DONCASTER and BASSETLAW AREA PRESCRIBING COMMITTEE
MINUTES from Thursday 25th November. 2010
NHS Doncaster RDaSH Mental Health FT Doncaster LPC
Dr Alastair Graves - APC & PEC Mr Andrew Houston - Senior √ Mr Richard Harris
Chair Mental Health Pharmacist
Dr Rumit Shah – PEC √ Dr Saadeh George - Medical Ms Sue O’ Horan - Deputy
Prescribing Lead (APC Deputy Director Representative
Mr Stephen Davies – Assistant √
Director of Primary Care
Mr David Oxley – Head of √ DBHFT NHS Bassetlaw
Medicines and Prescribing
Mrs Joanne Forrestall – Mr Andrew Barker – Chief Ms Nicky Bird – Pharmacist
Commissioning Planned Care Pharmacist Manager (Notts-PCT)
Ms Lisa Bailey – Mr Lee Wilson – Consultant √ Mr Rob Wise – Prescribing
Commissioning Planned Care – Pharmacist - deputy Advisor (BPCT)
Ms Chris Prewett – Medicines Dr Richard Leigh – Medical √
Management Group Chair – Director representative
Ms Anne Burton – Non Medical √ Doncaster LMC
PBC NHS Nottinghamshire Dr Rosie Hamlin
Dr Judith Fearns √ Mr Adrian Perks – Associate
Director of Offender Health
Mr Rick Fuller – Sector Manger of Lloyds Pharmacy
Offender Health (NOTTS)
Ms Rebecca Holt - Contract
pharmacist (Doncaster prisons
and mental health trust)
In Attendance: Mrs Vicki Holmes – Minute Secretary (NHS Doncaster)
Mrs Gill Bradley – Practice Pharmacist (NHS Doncaster)
Mrs Jen Cox – Medicines Assurance Technician (NHS
Mr Anil Rajpal – Senior Pharmacist (RDaSH)
Agenda Discussion Points Action
Apologies were received for Dr Alastair Graves, Mr Andrew Barker, Dr
Rosie Hamlin. Mr Rob Wise, Ms Rebecca Holt, Mrs Joanne Forrestall,
Ms Lisa Bailey, Mr Richard Harris, Ms Nicky Bird and Ms Sue O’Horan.
The committee was not quorate but it was agreed to progress as NHS
Bassetlaw had received the agenda the week before the meeting and
had provided comments which would be raised as part of the
11/10/2 Declarations of Interest, Gifts or Hospitality
No declarations were received.
11/10/3 Minutes of last meeting
The minutes of the last meeting held on the 28th October 2010 were NHSD-
agreed as a true and accurate record with the following amendment;
Page 2, Section 07/10/10, post meeting note, NHS Bassetlaw,
bullet point 3 to read:
“Any information pertinent to pharmacies is cascaded via the postal
The minutes will be made available on the Medicines Management NHSD-
11/10/4 Matters Arising (not on the agenda)
06/10/9.2 Shared Care Protocol for the Management of Epilepsy in Adults
The committee were informed that consultation has taken place with
NHS Barnsley, NHS Bassetlaw and NHS Rotherham, who are in
agreement that a single policy for use within South Yorkshire is required.
The NHS Doncaster Assistant Director of Primary Care is to meet with NHSD-
representatives from NHS Sheffield APC & Neurology on the 21st MC
December to discuss the development of this policy. The Chair of the
NHS Sheffield APC has suggested for future policies to be developed
inline with all trusts within the area.
11/10/5 Matters Arising
04/10/9.4 Traffic Light System Status: Testosterone
The entries for testosterone products indicated for use in testosterone
replacement therapy for male hypogonadism when deficiency has been
diagnosed by an endocrinologist and confirmed by clinical features and
biochemical tests were approved by the committee. The committee were
informed that DBHFT Endocrinology is in support of the categorisation
and guidance on the entries.
The entries will be updated on the traffic light system and the details NHSD-
included in the November APC bulletin. MC
09/10/6 TLS Drug for Review: Dronedarone hydrochloride (Multaq)
The committee approved version d0.2 of the Guidance for the NHSD-
Prescribing of Dronedarone for Atrial Fibrillation with the following MC
Transfer of prescribing, point 3, footnote to add:
A patient may request that the blood test is taken at their registered GP Practice providing;
They present with a phlebotomy form that has been provided and completed by Cardiology and
clearly states for the results to be sent to Cardiology for action
The phlebotomy form contains details of why the blood test is required (i.e. Dronedarone started)
There is an available routine appointment with the HealthCare Assistant or Nurse
The patient is aware that interpretation of the results and communication of any significance to the
GP and/or patient is the responsibility of the Cardiology Consultant
The document will be made available on the medicines management
webpage, the entry will be updated on the traffic light system and the MC
details included in the November APC bulletin.
01/09/4.3 NHS Doncaster Medicines Management Website – Annual Review
The committee received the NHS Doncaster medicines management
website annual review. The report is also due to be received at the next
NHS Doncaster Prescribing Sub-Group meeting.
The committee were informed that a feedback form for users to the NHSD-
website to complete will be included as a permanent feature on the MC
website. Details will be included in the November APC bulletin.
The committee suggested for the questionnaire to be re-circulated on a
6 monthly basis.
11/10/6 Traffic Light – Drugs for Review
Roflumilast (Daxas) for Severe chronic obstructive pulmonary disease NHSD-
(COPD) will remain as Red 7 and will return to the January meeting for MC
All other drugs for review were agreed as proposed, will be updated on NHSD-
the traffic light system and the details included in the November APC MC
11/10/6.1 APC Officers actions
All officers actions were agreed as proposed, will be updated on the NHSD-
traffic light system and the details included in the November APC MC
11/10/7 Traffic Light – Additions for Consideration
The drug name for ICaps for Age related macular degeneration was NHSD-
agreed to read “ICaps (This includes all dietary antioxidants and MC
supplements to prevent AMD)” and will be categorised as grey with a
review date of Nov-15.
Post meeting note
Confirmation has been received from DBHFT Ophthalmology that they are in
support of the entry categorisation of grey.
Reboxetine (Erdonax) for All licensed indications will be included as
Grey with a review date of Nov-15. RDaSH requested that all patients
currently prescribed Reboxetine are to be reviewed by the initiating
prescriber. Details will be included in the November APC bulletin and NHSD-
the next NHS Doncaster Prescribing & Medicines Support newsletter. MC
All other additions for consideration were agreed as proposed, will be NHSD-
updated on the traffic light system and the details included in the MC
November APC bulletin.
11/10/8 Framework of NICE Guidance – Clinical Governance
The committee received the October 2010 Framework of NICE guidance NHSD-
from NHS Doncaster. MC
APC officers will provide assurance to Clinical Governance that:
NICE TA 201: Omalizumab for the treatment of severe persistent
allergic asthma in children aged 6 to 11 years
NICE TA 202: Ofatumumab for the treatment of chronic lymphocytic
leukaemia refractory to fludarabine and alemtuzumab
NICE TA 203: Liraglutide for the treatment of type 2 diabetes mellitus
NICE TA 204: Denosumab for the prevention of osteoporotic
fractures in postmenopausal women
NICE TA 205: Eltrombopag for the treatment of chronic immune
(idiopathic) thrombocytopenic purpura
NICE TA 206: Bendamustine for the treatment of indolent (low-
grade) non-hodgkins lymphoma that is refractory to rituximab
NICE TA 207: Temsirolimus for the treatment of relapsed or
refractory mantle cell lymphoma
Have been considered by the committee, the entry has been reviewed
and guidance has been added to the entry on the traffic light system.
It was agreed that CG111, PH28, IPG359, IPG360, IPG361, IPG362,
IPG363 and IPG364 do not require any action from the APC.
11/10/9 Traffic Light System: November 2010 Prescribing Data Report &
The committee received the November prescribing data report for
information. The report is due to be discussed at the next NHS
Doncaster Prescribing Sub-Group and NHS Bassetlaw Clinical
Governance and Quality Group meetings.
The committee approved the November prescribing data bulletin for NHSD-
11/10/10 New Business
11/10/10 DBHFT Drug & Therapeutics Committee Terms of Reference
The committee received the approved DBHFT Drug & Therapeutics
committee terms of reference October 2010 for information.
11/10/11 DBHFT D&TC Update
No further update was received.
11/10/12 Formulary Liaison Group Update
The minutes from the meeting held on the 24th September 2010 were
10/43.5 APC Referrals
It was highlighted that there are inconsistencies between the
recommendations made by the FLG and the traffic light system entries
for Fentanyl nasal spray and Indacaterol maleate. The FLG are to note FLG
the approved categorisations given to these entries.
11/10/13 Doncaster PCT Prescribing Sub Group Update
The minutes from the meeting held on the 30th September 2010 were
11/10/14 Bassetlaw PCT Clinical Quality and Governance Group update
No further update was received.
11/10/15 RDaSH & Medicines Management Committee update
No further update was received
11/10/16 Yorkshire and PCT Prescribing/Medicines Management Leads
No further update was received
11/10/17 Doncaster Community Healthcare Medicine Management Group
The minutes from the meetings held on the 10th August and 12th October
2010 were received.
10/10/18 Doncaster Prisons Drug & Therapeutic Committee
No further update was received.
11/10/19 Sheffield Area Prescribing Committee Update
The minutes from the meetings held on the 27th July and 28th September
11/10/19 Any Other Business
Cannabis Oromucosal Spray (Sativex) for Spasticity in Multiple
The committee agreed to re-categorise the entry on the TLS from Red 1 NHSD-
to Grey on the guidance of the Yorkshire & Humber Specialised
Commissioning Group policy. The approved policy has been adopted by
NHS Doncaster and states that insufficient evidence is available to
support prescribing of the drug.
The committee agreed for all related TLS entries to be reviewed on
adoption of these policies.
Goserelin (Zoladex) for prostate cancer and endometriosis:
The committee were informed that there have been problems reported
of GP’s declining the transfer of care from secondary to primary care of
stable patients prescribed Goserelin for prostate cancer or
Details on the definition of Amber-G will be included in the November NHSD-
APC bulletin. MC
A request has been received for Goserelin, for use in shrinking uterine
fibroids prior to surgery, to be considered as a TLS entry. Guidance to NHSD-
support this recommendation will be requested from specialist services MC
before returning to the committee for consideration.
RDaSH Senior Mental Health Pharmacist requested for assistance to be
provided from Primary Care in the sharing of clinical information RDaSH
between primary and secondary care. The NHS Doncaster Assistant /NHSD-
Director of Primary Care agreed to support RDaSH with this matter. MC
The shared care protocol for the prescribing of antipsychotics will also RDaSH
be reviewed by the RDaSH medicines management committee. This will /NHSD-
return to the committee over the following months. MC
Committee members were reminded that there is no meeting scheduled
for December; however pieces of work will be sent out to members via
email at the end of December for comment.
11/10/20 Date, time & venue of next meeting
12 noon prompt, Thursday 27th January 2010 in the boardroom, Park
lodge, St Catherine’s Site