month.
Noted that application for use of ankinra in treatment of Gout is currently pending with Gateshead CCG.
NICE Guidance May & June 2014
Item 15
Enc
Discussion:

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TA312 – MS – alemtuzumab - approved as an option by NICE but not applicable to GHFNT as patients
receive this treatment in Newcastle for this condition.
TA313 – Psoriatic arthritis – ustekinumab – not approved by NICE and not on the formulary.
TA315 – Canagliflozin in combination for type 2 diabetes - – approved as an option by NICE. Formulary will
reflect this.
CG180 – Advanced breast cancer (update): diagnosis & treatment – all drugs currently on the formulary
CG181 – Atrial fibrillation – all drugs currently on the formulary. Noted that no longer recommends aspirin &
GHFNT Anticoagulant Monitoring Service already monitor Time in Therapeutic range & can provide advice
to GPs as required.
NICE guidance published in May & June 2014 can be found on the NICE website. The committee is asked to note
any implications for prescribing guidance across Gateshead and any additional prescribing costs resulting from
implementation of the guidance.
Northern (NHS) Treatment Advisory Group
Recommendations
Item 16
Enc
Discussion:
Received for information.
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Item 17
Rivaroxaban for ACS – noted not recommended for use.
High dose vitamins and minerals for prevention of AMD - noted not recommended for use.
Dapoxetine for PE – noted not recommended for use.
Drug Safety Updates May & June 2014
Enc
Following MHRA Drug Safety Updates issued since last meeting:
 May 2014 Drug Safety Update
 June 2014 Drug Safety Update
Noted the new restrictions on use of domperidone, this has been communicated to prescribers.
The committee is asked to note any implications for prescribing across Gateshead and recommend any actions
required.
Item 18
Items for Information Only
Enc
Discussion:
Items circulated were: Gateshead CCG Q4 2013/14 Report
Circulated for information. Concerns re increasing use of rosuvastatin and Omacor. This will be taken with
up the appropriate prescribers
 Gateshead Primary Care Guidelines
The highlighted guidelines are due for review and work is underway to address this.
 Gateshead CCG Strong Opioid Prescribing
Concerns re increased prescribing of oxycodone. Possible reasons for this were discussed. Noted that local
acute pain and chronic pain guideline are currently being reviewed which may help address this issue.
 NTW Antibiotic Quarterly Report
Received for information.
Item 22
AOB
Discussion:
Metolazone
Metolazone was removed from the formulary when it was discontinued. There is now an unlicensed version
available so agreed to add Metolazone back on the formulary as a Green+ drug to be used on advice of heart
failure team only.
Summary Care Records
Currently not all GP practices in Gateshead are signed up to this. It is to become mandatory in 2015 and CCG are
working on rolling out to remaining practices.
Therapeutic Switches in Primary Care
Pharmacius and CCG will inform GHFNT pharmacy team when therapeutic switches are going to be rolled in GP
practices to ensure continuity of care across the interface e.g. current switch from temazepam to zopiclone.
Erectile Dysfunction
Noted that tadalafil is now classed as Green+, and like other drugs for erectile dysfunction will be initiated for those
indications requiring initial referral to secondary care and then passed back to primary care for future prescribing.
Dossette Box Leaflet
Purpose of leaflet is act as prompt for patient to contact community pharmacy on discharge to arrange further
supply of medication post discharge, and to also ensure the community pharmacy received a photocopy of the
discharge prescription post discharge... Draft now received from Local Pharmaceutical Committee (LPC). It was felt
that the draft needed further work before it could be taken to GHFNT Patient Information Panel for approval.
Date of Next Meeting: Wednesday 10th Sept July 2014 9am-12noon Room 4, QEH Education Centre