Fife Prescribers Forum

Dunnikier House Hotel
Kirkcaldy
29th October 2008

Present Apologies
Fiona Graham Jennifer Erskine Elaine Stark
Wendy McCormack May Currie Ruth Robins
Gaynor Black Alicia Nelson Dow Anne McEwen
Colette Henderson Sharon Kirk Shirley Fane
Michelle Horne John Campbell Lyne Coyne
Nicky Credland Jacki Taylor Gwyneth Thom
Lyndsey Pert Catriona Marshall Lesley Frew
Susan Chapman Sheila Robertson Ann Marie Gillespie
Susanneke Lucas Rhona Bishop Tracey Murphy
Grace Thompson Gill Dennes Lesley Colquhoun
Lorraine Summers June Lindsay Maureen Pheely
Heather Sheddon Irene Russell Lorna Stewart
Lena Stewart Karen Martin Lorna McKenzie
Janet Boylan Tessa Kidd
Karen Lee

Introduction and welcome and thanks given to Servier, Allen & Hanburys and Boehringer Ingelheim for their financial support for the evening meeting.

Minutes of previous meeting –
Minutes from the last meeting were read by all in attendance, and accepted.
Update on any other meetings
Nicky Credland updated group on Diabetic MCN meeting. Sharps policy is currently being updated. Will initially be for Dunfermline and West Fife CHP, with the intention of roll out to NHS Fife. Tessa Kidd has been writing policy – as sharps bins not prescribed for diabetic patients which means that there is a Health and Safety issue with sharps used by diabetics [sharps are put into general household rubbish]. It will be the responsibility of whoever prescribes the sharps to ensure that provision for safe disposal is provided. A new patient leaflet has been developed. 1 litre sharp bin to be prescribed. Each practice requires a SEPA certificate.
Wendy updated the group that there are now two AHP prescribers – namely Karen and Wendy – and Fiona is studying at the moment. Discussion about courses available at different universities. Also discussed Supplementary Prescribing course vs. the independent prescriber’s course.
Colette advised the group that the Fife Prescribers Website has been updated with new links & AHPs [recently qualified] details could be added to website.
All student prescribers will meet to discuss shadowing – Colette to organise.
Wendy discussed anecdotal evidence that patients are satisfied when CDM clinics are nurse led.
24th November – 9am to 4pm, Respiratory Meeting at Dean Park Hotel, Kirkcaldy. Looking at new asthma guidelines and will cover the topic of Spirometry in children.
17th November [evening] and 20th November [afternoon] Respiratory meetings being run by NHS Fife. Same programme being run twice. All non medical prescribers should have received an invitation to attend one of these meetings – can attend the one that suits them best.
Actions from previous meeting
Karen Lee has contacted Andy Robson [lung function department] at Edinburgh Royal Infirmary re Spirometry in Children. No response as yet. Also contacted Anne Ritchie re the same – again no response as yet. Karen has been asked to e mail the group when she has a response rather than wait until the next meeting to discuss it.
Karen is also waiting on dates for Molly Courtney to come to meeting. Group agreed that spring would be a good time for her to come to the meeting.
Discussed X Ray challenges again. Still no further forward with this. Course completed by many, but no guidance as when they can start referring as yet.
Fife Formulary – nurse Rx input
Question asked re would anyone like to attend the Fife Formulary Development Group meeting. Primary care representation is needed. The meeting lasts for about 2 hours, and is held every 6 – 8 weeks. Heather Sheddon, Michelle Horne, Gaynor Black, and Lorraine Summers are all interested – issues were raised about using their clinical time to attend a meeting. Colette will discuss with NHS Fife re if the practice could be reimbursed to allow them to attend before any decisions are made about who would be keen to attend.
What’s on your mind?
Barcodes on Prescriptions – question asked if this will be introduced for all NMPs. Yes was the answer – some systems e.g. emiss already have this on their system.
Emiss being introduced in some practices – St Andrews have just had it installed. Good points raised so far are BNF live on system, good patient information leaflets, emis templates can be changed – it also seems that the information that is input into system drills through all the various screens.
Heather enquired about paperless/paperlight practice when awaiting for notes. Same challenges faced in secondary care – concerns about awaiting notes and sending letters to surgery – this can take up to 2 weeks. Most concerning is issues with stopping drugs when in hospital and not clear when / if they need to be restarted.
Awaiting a possible system for everyone to access notes from primary and secondary care.
Update from NMP Advisor
Colette’s NPM frequently asked questions booklet is almost finalised.
Clinical Supervision events planned
1. Minor Ailments.
2. CMPs in practice Pod/Pharm/Nurses [Best Practice Guides]
3. Fife Formulary
4. Scenarios

CPD events planned
Pain Management meeting – planned for February next year
Wound Care / soft tissue injuries also planned for next year. Date TBC.
Date of next meeting
Date of next meeting set for Tuesday 3rd February 2009 at the Dunnikier House Hotel.
Meeting summary and close
Everyone thanked for attending the meeting, and the meeting was brought to a close.

Dunnikier House Hotel
Kirkcaldy
3rd September

Minutes of Meeting
Present Apologies
Colette Henderson Ann McKean
Sheila Robertson Karen Martin
Gaynor Black Catriona Marshall
Nicky Credland Alicia Nelson Dow
Heather Sheddon Sharon Kirk
Susan Chapman Elaine Stark
Jacquie Taylor Carole Hatten
Olga Fielding Joanne MacDonald
Lorna Stewart
Hazel York
Jennifer Erskine
Lorna McKenzie
Introduction and welcome
Meeting opened and delegates welcomed. Thanks were given to Servier, Recordati and Boehringer for their financial support of the meeting.
Minutes of previous meeting
Minutes were accepted as accurate by those present.
Update on any other meetings
Jacquie reported that the non-medical prescriber’s acute meeting had discussed the policy that is now in place. Line managers require written information on prescriber’s competencies. It is hoped that by the time the policy is updated a proforma will be included that will enable continuity of competency acknowledgement. Colette confirmed that the policy is due to be updated in 2010.
Heather commented that Gill Dennes will be organising a study day related to new Asthma guidelines that are due in December. Discussion then occurred about spirometry in children. Problems were highlighted that there were no paediatric guidance vitalograph values. After further discussions advice was given to either refer to specialist- contact respiratory technicians who deal with the machinery used and that other delegates would take it back to practice and discuss it personally. This highlighted training issues on paediatric investigation. This should be helpful with the proposed or future training events. Colette stated that she is providing a study event around paediatric examination; she was going to discuss this later in the meeting.
Susan stated that ‘Byetta’ has now been taken to the Area and Drugs and Therapeutic Committee to be prescribed by practice nurses and GP’s who have the competence.
Rosiglitazone, Nicky and Susan debated the clarity of the guidelines. It was stated that new guidelines due will ensure that prescribing this drug will become clearer.
X-ray
Colette stated that we are awaiting the XR referral policy. There are RCN guidelines out for nurses requesting x-rays. Lorna will discuss this at the Dunfermline Respiratory task group meeting next week.
Update from Colette Henderson
Colette stated that there will guidance issued soon re prescribing for syringe drivers. This is related to the mixing of drugs being administered. Colette has said that all non medical prescribers will receive the guidance. Discussions took place around this subject. As always prescribers awareness of compatibility of drugs is paramount when prescribing.
Colette has put together a booklet on frequently asked questions for the non-medical prescriber. It includes information on medicines management in NHS Fife, this will be published soon.
A CPD event to be organised in November 2008 - week of 17th. Plans to discuss respiratory care. It is hoped that a future events will include wound care. Sheila has agreed to assist with giving names of potential facilitators. Thought for February 2009 CPD event to be on pain and pain management.
What’s on your mind?
Nicky then asked if fellow prescribers keep a record of all numbers on each prescription sheets. Good practice must be adhered to and this is detailed in the blue Non Medical Prescribing in Scotland folder that everyone should have access to. Nicky added that she has come across issues when printing computer scripts it is not always her name that comes on to Gpass scripts it was thought that she should discuss this with her practice manager as this is only because the computer has been set up to do this. Discussions around pad safety showed varied safety precautions taken by prescribers, who all appear to be practising safely.
Next meeting
29th October 2008. Same venue.
Meeting closed and delegates thanked for their attendance.

Dunnikier House Hotel
Kirkcaldy
18th June 2008

Minutes of Meeting
Present Apologies
Gwyneth Thom Lorna Stewart
Nicky Credlin Jacki Redfern
Jaqui Taylor Gaynor Black
Sharon Kirk Anne McKean
Susan Chapman Catriona Marshall
Gill Dennes Tracey Murphy
Heather Sheddon Jill Logan
Colette Henderson Sheila Robertson
Lorna McKenzie
Elaine Stark
Shirley Fane
Tessa Kidd
Rhona Bishop
Introduction and Welcome
Delegates were welcomed and Servier, Recordati and Boehringer thanked for their financial support of the meeting.
Minutes of previous meeting
Minutes were read and accepted by those present.
Update on any other meetings
Feedback from Sharon Kirk re ANP conference. Poor attendance this year. Workshops were good.
Dunfermline and West Fife Respiratory Group has had meeting – guidance being rolled out to Fife regarding Dry powder: advice recommends 1st line easihaler in place of pulvinal. Not looking at big switches. Group has also looked at COPD action plans. All practices should have received them by now. Good feedback on these as they can be adapted for the individual patients needs.
Review of Educational Meetings – May
Good discussion around both meetings. Feedback was good, comments were all constructive. Planning on having legal issues discussed on an annual basis. Issue raised was that some people missed from the distribution list. Colette to address this. Next educational meeting is in planning phase – and everyone will be notified in due course of dates and topics.
Monday 23rd of June, and again on Friday 27th June Andrew Jamieson was chairing a meeting re rosiglitazone and ? the need to stop using this drug. Much discussion around research required for glitazones
Any other business
Discussion around Molly Courtney attending meeting. It was felt that this would be appropriate, and it would be useful to hear her present to a smaller interactive audience.
Further talk around nurse x ray referrals - questions raised around nurses referring out with Fife e.g. nurses in the East Neuk refer to Dundee, and how this will work.
Susan Chapman recommended the Charles Bloe training for X Rays, costs £15, internet based and is a self directed online package.
Sharon Kirk recommended the Charles Bloe training for blood investigations again this is an online internet based, self directed learning package.
Some discussion around the NES Paediatric Training – some present felt that it was too basic. Colette to find out if Practice Nurses could access this and will feedback at the next meeting.
Discussion around training for PNs and funding of events. Nurses could approach reps for funding.
Heather Sheddon asked group what was being prescribed by nurses for exacerbations of COPD and the question was asked “Do we need guidance for steroids?” Gill Dennes will feed this back to the Resp MCN and then back to the group
Practice Nurse payscales were discussed.
General questions around prescribing in practice. Susan Chapman recommends discussing personal prescribing with the CHP pharmacist who will print off your prescribing stats. There are challenges quantifying true figures as repeat prescriptions may be signed by GPs after initiation by non medical prescribers.
Peak flow readings v spirometry in paediatrics. If Peff is persistently low try spirometry – it’s in the new guidelines.
Suggested websites for checking out were www.testandcal.com for numeracy tests for anyone undertaking non medical prescribing modules.
GPIAG are to be putting the new asthma guidelines on their site, with the main changes summarised and are also planning on producing aide memoirs, and updated summary sheets. These should be published in the summer.
Meeting summary and close
Next meeting date to be Wednesday 3rd September 2008 at the Dunnikier House Hotel, Kirkcaldy.

Wednesday 29th October 2008 1830 at the Dunnikier House Hotel Kirkcaldy

The next meeting of Fife Prescribers forum will be Wednesday 3rd September 1830 pm at the Dunnikier House Hotel, Kirkcaldy.