Medicine Management Policy Rev 8 04 2012 fd ld by 3yLAz82

VIEWS: 7 PAGES: 28

									                                      Providing Services to the NHS




        East Berkshire Primary Care
               Out of Hours
       Medicines Management Policy




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy   Rev 8                                   04/2012
 Version                          8


 Ratified                         Yes


 Date Ratified                    01.05.2012

 Name of Originator               Marie Bass

 Date Issued                      08.05.2012

 Review Date                      08.05.2013




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy   2
Contents


1 Policy Statement ........................................................................................................... 4
2 Accountability ............................................................................................................... 4
3 Procurement and Supply of Medicines ....................................................................... 4
     3.1    Outdated Medicines ......................................................................................................... 4
     3.2    Storage of Medicines ....................................................................................................... 5
     3.3    Reporting of Losses / Misuse ........................................................................................... 5
     3.4    Monitoring of Storage ....................................................................................................... 5
4 Prescribing Medicines .................................................................................................. 5
     4.1    Administration of Medicines to Patients ............................................................................ 5
     4.2    Consent to Treatment ...................................................................................................... 5
     4.3    Checking of Medicines before Administration. .................................................................. 5
     4.4    Administration of Medicines ............................................................................................. 6
     4.5    Unused Medicines ........................................................................................................... 6
     4.6    Medicine Administration Errors ........................................................................................ 6
     4.7    Self Administration of Medicines by Patients .................................................................... 6
     4.8    Medicines for Clinicians ................................................................................................... 6
5 Hazards .......................................................................................................................... 6
6 Controlled Drugs .......................................................................................................... 6
7 Defect Reporting ........................................................................................................... 7
8 Adverse Drugs Reactions ............................................................................................ 7
9 Central Alerts ................................................................................................................ 7
10 Risk Management ....................................................................................................... 7
11 Review ......................................................................................................................... 7
   Appendix 1 - Medicines held in the Primary Care Centres ..................................... 8
   Appendix 2 – Medication held for Patient use in the GP visit cars ....................... 11
   Appendix 3 – Medication authorised for administration under PGD .................... 14
   Appendix 4 – Medication held for use within the Urgent Care Centre .................. 15
   Appendix 5 - Medicine Management Procedure..................................................... 17
   Appendix A - Supplier Contact Details.......................................................................25
   Appendix B - Stock Re Order Levels..........................................................................26




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                                       3
 1. Policy Statement
      East Berkshire Primary Care Out Of Hours (EBPCOOH) is committed to the safe and secure
      handling of medicines.
      EBPCOOH will govern the management of medicines using the current legislation and national
      guidance, and at all times with the best interests of patients to whom medicines are
      administered.


 2. Accountability
      The Chief Executive Officer (CEO) has overall responsibility for ensuring that systems for the
      safe and secure handling of medicines are followed and that the security of medicines handled
      by the EBPCOOH or any contracted third party is maintained.
      The Council have responsibility and accountability for ensuring the provision of the appropriate
      resources required to implement this policy, and ensuring that all medicines are of a suitable
      quality.
      The pharmacist is responsible for advising on the safe and secure handling of medicines for
      EBPCOOH and reports through the Quality, Governance, Patient Safety & Risk (QGPS&R)
      Committee.
      The Clinical Governance Lead has responsibility and accountability for the safe and secure
      handling of medicines within the operational environment.
      The Medical Director and Clinical Executive are responsible and accountable for the day to day
      safe and secure handling of medicines within the operational environment, and must ensure
      that:
                      Copies of the Medicines Management Policy are available to all clinicians.
                      Clinicians understand and are competent to carry out the duties described by
                       these policies and procedures.
      Clinicians have a responsibility to maintain their competency in the management of medicines
      and to ensure their familiarity with changes to therapeutic guidelines as the contractor adopts
      them.


 3. Procurement and Supply of Medicines
      The Medicines Management Team (under direction from the Management Executive) is
      responsible for obtaining all medicinal products that are required and of a suitable quality. Only
      those medicines listed in the approved guidelines will be purchased and or used by EBPCOOH
      All medicines (unless patients’ own) administered or supplied to patients must be supplied by
      EBPCOOH using the company stock control system
      The lists of medicines carried in each EBPCOOH GP Vehicle, PCC and UCC are detailed in
      their respective Appendices
      The Medicines Management Team is responsible for ensuring that the system for requisitioning
      and returning of medicines is followed.
3.1      Outdated Medicines
      Out of date, recalled and medicines unsuitable for use should be removed and sent back to
      the Medicines Management Team for destruction. The Clinical Governance Lead should
      ensure a safe system is in place for this to be achieved.




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                        4
3.2      Storage of Medicines
      Medicines will be stored under the control of the QGPS&R committee and managers must
      safeguard all medicines issued to any location.
      Medicines must be stored in a locked cupboard in a safe environment in an area that is not
      accessible by the public. Stock must be regularly rotated and checked to ensure medicines
      have not expired.
      Health professionals are personally responsible for the security of all medicines while they are
      in their possession.
3.3 Reporting of Losses / Misuse
      The loss or suspected loss or misuse of any medicinal product must be reported according to
      the Adverse Incident Reporting and Investigation Policy no later than the next working day.
3.4 Monitoring of Storage
      The Operations Manager , nominated by the CEO, will make checks to ensure compliance with
      the Medicines Management Policy every month.
      A regular audit is required quarterly by the Medicines Management Team to ensure that the
      stock is in line with the Stock Control Management System. Any Discrepancies are to be
      brought to the attention of the Medical Director via the QGPS&R committee.


 4. Prescribing Medicines
      Only those employed by EBPCOOH directly or contracted and authorised to prescribe can
      issue prescriptions to a patient within our services, (e.g. Doctor, Dentist or Non-Medical
      Prescriber may prescribe medicines).
      Where possible, prescriptions should be issued and printed via the Adastra system.
      All prescribers should follow the “Guidance on prescribing”, stated in the latest issue of the
      British National Formulary.
4.1 Administration of Medicines to Patients
      The following groups are authorised to administer medicines:
        Competent registered health professionals (within the legislative framework).
        The patient (to him / herself) either under supervision or by self-administration.
        A trainee under the direct supervision of a competent health professional. The supervising
            health professional is responsible for ensuring that the medicine is correctly
            administered.
      The list of medicines authorised for administration by approved PGD certified person is at
      Appendix 1.
      All registered health professionals are accountable for their practice and must be able to
      demonstrate competence. Any authorised person administering a medicine to a patient must
      be satisfied that they know the therapeutic uses of the medicine, its normal dosage, side
      effects, precautions and contra-indications.
4.2 Consent to Treatment
      In general, patients have a right to receive information about a medicine prior to use and to
      refuse administration provided they have the capacity to do so, as outlined in the EBPCOOH
      Consent Policy.
4.3 Checking of Medicines before Administration.
      Clinicians must check appropriateness of any medicine, including its contra-indications, in the
      British National Formulary and Local Prescribing Guidelines.

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                         5
   Any medicine that is found or thought to be defective should not be used and the Adverse
   Incident Reporting and Investigation Policy should be followed.
4.4 Administration of Medicines
   Administration to the patient should be in accordance with a prescription written by an
   authorised health professional. In line with that clinician’s regulatory body’s Clinical Practice
   Guidelines.
   All calculations must be conducted in accordance with the Clinical Practice Guidelines. A
   record of administration should be made, including the administering person and the quantity,
   timing, and route of each medicine given.
   Adverse effects should be recorded. Medicines refused, wasted or disposed of should be
   recorded. Medicines must not be prepared in advance of administration.
4.5 Unused Medicines
   Medicines removed from their container / packaging and not immediately administered must be
   discarded. Unused or discarded medicines must be disposed of into a sharps bin.
4.6 Medicine Administration Errors
   A medicine administration error occurs when a patient has received:
          The wrong medicine.
          The wrong dosage of the intended medicine.
          A dose at the wrong time.
          A medicine administered by the wrong route.
          A medicine that is wrongly prescribed or given without an authorised prescription or a
           current authorised Patient Group Direction.
          A medication is omitted without a documented clinical reason.
   Whenever an error in the administration or supply of a medicine is found the Adverse Incident
   Reporting and Investigation Policy should be followed and an IR1 form (See EBPCOOH Risk
   Management Policy & Procedures) should be completed for review and investigation.
4.7 Self Administration of Medicines by Patients
   Any medicine taken by a patient in the presence of a clinician must be documented on the
   Patient Care Record.
4.8 Medicines for Clinicians
   Clinicians must not take medicines from stock for personal use. Normally the clinicians should
   consult their General Practitioner.
   Medication prescribed should only be issued for patients registered with the Out of Hours
   Service and prescriptions not written for any other use including repeat prescriptions.


 5. Hazards
   Handling of hazardous substances should be in accordance with COSHH Regulations.


 6. Controlled Drugs
    See Controlled Drugs Policy.




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                       6
 7. Defect Reporting
   In the event of a defect or suspected defect in a medicine:
              The medicine must be labelled and stored separately from other medicines to prevent
               inadvertent use. The Clinical Governance Lead must be notified and will decide (in
               consultation with the Pharmacy Advisor or a Medical Director) if it is appropriate to
               withdrawn from use all medicine of the same batch in accordance with the Adverse
               Incident Reporting and Investigation Policy.
              The defect or suspected defect must be reported in accordance with the EBPCOOH’s
               Adverse Incident Reporting and Investigation Policy Form and reported to the MHRA.
   The incident will be reviewed in accordance with EBPCOOH’s Adverse Incident Reporting and
   Investigation Policy.


 8. Adverse Drugs Reactions
   Adverse Drug Reactions (ADRs) should be recorded on the patients’ records on the Adastra
   System
   The following ADRs should be reported to the Medicines and Healthcare products Regulatory
   Agency (MHRA) by completing a yellow card (which can be downloaded from the MRHA web
   site http://www.mhra.gov.uk/index.htm )
              All serious adverse reactions in adults.
              All serious and minor reactions in children (under 18).
   Serious reactions including those that are:
               Fatal
               Life threatening.
               Disabling.
               Incapacitating.
               Result in or prolonged hospitalisation and / or are medically significant.
               Congenital abnormalities.
   If in doubt about the seriousness of a reaction, report it.


 9. Central Alerts
   Central Alerting System cascade will be actioned in accordance with the Adverse Incident
   Reporting and Investigation Policy.


 10. Risk Management
   Risk assessments will be carried out (in accordance with the Adverse Incident Reporting and
   Investigation Policy) in connection with medicines and procedures (including the use of delivery
   devices) to determine the potential risks to patients and clinicians.


 11. Review
     Review of medication errors and incidents takes place at the QGPS&R committee.

     This policy and the associated procedures will be reviewed annually.

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                          7
                                                                               Appendix 1
       Medicines held in the Primary Care Centres

Medicine                                                    Pack Size     Qty Held
aciclovir tablets 800mg                                          35
adrenaline acid tartrate injection 500 micrograms/0          individual
amoxicillin capsules 250mg                                       21
amoxicillin capsules 500mg                                       21
amoxicillin oral suspension 125mg/5ml                         100mls
amoxicillin oral suspension 250mg/5ml                         100mls
aspirin dispersible tablet 300mg                                 32
atropine sulphate injection 600 micrograms/1ml               individual
atrovent UDVs nebuliser solution 250 micrograms/1ml          individual
benzylpenicillin powder for solution for injection 600 mg    individual
Catheter Female                                              individual
Catheter Male                                                individual
cefalexin capsules 500mg                                         21
cefalexin suspension 125mg/5ml                                   27
cefalexin suspension 250mg/5ml                                100mls
cefalexin capsules 250mg                                      100mls
ceftriaxone injection 250mg                                  individual
cetrizine tablets 10mg                                            7
chlorphenamine injection 10mg/ml                             individual
chlorphenamine oral solution 2mg/5ml                          150mls
chlorphenamine tablets 4mg                                       28
chlorpromazine tablets 25mg                                      28
co-amoxiclav oral suspension 125mg + 31mg/5ml                   100
co-amoxiclav tablets 250mg + 125mg                               21
co-amoxiclav tablets 500mg + 125mg                               21
cyclizine lactate injection 50mg/1ml                         individual
dexamethasone sodium phosphate injection 4mg/1ml             individual
diamorphine hydrochloride injection 10mg                     individual
diamorphine hydrochloride injection 30mg                     individual
diazepam rectal tubes 5mg                                    individual
diazepam tablets 5mg                                             10
diclofenac sodium enteric coated tablets 50mg                    58
diclofenac sodium injection 25mg/ml                          individual
dihydrocodeine tablets 30mg                                      28
dioralyte sachets (blackcurrent)                             individual
dioralyte sachets (citrus)                                   individual
domperidone suppository 30mg                                 individual
domperidone tablets 10mg                                         30
erythromycin enteric coated tablets 250mg                        28
erythromycin ethylsuccinate sugar-free suspension
125mg/5ml                                                     100mls

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                     8
erythromycin ethylsuccinate sugar-free suspension
250mg/5ml                                              100mls
flucloxacillin capsules 250mg                             28
flucloxacillin capsules 500mg                             28
furosemide injection 20mg/2ml                         individual
furosemide tablets 40mg                                   28
Gaviscon extra strength tablets                           24
glucagon injection 1mg                                individual
Glucogel gel 25g (hypostop)                           individual
glycerol suppository 4mg                              individual
glyceryl trinitrate aerosol spray                     individual
haloperidol injection 5mg/ml                          individual
hydrocortisone sodium phosphate injection 100mg/1ml   individual
hyoscine butylbromide injection 20mg/1ml              individual
hyoscine butylbromide tablets 10mg                        20
hyoscine hydrobromide injection 400 micrograms/1ml    individual
ibuprofen syrup 100mg/5ml                              100mls
ibuprofen tablets 200mg                                   24
Instillagel 6ml                                       individual
Instillagel 11ml                                      individual
KAY-CEE-L sugar free syrup                             500mls
lansoprazole 30mg                                         28
levomepromazine injection 25mg/ml                     individual
levonorgestrel tablets 1500 micrograms                     1
loperamide capsules 2mg                                   30
metoclopramide injection 10mg/2ml                     individual
metoclopramide tablets 10mg                               28
Microlax Enemas                                       individual
metronidazole tablets 400mg                               21
midazolam injection 10mg/2ml                          individual
morphine sulphate injection 10mg/1ml                  individual
morphine sulphate injection 30mg/1ml                  individual
naloxone hydrochloride injection 400 micrograms/1ml   individual
naproxen tablets 500mg                                    28
oramorph oral solution 10mg/5ml                        100mls
oxycodone hydrochloride injection 10mg.1ml            individual
paracetamol sugar-free suspension 120mg/5ml            100mls
paracetamol suppository 120mg                         individual
paracetamol suspension 250mg/5ml                       100mls
paracetamol tablets 500mg                                 32
penicillin v sugar-free oral solution 125mg/5ml        100mls
penicillin v sugar-free oral solution250mg/5ml         100mls
penicillin v tablets 250mg                                28
pethidine injection 50mg/1ml                          individual
prednisolone enteric coated tablets 5mg                   28
prednisolone soluble tablets 5mg                          30
prochlorperazine maleate buccal tablets 3mg               20
prochlorperazine maleate tablets 5mg                      28
prochlorperazine mesilate injection 12.5mg/1ml        individual

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                 9
procyclidine tablets 5mg                                   28
pulmicort respules nebuliser suspension 0.5mg          individual
salbutamol cfc free inhaler 100 micrograms             individual
salbutamol injection 0.5mg/ml                          individual
salbutamol unit dose nebulising solution 2.5mg/2.5ml   individual
salbutamol unit dose nebulising solution 5mg/2.5ml     individual
sodium chloride injection 0.9%                         individual
sofradex ear/eye drops                                   10mls
Steripod                                               individual
tramadol capsules 50mg                                     30
tramdol injection 100mg/2ml                            individual
trimethoprim tablets 200mg                                 14
Uriotainer                                             individual
water for injection 5ml                                individual
water for injections 10ml                              individual




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                  10
                                                                                 Appendix 2

     Medication held for Patient use in the GP visit cars
Name                                                        Pack Size     Qty Held
aciclovir tablets 800mg                                          35          1
adrenaline acid tartrate injection 500 micrograms/0          individual      2
amoxicillin capsules 250mg                                       21          6
amoxicillin capsules 500mg                                       21          2
amoxicillin oral suspension 125mg/5ml                         100mls         2
amoxicillin oral suspension 250mg/5ml                         100mls         2
aspirin dispersible tablet 300mg                                 32          2
atropine sulphate injection 600 micrograms/1ml               individual      2
atrovent UDVs nebuliser solution 250 micrograms/1ml          individual
benzylpenicillin powder for solution for injection 600 mg    individual      2
Catheter Female                                              individual      1
Catheter Male                                                individual      1
cefalexin capsules 500mg                                         21          4
cefalexin suspension 125mg/5ml                                100mls         2
cefalexin suspension 250mg/5ml                                100mls         2
cefalexin capsules 250mg                                         21          4
ceftriaxone injection 250mg                                  individual
cetrizine tablets 10mg                                            7          1
chlorphenamine injection 10mg/ml                             individual
chlorphenamine oral solution 2mg/5ml                          150mls         2
chlorphenamine tablets 4mg                                       28          2
chlorpromazine tablets 25mg                                      28          2
co-amoxiclav oral suspension 125mg + 31mg/5ml                   100          2
co-amoxiclav tablets 250mg + 125mg                               21          2
co-amoxiclav tablets 500mg + 125mg                               21          2
cyclizine lactate injection 50mg/1ml                         individual      1
dexamethasone sodium phosphate injection 4mg/1ml             individual
diazepam rectal tubes 5mg                                    individual      1
diazepam tablets 5mg                                             10          2
diclofenac sodium enteric coated tablets 50mg                    58          2
diclofenac sodium injection 25mg/ml                          individual      4
dihydrocodeine tablets 30mg                                      28          2
dioralyte sachets (blackcurrent)                             individual      2
dioralyte sachets (citrus)                                   individual      2
domperidone suppository 30mg                                 individual      7
domperidone tablets 10mg                                         30          1
erythromycin enteric coated tablets 250mg                        28          2
erythromycin ethylsuccinate sugar-free suspension
125mg/5ml                                                     100mls         2
erythromycin ethylsuccinate sugar-free suspension
250mg/5ml                                                     100mls         2
flucloxacillin capsules 250mg                                   28           1



EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                     11
Name                                                   Pack Size    Qty Held
flucloxacillin capsules 500mg                              28          2
furosemide injection 20mg/2ml                          individual      2
furosemide tablets 40mg                                    28          1
Gaviscon extra strength tablets                            24          1
glucagon injection 1mg                                 individual      1
Glucogel gel 25g (hypostop)                            individual      1
glycerol suppository 4mg                               individual      7
glyceryl trinitrate aerosol spray                      individual      1
haloperidol injection 5mg/ml                           individual
hydrocortisone sodium phosphate injection 100mg/1ml    individual      2
hyoscine butylbromide injection 20mg/1ml               individual      2
hyoscine butylbromide tablets 10mg                         20          2
hyoscine hydrobromide injection 400 micrograms/1ml     individual
ibuprofen syrup 100mg/5ml                                 100          2
ibuprofen tablets 200mg                                    24          1
Instillagel 6ml                                        individual
Instillagel 11ml                                       individual
lansoprazole 30mg                                          28          1
levomepromazine injection 25mg/ml                      individual      1
loperamide capsules 2mg                                    30          1
metoclopramide injection 10mg/2ml                      individual      3
metoclopramide tablets 10mg                                28          1
Microlax Enemas                                        individual      1
metronidazole tablets 400mg                                21          2
naloxone hydrochloride injection 400 micrograms/1ml    individual      2
naproxen tablets 500mg                                     28          2
paracetamol sugar-free suspension 120mg/5ml             100mls         2
paracetamol suppository 120mg                          individual      7
paracetamol suspension 250mg/5ml                        100mls         2
paracetamol tablets 500mg                                  32          2
penicillin v sugar-free oral solution 125mg/5ml         100mls         2
penicillin v sugar-free oral solution250mg/5ml          100mls         2
penicillin v tablets 250mg                                 28          1
prednisolone enteric coated tablets 5mg                    28          2
prednisolone soluble tablets 5mg                           30          2
prochlorperazine maleate buccal tablets 3mg                20          1
prochlorperazine maleate tablets 5mg                       28          2
prochlorperazine mesilate injection 12.5mg/1ml         individual      4
procyclidine tablets 5mg                                   28          1
pulmicort respules nebuliser suspension 0.5mg          individual
salbutamol cfc free inhaler 100 micrograms             individual      2
salbutamol injection 0.5mg/ml                          individual      2
salbutamol unit dose nebulising solution 2.5mg/2.5ml   individual
salbutamol unit dose nebulising solution 5mg/2.5ml     individual
sodium chloride injection 0.9%                         individual
sofradex ear/eye drops                                   10ml          1

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                 12
Name                                Pack Size    Qty Held
Steripod                            individual
tramadol capsules 50mg                  30          2
tramadol injection 100mg/2ml        individual      2
trimethoprim tablets 200mg              14          2
Uriotainer                          individual
water for injections 5ml            individual      4
water for injections 10ml           individual      4




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy    13
                                                                                     Appendix 3
                     Medication authorised for administration under PGD


EBPC CCG001         Treatment of Acute Otitis Media and Acute Sinusitis with Amoxicillin

EBPC CCG002         Second Line Treatment of uncomplicated Lower Urinary Tract Infection in
                    Females with cephalexin
                    Treatment of Bacterial Conjunctivitis,
EBPC CCG003
                    Prophylaxis of infection following removal of conjunctival foreign body or
                    superficial corneal injury with chloramphenicol eye drops/ointment
EBPC CCG004         Treatment of Urticaria (nettle rash, hives) and Pruritus associated with skin
                    rashes, insect bites and mite infestations with chlorphenamine
EBPC CCG005         Treatment of Bites (Animal or Human) or Clench Fist Injuries with co-amoxiclav
                     Second Line Treatment for Acute Otitis media (AOM), Acute
EBPC CCG006          tonsillitis/Pharyngitis, Minor Wound or Skin Infection including widespread
                     Impetigo with erythromycin


EBPC CCG007          First Line Treatment of Impetigo or other minor wound or skin infection requiring
                     antibiotic cover with flucloxacillin
EBPC CCG008          Treatment of mild to moderate pain with ibuprofen

EBPC CCG009          Women requesting emergency hormonal contraception within 72 hours of
                     unprotected sexual intercourse
EBPC CCG010          Local Anaesthesia with lidocaine 1% injection prior to wound suturing or wound
                     management of a digit
                     Treatment of Pyrexia and the symptomatic relief of mild to moderate Pain with
EBPC CCG011          paracetamol




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                    14
                                                                        Appendix 4

                    Medication held for use within the Urgent Care Centre


Medicine                                                        Pack Size   Qty Held
Adrenaline acid tartrate injection 1mg/1ml (1:1000)
Allercalm 4mg
AMETOP gel 4%
Amoxicillin 250mg capsules
Amoxicillin 500mg capsules
Amoxicillin sugar free syrup 250mg/5ml
Aspirin dispersible tablet 300mg
AVOCA applicator 75%
Calamine lotion
Cefalexin 250mg capsules
Cefalexin syrup 250mg/5ml
Cetirizine 10mg 30 tablets
Cetirizine 10mg 7 tablets
Chloramphenicol eye drops 0.5%
Chloramphenicol eye ointment 1%
Chlorphenamine 4mg tablets
Chlorphenamine injection 10mg/ml
Chlorphenamine oral solution 2mg/5ml
Ciprofloxacin tablets 250mg
Clindamycin capsules 150mg
Co-amoxiclav 250mg/125mg tablets
Co-amoxiclav 500mg/125mg tablets
Cryogesic ethyl chloride direct stream
Diclofenac sodium injection 75mg/3ml
Diclofenac sodium suppository 100mg
Erythromycin 250mg tabs
Erythromycin ethylsuccinate suspension 250mg/5ml
Flucloxacillin 250mg capsules
Flucloxacillin 500mg capsules
FLUCLOXACILLIN elixir 250mg/5ml
Fluorescein sodium preservative free eye drops 2%
Glucagon injection 1mg
GLUCOGEL gel
GTN spray
Ibuprofen 400mg tablets
Ibuprofen syrup 100mg/5ml
Lidocaine 5%+Phenylephedrine hydrochloride5%topical solution
Lidocaine hydrochloride injection 1%
Liquiband tissue adhesive
Metoclopramide injection 10mg/2ml
Metronidazole 400mg tablets

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                 15
Medicine                                          Pack Size   Qty Held
MINIMS PROXYMETACAINE eye drops 0.5%
Naproxen 500mg
OTOSPORIN ear drops
Oxybuprocaine hydrochloride eye drops 0.4%
Paracetamol 500mg tablets
Paracetamol sugar-free suspension 120mg/5ml
Paracetamol suppository 120mg
Paracetamol suspension 250mg/5ml
Phenoxymethylpenicillin 250mg tablets
Phenoxymethylpenicillin oral solution 250mg/5ml
REVAXIS adsorbed vaccine
Silver sulfadiazine cream 1%
Sodium chloride eye drops 0.9%
SOLU-CORTEF injection 100mg/vial
Trimethoprim 200mg tablets
XYLOCAINE WITH ADRENALINE 1:200,000 2% w/v




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy               16
                                           Appendix 5




                  Medicine Management
                              Procedures




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy       17
1. Introduction
          East Berkshire Primary Care Out of Hours Service (EBPCOOH) is committed to the
          safe and secure handling of medicines. The EBPCOOH will govern the management of
          medicines using the current legislation and national guidance, and at all times with the
          best interests of patients to whom medicines are administrated. The Chief Executive
          has overall responsibility for ensuring that systems for the safe and secure handling of
          medicines are followed and maintained by the EBPCOOH. Only medications approved
          by the Clinical Review Committee via an approved Drug Formulary will be purchased.
          This should be reviewed on an annual basis. Medications will only be issued in their
          original manufacturers packaging.


2. Suppliers
          EBPCOOH uses several suppliers that are licensed wholesalers to ensure products are
          of a suitable quality for the continuous supply of medications needed in order for the
          service to run efficiently. There are times when a supplier has stock availability issues
          with some items. It then becomes necessary to place an order with another supplier to
          meet the requirements of the EBPCOOH at any given time. The main medication
          supplier used is Kent Pharmaceuticals; they supply approximately 95% of the
          medication needed. The other 5% is made up from Williams Medical Supplies and Heer
          Pharmacy.

          Contact details for each supplier can be found in Appendix A.


3. When to place an order
          Medication orders are placed when the Call Centre stock levels have reached a pre set
          reorder level on the Adastra V3 system. To run the report needed follow the details set
          out in section 3.2

       3.1 Stock Re Order Levels

          Stock re order levels for each site vary slightly as some centres are busier than others
          and the stock levels need to reflect this. Medication re order levels can be found in
          Appendix 2.

       3.2 Running Re Order report

                 Log on to the Adastra V3 system at the Call Centre location
                 On the left hand side of the screen select the tab Reporting
                 Select Run User Report
                 This will open up the list of report sections
                 Select Medicine Management
                 Double click on Re Order Levels - Call Centre (the screen will now display all
                  items that are below the re order level
                 It is advisable to print off the report so that it can be used for making notes as
                  the order is built
                 To export onto an Excel spreadsheet, select Microsoft Excel Worksheet in the
                  File Format drop down at the top of the screen
                 Click Export
                 Select the Medicine Management folder on Box net
                 Select V3 Exports
                 Save as Re Order ddmmyyyy

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                     18
       3.3 Checking Call Centre Stock Levels

          Once the report has been saved, the rest of the stock levels need to be checked to see
          what medications are approaching their re order level.

          Look at the Call Centre Stock Levels via the Stock Control Tab on V3 to see what other
          medications are approaching their re order levels.

          Make a note of any medications that are almost at re order level so that these can be
          added to the current order.

4. Preparing an Order: Kent Pharmaceuticals

          Once the Re order report has been run and saved as set out in section 3.2, the order
          can be prepared.

                 Open the Medicine Management folder on Box net
                 Select Drug Orders folder, this will open up folders with suppliers names
                 Select the Supplier that the order needs to be placed with (e.g. Kent)
                 Double click on Kent Orders, this will open up an Excel spreadsheet with date
                  tabs along the bottom
                 Scroll along to the last dated tab and copy line 1 and paste into a new tab
                 Rename the tab with the current date, click save

                 Open Box net/Medicine Management/Drug Orders/Kent/Kent Drug Prices
                 Ignore the folder named Old (this is where previous price lists are kept)
                 Open up the current price list spreadsheet
                 This will list all the current prices, product codes, drug name, strength and pack
                  size

                 With the printed paper copy of the medications needed, go through the current
                  prices spreadsheet, copying the items that need to be ordered and pasting them
                  onto the Kent Orders spreadsheet under the current date tab
                 The current price list spreadsheet can now be closed as it is no longer needed.
                 Once all items (including those that are near re order level) on the list have been
                  copied over onto the Kent Orders spreadsheet, click save

                 Quantities and VAT need to be added on to the order
                 Fill in the quantity needed for each medication then multiply price x quantity and
                  place the total in the costing column
                 To add VAT multiply costing x 1.2, this will give you the final total cost including
                  VAT, add this figure into the Total column
                 Finally to list the total VAT for each medication, total - costing, place this figure
                  in the VAT column
                 Once this has been completed for each medication, add all total columns
                  together to give the final price.
                 This price is now ready to add onto a Purchase Order for approval by
                  management.

        4.1 How to place the order

          Kent Pharmaceuticals medications are ordered via email to hospital@kentpharm.co.uk
          A Purchase Order still needs to be raised for the total price of the order to allow a
          manager to authorise the purchase. The order needs to be emailed to the approving

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                      19
          manager along with the Purchase Order request so that it is clear exactly what is being
          ordered and the costs involved. Section 4 needs to be carried out before the Purchase
          Order can be raised. Once this has been approved;

        4.2 Raising the Purchase Order

                 Log on to www.pocontrol.com
                 Buy something
                 Repeat order
                 Select the last Kent Pharmaceuticals Ltd order
                 Scroll down to the bottom of the Purchase Order and select Duplicate
                 This will open up a new Order page
                 Add in a Due Date (one week from the order date)
                 Change the date on the Description tab (this needs to match the date tab on the
                  Kent Orders spreadsheet)
                 Enter the Unit Price as per the spreadsheet total
                 Click Get Approval tab
                 Select appropriate manager to Approve order
                 Click Forward for Approval
                 Once the Purchase Order approval has been confirmed make a note of the
                  Purchase Order number on the Kent Orders Spreadsheet so that when the
                  invoices come in, they can be reconciled against the correct order.
                 The order is now ready to be forwarded to Kent for processing.

        4.3 Via Email

           Once steps 3.2, 3.3, 4, 4.2 have been completed;

                 Open Box net/Medicine Management/Drug Orders
                 Select the Kent Folder, this will open up an Excel spreadsheet with date tabs
                  along the bottom
                 Select the date tab needed for the current order
                 Copy the whole page (it is important to only send one page, as sending the
                  whole spreadsheet could result in being sent an incorrect order or all of the
                  previous orders again
                 Paste onto an email
                 Send to hospital@kentpharm.co.uk for processing.


        4.4 Reconciling Delivery

          Once the delivery arrives, it must be reconciled. The following steps need to be taken to
          ensure that all items ordered are accounted for;

                 The invoice will be in with the delivery, check off the items against the invoice in
                  the first instance
                 Open Box net/Medicine Management/Drug Orders/Kent/Kent Orders
                 Select the correct date tab and cross reference the invoice with what was
                  ordered
                 The number received may be lower than the number ordered if the supplier did
                  not have enough stock to provide the whole order. The items will arrive in
                  another order once back in stock
                 Each time a delivery arrives, the above process will need to be carried out until
                  all items have arrived

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                     20
                 In the comments section on the spreadsheet enter ARRIVED if all of the stock
                  has been delivered
                 If there has been a part delivery enter the quantity that has arrived


        4.5 Attaching Invoice to the Purchase Order System

                 Once the order is reconciled, the invoices need to be attached to the Purchase
                  Order
                 Scan the invoice and save as a PDF document under Box net/Medicine
                  Management/Scanned Invoices/name of supplier/Purchase Order number
                 If there whole delivery has not arrived altogether, then the scanned invoices will
                  need to be saved as KENT EBPC1234.1, KENT EBPC1234.2, so that they can
                  be added separately to the Purchase Order System
                 Place the original invoice in the Finance tray for collection


       5. Preparing an Order: Heer Pharmacy
       Heer Pharmacy is used for the ordering of controlled drugs (See Appendix A), Controlled
       Drug Register Inserts, Catheters and catheter related items. Heer Pharmacy can also be
       used to supply medicines that are not available via Kent Pharmaceuticals or that are
       needed at short notice.

       As the orders for Heer Pharmacy are done at the last minute or very late notice it is not
       possible to raise a Purchase Order prior to placing these orders. The Pharmacy will issue
       an invoice when the delivery is made to Herschel Medical Centre and then the Purchase
       Order can be raised to reflect the order.

       Orders are made to the Pharmacy via Fax 01753 538354

        5.1 How to place the order

          When items need to be ordered from Heer Pharmacy the following steps need to be
       taken;

                 Open Box net/Medicine Management/Drug Orders/Heer/Master Fax Form
                 Save As Fax Order ddmmyyyy
                 Fill in the order form with items needed, making sure that the date is added at
                  the top of the order.
                 Once the order form has been completed, save
                 Print off
                 Fax the order to 01753 538354


       5.2 Reconciling the Delivery

          Once the items are ready, the pharmacy will contact a member of the Medicine
          Management team to arrange delivery to the Herschel Medical Centre. The delivery is
          made at 1900 when the Out of Hours service is in operation and a receptionist is able to
          receive the delivery. The receptionists have been informed that the delivery is due from
          Heer Pharmacy and needs to be locked away from the main medications in readiness
          for collection by a member of the Medicines Management team.



EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                    21
          Once collected, the order needs to be checked with the initial fax order. There will be an
          invoice within the delivery which is needed in order for a Purchase Order to be raised.
          The following steps need to be taken;

                 Log on to www.pocontrol.com
                 Buy something
                 Repeat order
                 Select the last Heer Pharmacy order
                 Scroll down to the bottom of the Purchase Order and select Duplicate
                 This will open up a new Order page
                 Add in a Due Date (one week from the order date)
                 Change the date on the Description tab (this needs to match the order date on
                  the initial fax sent)
                 Enter the Unit Price as per the spreadsheet total
                 Click Get Approval tab
                 Select appropriate manager to Approve order (normally the finance manager as
                  the order has already been received)
                 Click Forward for Approval


        5.3 Attaching Invoice to the Purchase Order System

                 Once the order is reconciled, the invoices need to be attached to the Purchase
                  Order
                 Scan the invoice and save as a PDF document under Box net/Medicine
                  Management/Scanned Invoices/name of supplier/Purchase Order number
                 Place the original invoice in the Finance tray for collection


        6. Preparing an Order: Williams Medical Supplies

        Williams Medical Supplies is used to place orders for refrigerated medicines and several
        medications that are not readily available from the main supplier. These items are mostly
        used in the Urgent Care Centre.


         6.1 How to place the order

        All orders for Williams Medical Supplies are made via the Purchase Order System

                 Log on to www.pocontrol.com
                 Buy something
                 New order
                 Click on the Company Name Tab and type wms in the search box, click search
                 The address and contact detail will be added onto the order automatically, then
                  click next
                 Select Out of Hours or Maidenhead UCC in the Department tab, then click next
                 Most items are already entered onto the Description tab, select each item
                  needed on a new line
                 In the Charge to tab enter, Drugs & Clinical Supplies
                 The unit price will have automatically been added in, however the VAT has to
                  be added on to this price
                 To find out the price of the item including VAT multiply the price by 1.2 and this
                  will give you the total price per item. Remove the unit price and add in this new
                  figure

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                    22
                   Ignore the Discount % tab
                   Add the quantity needed of each item
                   Once each item has had the VAT added, click next
                   The delivery address for all items is EBPC (OOHS), (44 Finchampstead Road)
                    except for the Urgent Care Centre at Maidenhead, as they receive all of their
                    supplies directly during normal working hours
                   Add in a Recipient name (a competent person who is responsible for receiving
                    the delivery)
                   Add in a Due Date (one week from the order date)
                   The order is ready to send for Approval, click Get Approval tab at the bottom of
                    the order
                   Select appropriate manager to Approve order
                   Click Forward for Approval

                   Once the Purchase Order has been approved it needs to be sent to the supplier
                   Log back onto the Purchase Order system
                   Select Approved tab on left hand side of the screen
                   Click on the correct Purchase Order
                   At the bottom of the order, select email PO tab
                   The order has now been sent directly to the supplier for processing

          6.2 Reconciling Delivery

          Once the delivery arrives, it must be reconciled with the Purchase Order System.

                   Log back onto the Purchase Order system
                   Select Reconcile Delivery
                   Select the correct Purchase Order number
                   In the Quantity box on the right hand side of the order, enter the number of
                    items delivered. The number received may be lower than the number ordered if
                    the supplier was not able to provide the whole amount initially ordered. The
                    items will arrive in another order once back in stock
                   Each time a delivery arrives, the above process will need to be carried out until
                    all items have arrived

          6.3 Attaching Invoice to the Purchase Order System

                   Once the order is reconciled, the invoices need to be attached to the Purchase
                    Order
                   Scan the invoice and save as a PDF document under Box net/Medicine
                    Management/Scanned Invoices/name of supplier/Purchase Order number
                   Place the original invoice in the Finance tray for collection

    7. Logging Delivery of Medications onto Adastra V3 Stock Control

           Procedure for entering drugs onto Adastra V3 from Supplier.

           This is a manual process with the steps on how to log drugs listed below. As of
           November 2011, a scanning system is being piloted and once the scanning system is
           ready, further steps will be provided to users before the scanning system goes live.

           Logging drugs onto Adastra

          Log on to ADASTRA V3
          Select Supervisor or Receptionist Option.

EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                      23
      Select CALL CENTRE in Location pull down box
      Click on LOG DELIVERY and a new window will open
      From delivery from (supplier) pull down box, select supplier i.e. KENT
       PHARMACEUTICALS.
      Select item you wish to add by clicking on stock item pull down box and dragging to the
       required item.
      enter the batch number, expiry date and quantity in the three windows
      Click on the add button
      Click OK (bottom of window) and that will complete the addition of this particular item
      Repeat this process until all drugs are added.
      Note items added will appear in the lower window. There is a permanent trace. If an error
       is made it can be traced and rectified.


8. Controlled Drugs
Controlled drugs policy:

      Stock- managed by Medicines management team according to critical stock levels agreed
       by the EBPCOOH Medical Director
      Requisition: A PPA controlled drugs requisition form to be completed and signed by an
       EBPCOOH designated GP; no FP10 to be used to restock
      Collection: by designated GP with prior arrangement from nominated dispensing
       pharmacist
      Transportation: Duty medical team member (GP) using EBPCOOH vehicle and driver
      Additions to PCC stock: all drugs must be checked and signed into the controlled drug
       registers (at each PCC site) by 2 members of staff (e.g. GP + receptionist); including batch
       numbers and expiry dates
      New stock must also be recorded on the Adastra Stock Management System
      controlled drugs must be stored in the double locked security cabinets (conforming to
       British Standard BS2881) at each PCT site; the controlled drugs cabinet key to be kept
       locked in the PCC key safe at all times when not in use
      Access to the controlled drugs cabinet to be restricted only to those who can lawfully be in
       possession of controlled drugs (GP, pharmacist, registered nurse)
      controlled drugs must not be stored in the Vehicle drugs box unless they are being
       transported to another PCC site or a patients home for clinical use
      All controlled drugs receipts, prescriptions and stock movements must be recorded in the
       controlled drugs register at each site; entries should be made in black indelible ink. It must
       include name of drug, dosage and type of administration and signed by two members of
       staff-one of whom must be a clinician authorised to issue controlled drugs
      Out of date controlled drugs must be stored separately in the controlled drugs cupboard but
       must not be removed from the running total from the register until they are ready to
       be transported back to HQ for disposal
      All incidents involving controlled drugs (shortfalls, breakages etc) must be reported to the
       AO




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                     24
                                                                                     Appendix A

                               Supplier Contact Details



Supplier Name          Address                    Contact details                 Supplies
Kent.Pharmaceuticals   Kent    Pharmaceuticals    Tel: 01233 638614               Majority of drugs
Limited                Ltd                        Fax: 01233 646899
                       Wotton Road                Email:
                       Ashford                    hospitals@kentpharm.co.uk
                       Kent
                       TN23 6LL

R P S Heer             Heer Pharmacy              Tel: 01753 526722               Catheter equipment,
                       16 Chalvey Road West       Fax: 01753 538354               Controlled    Drugs,
                       Slough                                                     urgent      supplies
                       Berkshire                                                  needed     at    late
                       SL1 2PN                                                    notice
Williams.Medical.      Williams         Medical   Tel: 01685 846666               Mainly stock items
Supplies               Supplies Ltd               Fax: 01685 844725               for the Urgent Care
                       Craiglas House             Email: sales@wms.co.uk          Centre occasionally
                       The Maerdy Industrial                                      small drug orders
                       Estate
                       Rhymney
                       Gwent
                       NP22 5PY
Barrier Healthcare     Barrier Healthcare         Tel: 01427 787828
                       Britannia Mill             Fax: 01427 787848
                       Upton Road                 Email:
                       Kexby                      sales@barrierhealthcare.co.uk
                       Lincolnshire
                       DN21 5NF




EBPCOOH/CG/IR/MB/SW
Medicines Management Policy                      25
                                                                                      Appendix B

                  Stock Re Order levels

                  CC = Call Centre
                  H/W = Heatherwood Primary Care Centre
                  SL = Herschel Medical Centre
                  ST M = St Marks Hospital Primary Care Centre
                  UCC = Maidenhead Urgent Care Centre


                                                           Pack       C/C       H/W       S/L       ST/M   UCC
                         Medicine                          size

aciclovir tablets 800mg                                      35       4     2         2         2

adrenaline acid tartrate injection 500 micrograms/0      individual   4     2         2         2

amoxicillin capsules 250mg                                   21       29    12        12        12

amoxicillin capsules 500mg                                   21       12    4         4         4

amoxicillin oral suspension 125mg/5ml                     100mls      30    8         8         6

amoxicillin oral suspension 250mg/5ml                     100mls      12    6         4         4

aspirin dispersible tablet 300mg                             32       3     2         2         2

atropine sulphate injection 600 micrograms/1ml           individual   5     3         3         3

atrovent UDVs nebuliser solution 250 micrograms/1ml      individual   11    10        10        10
benzylpenicillin powder for solution for injection 600                5     2         4         2
mg                                                       individual
Catheter Female                                          individual   2     2         2         2

Catheter Male                                            individual   2     2         2         2

cefalexin capsules 500mg                                     21       15    8         8         6

cefalexin suspension 125mg/5ml                               27       6     4         3         4

cefalexin suspension 250mg/5ml                            100mls      12    3         3         4

cefalexin capsules 250mg                                  100mls      12    8         8         8

ceftriaxone injection 250mg                              individual   4     4         4         2

cetrizine tablets 10mg                                       7        4     2         2         2

chlorphenamine injection 10mg/ml                         individual   4     4         3         3

chlorphenamine oral solution 2mg/5ml                      150mls      10    3         3         3

chlorphenamine tablets 4mg                                   28       6     4         4         4

chlorpromazine tablets 25mg                                  28       3     1         1         1

co-amoxiclav oral suspension 125mg + 31mg/5ml               100       10    2         2         4

co-amoxiclav tablets 250mg + 125mg                           21       10    2         4         3

co-amoxiclav tablets 500mg + 125mg                           21       10    2         2         2

cyclizine lactate injection 50mg/1ml                     individual   5     4         4         4

dexamethasone sodium phosphate injection 4mg/1ml         individual   2     4         4         4

Dexamethasone tablets 2mg                                             7     1         2         2

diamorphine hydrochloride injection 10mg                 individual   0     0         0         0

diamorphine hydrochloride injection 30mg                 individual   0     0         0         0

diazepam rectal tubes 5mg                                individual   4     2         2         2

diazepam tablets 5mg                                         10       41    4         4         4

diclofenac sodium enteric coated tablets 50mg                58       12    4         4         4

diclofenac sodium injection 25mg/ml                      individual   11    5         5         4



    EBPCOOH/CG/IR/MB/SW
    Medicines Management Policy                              26
                                                       Pack       C/C       H/W       S/L       ST/M   UCC
                                                       size
                       Medicine

Diclofenac sodium suppository 100mg                  individual 5       5         7         5
                                                                  12    4         4         4
dihydrocodeine tablets 30mg                             28
                                                                  30    6         6         6
dioralyte sachets (blackcurrent)                     individual
                                                                  30    6         6         6
dioralyte sachets (citrus)                           individual
                                                                  9     7         7         7
domperidone suppository 30mg                         individual
                                                                  6     2         2         2
domperidone tablets 10mg                                30
                                                                  10    4         4         3
erythromycin enteric coated tablets 250mg               28
erythromycin ethylsuccinate sugar-free suspension                 6     3         3         3
125mg/5ml                                             100mls
erythromycin ethylsuccinate sugar-free suspension                 6     3         3         3
250mg/5ml                                             100mls
                                                                  10    4         4         2
flucloxacillin capsules 250mg                           28
                                                                  10    4         2         2
flucloxacillin capsules 500mg                           28
                                                                  5     3         2         3
furosemide injection 20mg/2ml                        individual
                                                                  3     2         2         2
furosemide tablets 40mg                                 28
                                                                  4     2         2         2
Gaviscon extra strength tablets                         24
                                                                  1     1         1         1
glucagon injection 1mg                               individual
                                                                  3     3         3         3
Glucogel gel 25g (hypostop)                          individual
                                                                  19    7         7         7
glycerol suppository 4mg                             individual
                                                                  3     1         1         1
glyceryl trinitrate aerosol spray                    individual
                                                                  2     2         2         1
haloperidol injection 5mg/ml                         individual
hydrocortisone sodium phosphate injection                         5     3         3         3
100mg/1ml                                            individual
                                                                  11    4         8         6
hyoscine butylbromide injection 20mg/1ml             individual
                                                                  10    4         4         4
hyoscine butylbromide tablets 10mg                      20
                                                                  10    5         5         4
hyoscine hydrobromide injection 400 micrograms/1ml   individual
                                                                  10    8         8         8
ibuprofen syrup 100mg/5ml                             100mls
                                                                  6     2         2         2
ibuprofen tablets 200mg                                 24
                                                                  9     2         2         2
Instillagel 6ml                                      individual
                                                                  9     2         2         2
Instillagel 11ml                                     individual
                                                                  1     1         1         1
KAY-CEE-L sugar free syrup                            500mls
                                                                  10    2         2         2
lansoprazole 30mg                                       28
                                                                  5     1         2         1
levomepromazine injection 25mg/ml                    individual
                                                                  3     2         2         2
levonorgestrel tablets 1500 micrograms                   1
                                                                  6     2         2         2
loperamide capsules 2mg                                 30
                                                                  16    8         7         8
metoclopramide injection 10mg/2ml                    individual
                                                                  10    3         2         2
metoclopramide tablets 10mg                             28
                                                                  9     7         7         4
Microlax Enemas                                      individual
                                                                  4     4         4         4
metronidazole tablets 400mg                             21
                                                                  5     4         2         4
midazolam injection 10mg/2ml                         individual
                                                                  0     5         5         5
morphine sulphate injection 10mg/1ml                 individual


    EBPCOOH/CG/IR/MB/SW
    Medicines Management Policy                          27
                                                         Pack       C/C       H/W       S/L       ST/M   UCC
                       Medicine                          size
                                                                    0     5         5         5
morphine sulphate injection 30mg/1ml                   individual
                                                                    5     2         2         1
naloxone hydrochloride injection 400 micrograms/1ml    individual
                                                                    8     4         3         4
naproxen tablets 500mg                                    28
                                                                    5     4         4         4
oramorph oral solution 10mg/5ml                         100mls
                                                                    0     0         0         0
oxycodone hydrochloride injection 10mg.1ml             individual
                                                                    12    6         6         5
paracetamol sugar-free suspension 120mg/5ml             100mls
                                                                    19    7         7         7
paracetamol suppository 120mg                          individual
                                                                    12    6         6         6
paracetamol suspension 250mg/5ml                        100mls
                                                                    12    5         5         5
paracetamol tablets 500mg                                 32
                                                                    6     3         4         4
penicillin v sugar-free oral solution 125mg/5ml         100mls
                                                                    6     4         4         4
penicillin v sugar-free oral solution250mg/5ml          100mls
                                                                    12    4         4         3
penicillin v tablets 250mg                                28
                                                                    0     2         5         5
pethidine injection 50mg/1ml                           individual
                                                                    12    4         4         4
prednisolone coated tablets 5mg                           28
                                                                    10    6         6         6
prednisolone soluble tablets 5mg                          30
                                                                    30    4         4         5
prochlorperazine maleate buccal tablets 3mg               20
                                                                    10    6         6         6
prochlorperazine maleate tablets 5mg                      28
                                                                    21    6         6         5
prochlorperazine mesilate injection 12.5mg/1ml         individual
                                                                    3     2         1         2
procyclidine tablets 5mg                                  28
                                                                    10    3         4         4
pulmicort respules nebuliser suspension 0.5mg          individual
                                                                    20    8         8         8
salbutamol cfc free inhaler 100 micrograms             individual
                                                                    5     4         3         2
salbutamol injection 0.5mg/ml                          individual
                                                                    21    10        10        10
salbutamol unit dose nebulising solution 2.5mg/2.5ml   individual
                                                                    21    10        10        10
salbutamol unit dose nebulising solution 5mg/2.5ml     individual
                                                                    3     3         3         3
sodium chloride injection 0.9%                         individual
                                                                    4     2         2         2
sofradex ear/eye drops                                  10mls
                                                                    10    5         5         5
Steripod                                               individual
                                                                    15    6         6         4
tramadol capsules 50mg                                    30
                                                                    11    4         4         4
tramdol injection 100mg/2ml                            individual
                                                                    20    4         4         3
trimethoprim tablets 200mg                                14
                                                                    8     2         2         2
Uriotainer                                             individual
                                                                    10    4         5         3
water for injections 5ml                               individual
                                                                    10    4         5         6
water for injections 10ml                              individual




    EBPCOOH/CG/IR/MB/SW
    Medicines Management Policy                            28

								
To top