Operation of the Formulary

Drugs listed are available for general prescribing unless specific restrictions are indicated.

Drugs which are not listed in the formulary will be obtained only in the following circumstances:

Patients receiving a non-formulary drug on admission

Treatment with a non-formulary drug may be continued in this case. Patients’ own supplies should always be used before requesting a supply from pharmacy and it should be borne in mind that there may be a delay in obtaining a non-formulary drug. An appropriate alternative should be considered in situations where treatment may otherwise be interrupted.

An admission to hospital represents an opportunity to review a patient’s existing drug therapy and, if appropriate, treatment may be changed to a drug that is on the Trust formulary.

Compassionate Request – Drugs required for a specific patient in exceptional circumstances

Any drug which is not on the Trust formulary and which is required before the date of the next DTC meeting may be requested using the Drugs and Therapeutics Committee procedure for Urgent/Compassionate use.

Such an application will be considered for “one-off” occasions of drug use. A full application must be made for drugs which are required for addition to the formulary (see below).

Additions to the Trust Medicines Formulary and DTC Meetings

The addition of new drugs to the formulary, and consequently to pharmacy stock, will be made only with the agreement of the Drugs and Therapeutics Committee. In order to request an addition to the formulary, a DTC Medicines Formulary request form must be completed in full and supporting evidence attached.

DTC applications must be received in pharmacy at least 2 weeks before the date of a DTC meeting in order for the item to be included in the agenda. DTC meetings are held every 2 months.

Drug Supply and Expenditure

Patients’ own medicines should be obtained and used before any drug is requested from pharmacy.

The Trust and local PCTs have agreed that a medicines supply of 2 – 4 weeks should be prescribed on out-patient and discharge prescriptions.

It should be noted that items prescribed on FP10(HP) forms and dispensed in a community pharmacy are charged to the Trust. Therefore the rules with regard to Trust formulary prescribing and length of treatment must be followed. Prescriptions should be issued from out-patient clinics only when drug treatment is required to start immediately. In all other circumstances treatment recommendations should be communicated to the patient’s GP using the out-patient clinic communication form. Patients should be encouraged to keep up to date with their usual medication supplies and informed that these may not be supplied from out-patient clinics.

A breakdown of drug expenditure (including FP10 expenditure) is regularly reported to each Division. Non-formulary and other inappropriate prescribing will be identified and reported to the Divisional leads.