The aim of the Formulary is to advise clinicians on evidence based drug treatments (which are cost and clinically effective) and commonly encountered in clinical practice.
The vast majority of prescribing in Mental Health both in primary and secondary care should be covered by this Formulary, together with an approved list of physical health medicines. The Formulary advises on the appropriate positioning of drugs in the treatment of mental health conditions.Compliance rates with the Formulary are fed back at Team level to Clinical Directorates on a regular basis.
All drugs should be prescribed generically unless a particular preparation needs to be specified because of variations in bioavailability between different brands, these are identified in the Formulary.It is recognised that on occasion non-formulary items will be legitimately requested although in such circumstances Pharmacists may seek a rationale from the prescribing clinicians. Licensed products should be used wherever possible.
It is anticipated that this Formulary will evolve through debate and suggestion and as new drugs become available.Requests for amendments to the formulary can only be made by consultant psychiatrists and should be made by submitting the Application to Amend the Formulary Form.Genuine ownership of the Formulary by clinicians in The Trust who prescribe for people with mental health problems will help to refine it and enhance its relevance to everyday clinical practice.
A price banding system has been included; the aim of the banding is to give the prescribing clinician an idea of the cost.The costs have been calculated using May 2011 Drug Tariff prices (the cost to primary care).Prices are for oral, immediate release preparations, 28 days supply at the highest BNF dose.Clinicians should note from this information that differences between formulations of the same drug can be significant as medicines come off Patent e.g. XL formulations, patches, orodispersible products
Each drug has been colour coded: green means any clinician can prescribe, amber means it is appropriate for all clinicians but must be initiated by a specialist before shared care is considered & red means specialist services only.
Essential Shared Care Agreements have been agreed for deployment in certain areas.
The National Patient Safety Agency has published a Reduction of Self Harm and High Risk Drugs Guidance.
The Royal College of General Practitioners and Secure Environments Pharmacists Group have published guidance on Safer Prescribing in Prison.
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