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Optometry Medications Supply Early Adopter West Dunbartonshire & Inverclyde CHCPs The Concept • Optometrists will supply from a range of medications as deemed appropriate to the patient’s presenting signs and symptoms. • Optometrists are now the ‘First Port of Call’ for all eye conditions in the community • Can we devise a method to allow Optometrists to supply these medications, to NHS standards, direct to patients at the point of diagnosis? The Hurdles • The Cost difference – Optometry cannot source eye preparations at the NHS Tariff price. • Easy access to the preparations by Optometry Practices • Correct labelling of the product. • Understanding the Cost Implications of creating hundreds of new prescribers. The Key Elements • Agreement from other professional groups that this should improve the service. • Medications and Healthcare products Regulatory Authority(MHRA) advise that Optometrists can label eye products. • Agreement that Optometry practices can source the listed products at the agreed tariff price. • Agreed GGC forms to record the supply & claim payments. • Pilot the roll out to assess the service and cost implications. The Solutions • Optometrists buy from current supplier and keep stock appropriate to their own needs • Optometrists label product within their own practice (legal requirement). • Patients sign a form indicating they have received the stated preparations • GGC process claims and PSD pay the submissions within the monthly schedule. • Prescribing Support & PCS monitor activity and costs The Medication List • • • • • • • • Hypromellose 0.3% Carbomer gel 980 Lacrilube Eye Ointment Chloramphenicol 0.5% Eye drops Chloramphenicol 1% Eye ointment Fucidic acid 1% viscous Eye drops Sodium Cromoglicate 2% Eye drops Olopatidine 1mg/ml (requires PGD) Additional PGD • The Patient Group Direction (PGD) allows Optometrists to supply a Prescription Only Medicine under defined circumstances. • Pharmacy and Optometry combine to create a PGD for Olopatadine 1mg/ml • Approval gained. • Optometrists decide whether to sign up to be able to supply Olopatadine according to the terms of the PGD. Labelling The name of the patient The name of the medicine Directions for use BNF precautions relating to the use of the medicine The words “Keep out of the reach and sight of children” • The words “For external use only” • Date of dispensing • • • • • • Name and address of the optometric practice Label Example Wilkie & Rider, 3 College Way, Dumbarton Keep out of the reach and sight of children FOR EXTERNAL USE ONLY 5ml Opatanol 0.1% EYE DROPS Put One drop(s) into the _____ eye(s) TWICE daily. Discard contents FOUR WEEKS after opening. Patient:______________Date:_______ Glasgow Formulary • DRY EYE • Hypromellose 0.3% is considered the first line treatment option for patients complaining of ‘dry eyes’ or tear deficiency. • CARBOMER 980 (CLINITAS GEL) (EYE DROPS) • carbomer 980 (VISCOTEARS) • carbomer 980 (GELTEARS) • LIQUID PARAFFIN (LACRI‐LUBE) (Eye ointme Glasgow Formulary Anti Infective • CHLORAMPHENICOL Prescribing Notes: • Available as 0.5% drops (which must be stored in a fridge), and 1% eye ointment. • FUSIDIC ACID Prescribing Notes: Available as modified‐release 1% viscous eye drops. Fusidic acid should only be used for staphylococcal infections such as blepharitis, not bacterial conjunctivitis. Glasgow Formulary‐ Anti Inflammatory • SODIUM CROMOGLICATE (2%) (EYE DROPS)Prescribing Notes: The 2% eye drops are the first‐line anti‐inflammatory preparation. • OLOPATADINE (EYE DROPS)Restrictions: Restricted to second‐line when sodium cromoglicate is ineffective or not tolerated. • www.ggcprescribing.org.uk The College of Optometrists Guidelines • Tear deficiency • Blepharitis • Conjunctivitis‐ acute allergic • Conjunctivitis ‐ bacterial www.college‐optometrists.org Members log in – clinical management guidelines Payment Verification • Separate record card per NHS investigation – primary or supplementary. • Medication supplied written on card. • Patient Medication Supply form completed, signed and retained in monthly batch. • Summary form completed and sent every month, duplicate retained. Governance • The GOS aspect of the Early Adopter/Pilot is no different from any other examination. Extra Information required • Medication – Type, batch no and expiry date. • Patient Instructions – Frequency and duration of treatment. • Follow up – further appointment, contact details, and reporting procedure. • Copy of GP Communication form. Governance • Monitoring of Rx Supply will be carried out by Margaret Ryan, (Lead of Prescribing Governance for NHSGG&C) and her team. They will receive regular reports on the supply activity from PCS/PSD Questions