Paul Fieldhouse (PF) - Chief Pharmacist & Clinical Lead for Medicines Optimisation (NLaG) (Chair) Jim Devlin (JD) – Medicines and Therapeutics Committee Chairman (NLaG) Dr Chathley, General Practitioner (North East Lincs) Paulash Haider (PH) - Procurement Pharmacist (NLaG) John Harper (JH) – Care Plus Group Margaret Henry (MH) - North East Lincolnshire Community Representative for Prescribing Andy Karvot (AK) – Consultant Pharmacist Antimicrobials (NLaG) Miss G Kaur (GK) – Consultant Surgeon Gemma McNally (GM) – Strategic Lead Pharmacist (NECS) Dr Ramesh, General Practitioner (North East Lincs) Dr Neveen Samuel (NS) – Prescribing Lead for Lincolnshire CCG Sarah Spooner (SS) – Clinical Lead Care Plus Group Hazel Tait (HT) - Assistant Contracts Manager (NLaG) Mrs Aliya Turk (AT) – Professional Secretary APC In Attendance: Joanne Rowson, Pharmacy Secretary (NLaG) Dr Dadiras, Consultant Rheumatologist – attended for item 7ii 2 Apologies Apologies were received from: Elizabeth Barron (EB) – RDash Mr Stuart Goddard (SG) – Head of Contracts & Provider Management (NLCCG) Dr Kasaraneni (KK) – Local Medical Committee Rachel Staniforth (RS) – Senior Pharmacist, North East Lincolnshire (NECS) 3 Declarations of Pecuniary Interest There were no declarations of financial interest. 4 Minutes of Previous Meeting and Matters Arising The minutes of the previous meeting held on 9 March 2017 were taken as read and accepted as a true record. Matters Arising Professional Secretary Update – Aliya Turk was introduced to the members present. Emollient Recommendations – GMc reported that this has been delayed. Post meeting note: Remove from agenda and will pick this up with Chapter 10 Review. Updates to Primary Care Antimicrobial Guidance Methenamine Hippurate – new line request submitted by Andy Karvot but sponsored by Cowling, Consultant Microbiologist. Evidence is somewhat weak but was
Review of the use of NOACs – Gemma McNally and Paulash Haider had discussed this. A range of novel oral anticoagulants are in use across the health economy. A strategy for the use of NOACs reflecting latest published evidence is required for discussion at a future APC. Action: PH Chapter 11 –It was agreed to request Mr Kotta to provide any final comments on Chapter 11. Action: AT Lurasidone – checking NAVIGO support the inclusion of lurasidone for prescribing in specialist care only. Action:AT NL CCG Prescribing formulary changes agreed at Engine Room - Net-formulary presentation of the formulary will be able to reflect preferred products proposed by CCGs. Co-Amoxiclav Prescribing in Primary and Secondary Care – Urgent Care departments have reviewed antimicrobial choice to encourage more appropriate prescribing of co-amoxiclav. The Trust has purchased an information tool called Refine which can provide reports on drug use. Supply of medication from outpatients – The outpatient departments have been requested to review any letters that suggest patients should contact their GP for medicines supply to make it clear that medicines are not required “immediately” and should be requested in line with their GP’s normal procedures NEL Continence formulary – final comments to be gathered for the next meeting. Joanne Rowson to re-circulate. Action: JR Eye-Com – update on minutes of previous meeting. Terms of Reference – Minor changes to the Terms of Reference were agreed. Paul Fieldhouse will continue as chair. The updated terms of reference will be published on the APC website Action: JR Colostomy bags – not discussed Formulary annotation will be added for Cinacalcet/Specialist Endocrinology Services – not discussed. 5 APC Working Arrangements NICE TA & NG Updates (March/April). NICE guidance discussed: IPG578 Noted NG68 Noted TA440 Not recommended by NICE