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The Kingston Joint Formulary has been developed  by  Kingston Hospital NHS Foundation Trust and Kingston Clinical Commissioning Group (CCG). It contains a list of medicines, dressings, dietary and other products which have been approved for use by Kingston Hospital NHS Foundation Trust Drugs and Therapeutics Group (DTG) and the Kingston CCG Medicines Committee. The aim of the Kingston Joint Formulary is to recommend clinically effective, safe and economic medicines for use in both primary and secondary care in the Kingston area. A joint formulary across both primary and secondary care supports prescribing across the hospital and primary care interface, to ensure consistency in prescribing and continuity in patient care.

The Kingston Joint Formulary also contains the following prescribing resources to promote and support effective and safe prescribing in Kingston:

  • Kingston Prescribing Guidelines for primary and secondary care
  • Shared Care Guidelines
  • Patient Group Directions (PGDs)
  • NICE Technical Appraisals (TAs) and
  • MHRA Drug safety alerts.

All prescribers in both primary and secondary care should adhere to the joint formulary, and adherence to the joint formulary is monitored on a regular basis. However, it is recognised that there will be instances where prescribing outside of the formulary will be both necessary and appropriate. Non-formulary prescribing requests should be discussed with the Pharmacy Dept in Kingston Hospital or the Kingston CCG Medicines Optimisation team, where applicable, before prescribing.

Products listed in the formulary are routinely stocked by Kingston Hospital Pharmacy Department unless otherwise stated and are available to all prescribers unless otherwise indicated.

Non-Formulary Medicines

Medicines which are not listed in the Formulary are ‘non-formulary’ medicines and should not be prescribed within the Kingston area. The only exceptions to prescribing a non-formulary medicine are:

  • When patient is admitted to Kingston Hospital on a non-formulary medicine and the patient’s own supply is not available or deemed unsuitable;
  • Medicines undergoing a Clinical Trial supported by the Kingston Hospital;
  • Specialist therapy for an individual patient agreed by a Kingston Hospital Senior Pharmacy Manager after discussion with the Consultant (unless a PbR exclusion drug). The requesting consultant will be asked to complete a new product request form if the request is for an unlicensed medicine; black triangle medicine; or high cost drug. In the case of an unlicensed medicine, a risk assessment will be undertaken by the Pharmacy Department and the Drug and Therapeutics Group notified of the request;
  • If the non-formulary medicine is requested for more than one patient within the same clinical division, the Chair of Kingston Hospital Drug and Therapeutics Group/Senior Pharmacy Manager will discuss with the requesting consultant and forward a new product request form for completion where appropriate.
  • An independent evaluation will then be undertaken by the Kingston Hospital Pharmacy Department for the drug to be discussed at a Drug and Therapeutic Group meeting. The Consultant will be invited to present his / her submission at the meeting and a decision will be made as to the formulary status and place of therapy of the medicine.

Non-formulary prescribing requests should be discussed with the Medicines Management Pharmacists at Kingston Hospital NHS Foundation Trust.

 

Adding a product or Formulation to the Joint Formulary

Requests to include a new drug or presentation in the Joint Formulary should be sent to  Medicines Management Pharmacists at Kingston Hospital NHS Foundation Trust.

Private Patients

Private patients are not exempt from the Trust Formulary. Doctors prescribing for private patients must comply with the Kingston Joint Formulary.

How do I find drugs in the Formulary?

The Joint Formulary is organised by British National Formulary (BNF) structure. The products under each heading are listed alphabetically, within drug groups where appropriate, and are organised by generic drug name. Brand names are specified only where a specific brand is required for a clinical reason or a specific brand has been agreed for use within the formulary. All medicines conform with rINN naming, with BAN names shown in brackets after the rINN name.

The Joint Formulary is intended to be used in conjunction with:

  • Local and area wide guidelines (see Guideline section and Individual Formulary Drug sections)
  • SW London Interface Prescribing Policy (available here)
  • Kingston Hospital Medicines Management Policy
  • Current BNF (available here)
  • Kingston Hospital Guidelines for the Management of Common Medical Emergencies (Blue Book, available here)
  • Primary and Secondary care guidelines on the use of Antimicrobial Drugs (see Guidelines in 5. Infections).
  • Individual drug manufacturer’s Summary of Product Characteristics (available here).

 

See How to use this Website section, for more tips on how to find information on this website.

Traffic lights colours for medicines and products in the Formulary

To aid quick and appropriate sector prescribing, medicines and other products in the joint formulary have been given a colour to indicate if it is suitable for initiation and continued prescribing in primary care and/or secondary:

 

 

SECONDARY CARE 

PRIMARY CARE

 

COLOUR

DEFINITION

Initiation/ continued prescribing

Initiation

Continued prescribing

EXAMPLES

Red     

 

Specialist use only.

 

Yes

No

No

South West London or locally agreed Hospital only drugs list.

In line with SWL Interface Prescribing Policy.

Amber 

 

For specialist initiation but may be transferred to primary care with agreement from the GP and/or in line with agreed guidelines, where available.

Yes

 

 

No

 

 

Yes but only if:

- Shared care and in line with transfer of care as per agreed guidelines, when patient is stable.

OR

- Where GP agrees to take over prescribing in stable patients

South West London or locally agreed shared care policies - agreed medicines.

In line with SWL Interface Prescribing Policy.

Drugs that require secondary care initiation and may be continued in primary care once the patient is stable (where no shared care agreement already in place). Note primary care prescriber must have agreed to continue care before patient can be transferred.

Green  

 

Suitable for initiation and continued prescribing in Primary and Secondary care.

Yes

Yes

Yes

In line with SWL Interface Prescribing Policy.

Within licensed indications and/or local guidelines/ recommendations.

NICE Recommendations

Drugs subject to a NICE Technology Appraisal (TA) require an application to the Kingston Hospital DTG in order to agree a local prescribing process for that drug. While the local prescribing process is being agreed, medicines subject to a NICE TA will be made available for prescribing. They will require approval by a Senior Pharmacy Manager at Kingston Hospital prior to supply.

Unlicensed medicines

Unlicensed medicines or licensed medicines used for an unlicensed indication have been included in the formulary for use in specific clinical settings, where these have been approved by the Kingston Hospital Drugs and Therapeutics Group and, where applicable to primary care use, the Kingston CCG Medicines Committee. Prescribers must take full responsibility for prescribing such products.

Hospital only medicines

Hospital only medicines are drugs which are considered unsuitable for prescribing in primary care. This list is available on the SW London Medicines Commissioning Group website and is continuously updated, click here to see the SW London Medicines Commissioning Group latest list.

Disclaimers and terms of use for this website

The advice provided in the joint formulary is not comprehensive and it is the prescriber’s responsibility to also consult other appropriate sources where necessary, such as the BNF and Summary of Product Characteristics (SPCs) for individual drugs in conjunction with the information on this website, particularly if more detailed or specialist information is required.

The contents of this site will be reviewed continuously in light of significant developments in the evidence base, new local or national guidelines or regulatory concerns.

Please see the Further Information section for more detail regarding the website terms and conditions.

ABBREVIATIONS AND SYMBOLS USED IN THE FORMULARY

A Stock held in Accident and Emergency only
AP Stock held in A & E and Pathology only
BWO Bladder wash out
NPSA National Patient Safety Agency’s Alert or Rapid Response Report available on the preparation
MHRA Medicines and Healthcare Products Regulatory Agency
P Stock held in Pathology only
PbR Excl Payment by results excluded drug
UNLIC Unlicensed medicine
 

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