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 Introduction


INTRODUCTION

 

The aim of the formulary

The main aim of this formulary is to promote safe, evidence-based, cost-effective prescribing. Limiting the range of medicines included in the formulary and promoting the use of generic medicines where appropriate:-

  • Enhances safety through familiarity with the medicines in use by all healthcare staff involved in the prescribing, dispensing and administration of medicines.
  • Ensures efficient use of NHS resources.

 

Development of the formulary

The formulary includes decisions made by the Area Prescribing Committee Oxfordshire (APCO). APCO meetings are held every two months. The Committee consists of GPs, representatives from the OCCG Medicines Optimisation team and representatives from healthcare providers across Oxfordshire particularly Oxford University Hospitals NHS Foundation Trust (OUHFT), Oxford Health NHS Foundation Trust (OHFT), Local Medical Committee and Local Pharmaceutical Committee. APCO considers new drugs and prescribing guidelines and provides recommendations on prescribing and medicines optimisation across the Oxfordshire Health Economy. The group considers any new NICE guidance including drugs. Following ratification by the Clinical Ratification Group (CRG), the key decisions from each APCO meeting are circulated as Bullet Points. APCO classifies drugs according to the local ‘Traffic Light’ system. All APCO decisions are dated within the individual product entry.

The Traffic Light Prescribing Classification in Oxfordshire provides information on restrictions on prescribing certain drugs across the whole health economy and all providers are contractually obliged to adhere to them.

 Red Traffic Light

Red: Medicines which should only be prescribed in secondary care by a specialist.  

 Amber Traffic Light 

Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred.   

 Amber Traffic Light 

Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must approved by the Area Prescribing Committee Oxfordshire (APCO).

 Green Traffic Light

Green: Medicines which are suitable for initiation and ongoing prescribing within primary care.   

 Brown Traffic Light 

Brown: Medicines which should only be prescribed in restricted circumstances.  

 Black Traffic Light

Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.

 

How should the formulary be used?

Formulary drugs, including the range of approved preparations for each drug, are listed according to the BNF classification system. Unlicensed drugs and preparations approved for use are included in the most relevant section.

First, second, and occasionally third line drugs are indicated where appropriate. First line drugs should be used unless there is a contraindication, the patient has suffered an adverse effect, or has not responded to the first line drug.

Non-formulary drugs should not be prescribed. Patients who are currently on a non-formulary drug, but were started within the NHS before this formulary was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop. If clinically appropriate patients on non-formulary drugs should be switched to drugs within the formulary.

There are currently several chapters which are still under review and will be finalised shortly. All APCO Traffic Light classifications have been captured within the formulary.

If a new drug has not been considered by APCO or further information is required it will be classed as non-formulary until a submission is made.

The formulary is not intended to replace the BNF or Summaries of Product Characteristics (SPC) which will need to be referred to for information on licensed indications, contraindications, cautions, side-effects, interactions and dosage etc. Hyperlinks are available to BNF, BNFc and to the SPC within the individual product entry.

 

How often will the formulary be updated?

The formulary will be updated every two months after APCO meetings.

 

 

If you have any comments or queries please email occg.medicines@nhs.net.


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