is not used to represent the route of administration. It is paramount that you are aware of the formal abbreviations in use and not colloquial, historical interpretations or slang. This is explored further in Chapter 4 of this book, Medicines Management and the Role of the Healthcare Provider.
Electronic Medicines Compendium
The electronic medicines compendium (emc) contains up‐to‐date, easily accessible information about medicines licensed for use in the UK and can be found at www.medicines.org.uk/emc. The emc has more than 14 000 documents, all of which have been checked and approved by either the UK or European government agencies which license medicines. These agencies are the UK MHRA and the European Medicines Agency (EMA). The emc is updated continually and you are able to browse for medicines, or active ingredients, using the A–Z buttons. The emc contains regulated and approved information on medicines available in the UK including:
1 Summaries of Product Characteristics (known as SPCs or SmPCs).A SmPC informs healthcare professionals on how to prescribe and use a medicine correctly. A SmPC is based on clinical trials that a pharmaceutical company has carried out and gives information about dose, use and possible side effects. A SmPC is always written in a standard format.
2 Patient Information Leaflets (PILs, Package Leaflets or PLs).A PIL is the leaflet that is included in the pack with any medicine. The PIL is a summary of the SmPC and is written for patients.
3 Risk Minimisation Materials (RMMs).RMMs are resources for healthcare professionals that aim to optimise the safe and effective use of a medicine. RMMs can come in a number of forms, such as educational programs, prescribing or dispensing guides, patient brochures, or alert cards.
4 Safety Alerts.Safety alerts are issued by the Regulator and/or marketing authorisation holder and contain important public health messages or safety critical information about a medicine.
5 Product Information.This is any additional information about a product. It may include important information such as change of packaging or issues related to stock levels.
Within the emc, there are also audio and video resources that provide additional information in a user‐friendly manner, promoting the safe an effective use of a medicine. For example, a video clip may demonstrate how to administer a certain medicine correctly.
What can be prescribed on an NHS prescription?
There are hundreds of medicinal products and devices (or appliances) available to treat and manage illnesses, conditions and diseases. A medicinal product is defined as an item which is not considered to be appliance and could be a drug, food, toiletry or type of cosmetic (Pharmaceutical Services Negotiating Committee (PSNC) https://psnc.org.uk/dispensing‐supply/dispensing‐a‐prescription/medicinal‐products). An approved medical device will carry the CE mark (Conformité Européene), which signifies that it conforms to the appropriate regulatory standards. Not all of these medical products, devices or appliances are available from the NHS. On receiving a prescription, pharmacy staff will check whether or not an item is allowed to be prescribed on the NHS prior to dispensing using the Drug Tariff.
The Drug Tariff
The Drug Tariff is produced monthly by the Pharmaceutical Directorate of the NHS Business Services Authority and the NHS Prescription Services for the Secretary of State. It is supplied primarily to pharmacists and doctor's surgeries and is available in print and online; any healthcare professional can view the most up‐to‐date online version. Only fully licensed and approved medications and devices, found on the Drug Tariff, can be prescribed within the NHS (unless for research purposes). Information on the Drug Tariff can be found on either the PSNC or the NHS Prescription Services websites. Within each of these sites you will find information on how to use the Drug Tariff, the Drug Tariff Preface and the information within the different Parts of the Drug Tariff. The Drug Tariff Preface is an important section as each month as it contains valuable information on additions, deletions and any other alterations to the Drug Tariff.
What The Drug Tariff does
The Drug Tariff outlines information such as:
what will be paid to pharmacies for the NHS services provided (for example, the cost of drugs and appliances supplied against an NHS prescription);
rules that need to be followed when dispensing items;
drug and appliance prices.
How to tell if a medicinal product is allowed on prescription
The ‘blacklist’ can be found in Schedule 1 to the NHS Regulations 2004 and is found in the Drug Tariff (part XVIIIA); it is a list of medicinal products which cannot be prescribed on the NHS. Any medicinal product not on the ‘blacklist’ can be prescribed on the NHS. Whiskey, for example, is not on the blacklist, so a prescription for this item would be passed for payment by NHS Prescription Services. The prescriber may, however, be questioned during the auditing process about the appropriateness of prescribing this item at NHS expense. As a general rule, if a branded (proprietary) product is listed on the ‘blacklist’ it cannot be prescribed on the NHS. Many of the medicinal products on the ‘blacklist’ are available over the counter for people to buy, while some do not have enough evidence to show their efficacy.
The PSCN flow chart (Figure 2.4) can be used to help identify whether an item is allowed to be dispensed on an NHS prescription form. Different practitioners may use different prescription pads or resources (seen below as FP10, FP10SS, FP10SP*).
If a medicinal product, or device, is prescribed that is not on the Drug Tariff, it cannot be dispensed.
Skills in practice
Go to the Drug Tariff (https://www.nhsbsa.nhs.uk/pharmacies‐gp‐practices‐and‐appliance‐contractors/drug‐tariff) and see which of the following products are blacklisted and should not be prescribed on the NHS.
ferrous sulfate compound tablets BP
Gaviscon granules
Lemsip flu strength
senokot tablets.
Figure 2.4 How to determine if a drug or devise can be prescribed on the NHS.
Other guides to prescribing
The Joint Royal Colleges Ambulance Liaison Committee (JRCALC) clinical guidelines
The Joint Royal Colleges Ambulance Liaison Committee Clinical (JRCALC) Guidelines is a helpful resource for paramedics and other healthcare
