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JoggingJune 15 2016

The Royal Pharmaceutical Society has published new guidance on prescribing specials medicines, updating the resources first published in 2011. The latest resource introduces case studies to illustrate the sort of challenges that must be met to ensure that patients receive optimal treatment.

Other revisions reflect regulatory changes, such as the update to the Medicines and Healthcare products Regulatory Agency Guidance Note 14 on the supply of specials, as well as changes in clinical practice and the requirements that the changing NHS environment presents.

“Decisions about the prescribing of specials rely heavily on professional judgment based on understanding individual patient need. To reflect this, the guidance is based around five principles that can be used to guide prescribing decisions; the principles are illustrated by case studies,” said the Society.

The five principles for prescribing specials are:

• establishing the optimal treatment for the patient
• understanding the patient’s experience and making a shared decision
• identifying medicines and preparations
• monitoring and reviewing the prescription
• ensuring effective prescribing governance.

“We encourage prescribers and pharmacists to work together to ensure that patients are prescribed specials appropriately and are supported to adhere to their treatment. This is particularly important when patients are moving between care settings.”

It notes that: “Prescribers and pharmacists both have a responsibility to ensure that where specials are prescribed they are the most appropriate choice and patients are supported to use them effectively.”

Case studies include learning points such as:

• the need for the prescriber to consider all options available to their patients before prescribing and supplying a special, as a licensed product may be suitable
• ensuring that the responsibility for prescribing and/or supplying a specials medicine is transferred, for example between a hospital setting and primary care, with full information about the medicine being transferred, too
• the need to regularly review specials prescribing as the patient’s needs may change or a licensed product may become available.

The guidance has been endorsed by the Royal College of Nursing, the Royal College of General Practitioners and the Academy of Medical Royal Colleges. The Society published its revised guidance for pharmacists on the procurement and supply of specials in 2015.

Links:

RPS announcement

RPS ‘Prescribing Specials Guidance for the prescribers of Specials’ June 2016

MHRA guidance note 14

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