Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - March 2017

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of March 2017. This month there are two guidelines that impact upon primary care.

The Stroke and transient ischaemic attack in over 16s clinical guideline has been updated to give a definition of aspirin intolerance, rather than a link to a definition. The guideline covers interventions in the acute stage of a stroke or transient ischaemic attack (TIA). It offers the best clinical advice on the diagnosis and acute management of stroke and TIA in the 48 hours after onset of symptoms, although some interventions of up to 2 weeks are covered as well.

The Familial breast cancer clinical guideline has been updated after a review of the evidence for chemoprevention for women with no personal history of breast cancer. The guideline covers care for people with a family history of breast, ovarian or another related (prostate or pancreatic) cancer. It aims to improve the long-term health of these families by describing strategies to reduce the risk of and promote early detection of breast cancer (including genetic testing and mammography). It also includes advice on treatments (tamoxifen, raloxifene) and surgery (mastectomy).

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

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Prescription Charges for 2017

The Department of Health announced in March that the price for an NHS prescription in England will increase by 20p to £8.60 with effect from the 1st April 2017.

The prices for 3 and 12 month pre-payment certificates are frozen and have remained the same at £29.10 and £104 respectively. For anyone requiring more than 3 items in 3 months or more than 12 in a year these certificates can provide significant savings.

Other NHS charges such as for dental work, wigs and fabric supports are also being increased in line with inflation.

Action: Clinicians should be aware of the current prescription charge and also the value for money represented by pre-payment certificates.

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CKS Updates - February 2017

During February 2017 Clinical Knowledge Summaries were updated for the following topics:

The following topics were all reviewed:

The topics have undergone minor restructures. More significant changes include recommendations for urgent referral for suspected cancer in the Breathlessness topic and amending several recommendations about repeating swabs for staphylococcal carriage, reducing period of treatment for recurrent boils and antiseptic choice in line with advice from Public Health England.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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NICE Guidance - February 2017

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of February 2017. This month there are two guidelines that impact upon primary care.

The Drug misuse prevention guideline covers targeted interventions to prevent misuse of drugs, including illegal drugs, 'legal highs' and prescription-only medicines. It aims to prevent or delay harmful use of drugs in children, young people and adults who are most likely to start using drugs or who are already experimenting or using drugs occasionally.

The Osteoporosis: assessing the risk of fragility fracture clinical guideline has been updated and covers assessing the risk of fragility fracture in people aged 18 and over with osteoporosis. It aims to provide guidance on the selection and use of risk assessment tools in the care of adults at risk of fragility fractures in all NHS settings. The update corrects the reference to the WHO in relation to the FRAX tool.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

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CKS Updates - January 2017

During January 2017 Clinical Knowledge Summaries were updated for the following topics:

The following topics were all reviewed:

The majority of topics have undergone minor restructures. More significant changes are as follow:

  • Edoxaban was added to the Anticoagulation - oral topic along with the MHRA information about the interaction between vitamin K antagonists and hepatitis C treatments
  • A section on end of life care was added to the Delirium topic
  • The Palliative Care topics were updated in line with NICE 2015 guidance Care of dying adults in the last days of life
  • Aspiration and corticosteroid injection are no longer recommended as treatments in primary care in the Pre-patellar Bursitis topic
  • The Temporomandibular disorders topic has been updated in line with recommendation from the Royal College of Surgeons Faculty of Dental Surgery

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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