Stoma Additional Products Savings Guidance

Transcription

1 Stoma Additional Products Savings Guidance Stoma care additional products (also known as ancillary products) are prescribed for individual patients to help prevent sore skin and other problems developing with the stoma. As part of the agreed MOP savings plan 17/18 practices are asked to implement the changes identified below to ensure patients are prescribed formulary choice stoma care additional products, please note this guidance only includes the stoma additional products and not the pouches etc. The most cost effective products have been selected on the advice and experience of the local stoma nurses. To help achieve the potential savings as soon as possible practices are encouraged to make the changes in Table ONE by the end of February For ancillary products on repeat, please follow the guidance below: The CCG IT team has developed searches for SystmOne to enable practices to identify non-formulary stoma additional products, to find the searches go to: Clinical reporting system > Dorset Systmone GP s folder > Dorset shared reports > Stoma DCCG Medicines Management For (see page 3) there is the option to run separate searches for each product category or a combined search. The combined search is named Table 1 *All Non- Formulary Stoma Appliances - this will search for all items in. Once patients have been identified from the searches, review to ensure patients are using the products for stoma care and then change non- formulary items to the Formulary choice listed in table one. Remove the non-formulary item from the patient s medication repeat list. Please ensure the correct size and monthly quantity is issued on the prescription (these are in -end column). If the GP practice, feel the patient is regularly over-ordering the stoma nurse should be contacted to follow this up (details on pg. 2). If the patient is unhappy with the change, please refer to the stoma additional products formulary here to select an alternative formulary choice product or contact the stoma clinic. Each patient should be issued with a patient letter informing them of the change (appendix 1). A record of this should be made in the patients notes. Practices are asked to complete the changes in Table ONE as soon as possible. For Table Two Reports are only available separately. Please review items in Table two for appropriate quantities, items will NOT need to be changed. For Table Three there is the option to run separate searches for each product category or a combined search. The combined search is named Table 3 *All Non- Formulary Stoma Appliances this will search for all items in Table Three. All items in Table 3 are non-formulary and prescribing would not be expected in primary care. Please refer patient back to the appropriate stoma clinic. Stoma products should be issued on a separate FP10 prescription to the patient s regular medication. Stoma FP10 prescriptions should be sent to the patients nominated dispensing organisation for stoma products (this may be different from the patients regular dispensing organisation). 1

2 If a practice has a patient receiving non-formulary stoma items and/or large quantities and has not had a recent review, the patient should be referred to their local stoma clinic (Poole General Hospital, Royal Bournemouth & Christchurch Hospital or Dorset County Hospital) The patient may also self-refer. To refer patients, contact the relevant stoma clinic via or telephone, using the contact details in the table below. Acute trust Lead contact Telephone & Dorset County Hospital NHS Foundation Trust Royal Bournemouth and Christchurch Hospitals Poole Hospital NHS foundation Trust Vikki Andrews Lead Nurse, Stoma Care Team Carla McDonald Stoma Nurse Specialist Tracy Lees Stoma Nurse Specialist Telephone: : Ext: stomacare@dchft.nhs.uk Telephone: stoma.care@rbch.nhs.uk Telephone: stoma.care@poole.nhs.uk For queries relating to Systmone searches please contact Lucie Barton, Medicines Management Technician, NHS Dorset CCG on Lucie.barton@dorsetccg.nhs.uk 2

3 TABLE ONE Please use the table below to help with changing products to a suitable formulary choice. Product Category Run SystmOne search named: If non- formulary items are identified from the relevant search CHANGE to the formulary choice below Manufacturer Pack size Average monthly quantity (Check repeat prescription does not exceed recommended amount) Adhesive Remover Sprays Dansac EasiSpray adhesive remover Code: Dansac Ltd 50ml 1-4 bottles per month Table 1 Adhesive remover sprays (Individual Adhesive Remover Wipes search) Table 1 Adhesive remover wipes (Individual Salts Adhesive Remover Wipes. (Formerly WipeAway Plus adhesive remover) Code: WAP2 Salts Healthcare X packs per month Barrier Wipes Salts Barrier Film Wipes Salts Healthcare X packs per month Table 1 Barrier Wipes (Individual (Formally Peri-Prep sensitive no sting protective film wipes) Code: PPS1 This search will also include barrier sprays. It has been agreed with the stoma nurses that patients on sprays can be changed to barrier wipes. Please note: Barrier sprays may be used on wounds. Please ensure any changes are for stoma use only. 3

4 Product Category Filler/Sealing Paste Run SystmOne search named: Table 1 Filler paste (Individual If non- formulary items are identified from the relevant search CHANGE to the formulary choice below Soft Paste Code: Manufacturer Pack size Average monthly quantity (Check repeat prescription does not exceed recommended amount) Dansac Ltd 50g 1-2 tubes per month The following items have an Amber status on the formulary. These items should only be started by a stoma specialist nurse and then prescribing may continue in primary care. If non formulary items have been identified from the searches please change to the formulary choice below; these have been agreed with the stoma nurses. Please ensure appropriate quantities are prescribed and over-ordering does not occur. Deodorising Spray Solidifying agents Lubricating Deodorant Table 1 Deodorising sprays. (Individual Table 1 Solidifying Agents (Individual FreshAire Code: FA1 OstoSorb gel 3g sachets Code: PFW5 Adapt Lubricating deodorant Salts 50ml 1 per month Respond Healthcare X30 1 per pouch change. (Patients use these long term) Hollister 236ml 1 squirt/sachet per pouch change Code: Adapt Lubricating Sachets Hollister X50 of baby oil or Table 1 Lubricating Deodorant (Individual Code: Only use after a trial alternative simple measures. 4

5 Product Category Run SystmOne search named: If non- formulary items are identified from the relevant search CHANGE to the formulary choice below Manufacturer Pack size Average monthly quantity OstoZyme multi (odour Ostomart Ltd 300ml Neutralising Lubricating Gel) Code: TCB6 (Check repeat prescription does not exceed recommended amount) Useful Tip: When issuing a new formulary product check the correct product code is selected (these are listed under each item in table one) N.B If the recommended formulary choice from table one is not available (due to manufacturing/stock problems) please select a replacement formulary choice found here. 5

6 TABLE TWO The following items are Amber status on the formulary. These items should only be initiated by a stoma specialist nurse; these items will NOT need changing to the formulary choice. However please review and ensure appropriate quantities are prescribed and over-ordering does not occur. Product Category Run SystmOne search named: Average monthly quantity (Check repeat prescription does not exceed recommended amount) Other Paste (abase Paste) Protective Powder (including ahesive) Table 2 Other paste Table 2 Protective Powder 1-2 Per month No change needed. Should only be a recurring item for patients with prolapsed stoma. Normally supplied by stoma nurse. Refer patient to stoma nurse if requested long term. 1 per month (No change needed) Short term use only Refer patient to stoma nurse if requested long term. Flange Extenders Table 2 Flange Extenders 1-3 strips per pouch change. (No change needed, review quantities prescribed) Refer to stoma nurse if more than the recommended amount is used. Appliance Belts Table 2 Appliance Belts 3-6 per year (No change needed. Review quantities prescribed). Refer to stoma nurse if more than 6 belts are ordered in a year. 6

7 TABLE THREE The following items are non-formulary and prescribing in primary care would not be expected: Underwear (except for hernia support underwear which is considered Amber Skin Cleansers and Washes Stoma Filters Liquid or aerosol adhesives (only sprays and wipes are formulary choice) Stoma barrier creams If a patient is requesting these items refer to the appropriate stoma clinic. Run SystmOne search named Table 3 * All non-formulary to identify these patients (there is also the option to run these reports separately). NB: Please check these items are being issued for Stoma care patients before referring to the Stoma clinics. To refer patients, contact the relevant stoma clinic via or telephone (See contact details on page 2). Useful Tip- If you are having problems identifying stoma additional products within the patient s medication list please follow the points below. Once the search has been run, retrieve your patient from the report Go back into the report (leaving the patient active) Close the patient list Right click on the report and click on run on current patient Click on expand all nodes button (this will show the matching clinical entry i.e. what product was identified from the search). 7

8 (Appendix 1) [practice logo] [practice address] [practice address] [practice address] [practice address] Tel: [practice telephone] [Practice website] [date] Dear [patient s name] NHS Prescriptions for stoma accessories. The practice is currently reviewing the prescribing for stoma accessories. Any change to your prescription has been made to help doctors ensure you are prescribed high quality products whilst making the most cost effective use of available resources. The products and quantities have been agreed with the help of the specialist stoma nurses across Dorset. Next time you receive a prescription for your stoma accessory, you may notice the item is from a different manufacturer however this should not affect its use. Please finish your existing supply before starting the new stoma accessory. This will not affect your pouch prescription. Please note your Dispensing Appliance Contactor must receive the prescription PRIOR to the delivery of the items. Should you have any queries, please do not hesitate to contact the practice. Yours sincerely [name of GP] [name of practice] 8