Episodes
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Experienced Medicines Advice pharmacists, Karoline Brennan and Daniel Hill, talk you through how to manage patients who are unable to swallow medicines. We describe a process for choosing suitable formulations, including crushing tablets.
Quick links to resources:
SPS swallowing difficulties resources
https://www.sps.nhs.uk/home/guidance/swallowing-difficulties/
Choosing medicines formulations in swallowing difficulties
https://www.sps.nhs.uk/articles/choosing-medicines-formulations-in-swallowing-difficulties/
Medicines suitable for adults with swallowing difficulties
https://www.sps.nhs.uk/articles/medicines-suitable-for-adults-with-swallowing-difficulties/ -
Sheetal Ladva, Senior Medicines Advice Pharmacist, presents a summary of the resources published by SPS between 25th and 31st January.
To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.
Quick links to highlighted resources:
Using contraception with enzyme-inducing medicines
Enzyme-inducing medicines reduce the effectiveness of certain contraceptives. Guidance on using contraception with these medicines is given.
https://www.sps.nhs.uk/articles/using-contraception-with-enzyme-inducing-medicines/
Understanding of transcribing for medicines administration
article has undergone a thorough content review, confirming its continued accuracy.
https://www.sps.nhs.uk/articles/understanding-transcribing-for-medicines-administration/
SPS podcasts
You can access SPS podcasts wherever you normally listen to your podcasts, via the SPS website, or from the SPS SoundCloud
https://on.soundcloud.com/nhs_sps
Medication Safety Update resource - collates all the latest medication safety communications and publications to inform, support and inspire medication safety improvements.
https://www.sps.nhs.uk/wp-content/uploads/2024/06/Medication-Safety-Update-January-2025.pdf
Next events – forthcoming webinars and conferences
https://www.sps.nhs.uk/home/events/next-events/
January Spotlight Monthly Digest - provides a summary of SPS outputs and resources.
https://www.sps.nhs.uk/articles/sps-spotlight-monthly-digest/#:~:text=January%E2%80%AFSpotlight%20Monthly%20Digest
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Alt text: A birds eye view picture of white headphones around a mug of coffee and a mobile phone sitting on a pale green wooden surface.
The text says NHS Specialist Pharmacy Service, New episode available, podcast, NHS SPS Weekly Update, 4 Feb: Monthly medication safety update, safer use of insulin, and updated PGD templates -
Missing episodes?
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Penny Daynes, Associate Regional Pharmacy Procurement Specialist, presents a summary of the resources published by SPS between 18th and 24th January.
To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.
Quick links to highlighted resources:
Managing dosage adjustments for prescribed medicines
Advice on managing medicines that may require dosage adjustments after they have been prescribed.
https://www.sps.nhs.uk/articles/managing-dosage-adjustments-for-prescribed-medicines/
Navigating a potential supply issue (requires log in)
Recommendations for secondary care pharmacy procurement teams to follow before escalating a supply issue or shortage to the SPS Regional Procurement Team.
https://www.sps.nhs.uk/articles/navigating-a-potential-supply-issue/
Assessing the clinical impact of lactose in medicines
People with lactose intolerance may request lactose-free medicines although the amounts, when present as an excipient, are unlikely to cause symptoms in most.
https://www.sps.nhs.uk/articles/assessing-the-clinical-impact-of-lactose-in-medicines/
SPS podcasts
You can access SPS podcasts wherever you normally listen to your podcasts, via the SPS website, or from the SPS SoundCloud
https://on.soundcloud.com/nhs_sps
We want to hear from you:
To help us evaluate the Medication Safety Update resource, we would be grateful if anyone who uses the Medication Safety Update could complete this short feedback survey.
https://forms.office.com/Pages/ResponsePage.aspx?id=VpftQ_9Bv0yVm0BqQIO3iy69MtABWsFCjFDc3yJffiRUM1NNSzVZRFNMVFA5RFlYSDdLQzJFNkhZVy4u
Next events – forthcoming webinars and conferences
https://www.sps.nhs.uk/home/events/next-events/
Podcast description:
NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'. -
Madeleine Foster, Chief Pharmaceutical Officer’s Clinical Fellow, presents a summary of the resources published by SPS between 11th and 17th January.
To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.
Quick links to highlighted resources:
Understanding polypharmacy, overprescribing and deprescribing
We explore the causes, consequences and tools to support pharmacy professionals in managing polypharmacy, overprescribing and deprescribing in practice.
https://www.sps.nhs.uk/articles/understanding-polypharmacy-overprescribing-and-deprescribing/
Covert administration of medicines: legal issues
A summary of key legal issues, a pathway of actions and links to national guidance to consider before administering medicines covertly to adults.
https://www.sps.nhs.uk/articles/covert-administration-of-medicines-legal-issues/
Assessment and storage of medicines for self-administration
Suitable medicines must be stored safely and securely in accordance with organisational policy, while still supporting self-administration
https://www.sps.nhs.uk/articles/assessment-and-storage-of-medicines-for-self-administration/
New Product Evaluations
A list of new product evaluations that are freely available to NHS staff.
https://www.sps.nhs.uk/articles/new-product-evaluations/
We want to hear from you:
To help us evaluate the Medication Safety Update resource, we would be grateful if anyone who uses the Medication Safety Update could complete this short feedback survey.
https://forms.office.com/Pages/ResponsePage.aspx?id=VpftQ_9Bv0yVm0BqQIO3iy69MtABWsFCjFDc3yJffiRUM1NNSzVZRFNMVFA5RFlYSDdLQzJFNkhZVy4u
Next events – forthcoming webinars and conferences
https://www.sps.nhs.uk/home/events/next-events/
Podcast description:
NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'. -
Experienced Medicines Advice pharmacists, Karoline Brennan and Daniel Hill, talk you through how to manage patients who are unable to swallow medicines. We describe a process on how to find the appropriate formulation for your patient if the medicine isn't already covered in the SPS swallowing difficulties resources.
Quick links to resources:
SPS swallowing difficulties resources
www.sps.nhs.uk/home/guidance/swa…ing-difficulties/
Checking if tablets can be crushed or capsules opened
https://www.sps.nhs.uk/articles/checking-if-tablets-can-be-crushed-or-capsules-opened/
Checking if medicines can be given with food
https://www.sps.nhs.uk/articles/checking-if-medicines-can-be-given-with-food/
Covert administration of medicines: legal issues
https://www.sps.nhs.uk/articles/covert-administration-of-medicines-legal-issues/
Link for medicines for children:
https://www.medicinesforchildren.org.uk/medicines -
Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the infected insect bites/stings service under Pharmacy First. Discussion includes how to differentiate between infected and non-infected insect bites, advice to give patients to prevent insect bites from becoming infected and how patients with insect borne diseases may present. (13m 53)
Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS
Liz Kramer – Community Pharmacist
Useful links:
NHS Lyme disease
https://www.nhs.uk/conditions/lyme-disease/
PCDS Lyme disease
https://www.pcds.org.uk/clinical-guidance/lyme-disease
Tick Borne Encephalitis
https://www.nhs.uk/conditions/tick-borne-encephalitis/
Malaria
https://www.nhs.uk/conditions/malaria/ -
Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the impetigo service under Pharmacy First. Discussion includes how patients with impetigo usually present, differential diagnoses, advice to prevent the spread of impetigo and information about how what to when first line treatments are out of stock, including information about the SPS Medicines Supply Tool. (11m)
Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS
Liz Kramer – Community Pharmacist
Useful links:
Information on how to stop impetigo spreading available via: Impetigo - NHS (www.nhs.uk)
Patient information leaflet from the British Association of Dermatologists
https://www.nhs.uk/conditions/impetigo/
SPS Medicines Supply Tool
https://www.sps.nhs.uk/wp-login.php?redirect_to=https%3A%2F%2Fwww.sps.nhs.uk%2Fhome%2Ftools%2Fmedicines-supply-tool%2F&reauth=1 -
Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the shingles service under Pharmacy First. Discussion includes the link between chickenpox and shingles, typical presentation of shingles, dermatomal distribution of shingles and how to respond to requests for video consultations. (20m 23s)
Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS
Liz Kramer – Community Pharmacist
Useful links:
Post exposure prophylaxis for chickenpox and shingles - GOV.UK (www.gov.uk)
Images of shingles:
NHS shingles resources
https://www.nhs.uk/conditions/shingles/
DermNet shingles resources
https://dermnetnz.org/topics/herpes-zoster
Primary Care Dermatology Society shingles resources
https://www.pcds.org.uk/clinical-guidance/herpes-zoster
Black & Brown skin resources (including images on diverse skin tones)
https://www.blackandbrownskin.co.uk/campaigns
DermNet dermatomes
https://dermnetnz.org/topics/dermatomes
Shingles immunisation programme: information for healthcare practitioners
https://www.gov.uk/government/publications/shingles-vaccination-guidance-for-healthcare-professionals/shingles-immunisation-programme-information-for-healthcare-practitioners -
Penny and Andy discuss new resources to support NHS procurement teams manage medicine shortages. They are joined by Sally and Andrew who talk about using the resources to navigate supply issues in their Trusts. The resources include a checklist with where to find information and how to escalate problems.
Speakers:
Penny Daynes, Associate Regional Pharmacy Procurement Specialist, North East and Yorkshire, NHS Specialist Pharmacy Service
Andy Stewart, Associate Regional Pharmacy Procurement Specialist, North West, NHS Specialist Pharmacy Service
Sally Parker, Senior Pharmacy Technician - Procurement, Calderdale and Huddersfield NHS Foundation Trust
Andrew Philpot, Principal Pharmacy Technician - Procurement and Outsourcing, NHS Humber Health Partnership -
Two of our experienced Medicines Advice Pharmacists, John Minshull and Luke Elliott, talk about answering queries regarding the dosing of medication in patients with renal impairment. They discuss when to use eGRF and Cockcroft and Gault when estimating creatinine clearance, recommended resources to support decision making, and where to get further advice.
Quick Links
The Renal Drug Database
https://www.renaldrugdatabase.com/s/about-rdd-2
Assessing the impact of renal impairment on medicines safety
https://www.sps.nhs.uk/articles/assessing-the-impact-of-renal-impairment-on-medicines-safety/
UKMI Enquiry Answering Guidelines
https://www.ukmi.nhs.uk/Resources?ContentID=69688558-86cc-4062-b5fa-a12f48b02830 -
Kieran Reynolds talks to Aimee Francisco about drugs in liver impairment. Discussion includes key issues to consider when prescribing in liver disease, medicines to avoid (or use with caution) in liver disease, drug induced liver injury and herbal medicines. (13m 29s)
Aimee Francisco - Advanced Specialist Gastroenterology Pharmacist at Gloucestershire Hospitals NHS FT and primary care lead at the British Hepatology Pharmacy Group (BHPG)
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS
Useful Links
SPS medicines monitoring tool
https://www.sps.nhs.uk/home/tools/drug-monitoring/
Questions to ask when giving medicines advice in liver impairment
https://www.sps.nhs.uk/articles/questions-to-ask-when-giving-medicines-advice-in-liver-impairment/
Information resources for managing medicines in liver impairment
https://www.sps.nhs.uk/articles/information-resources-for-managing-medicines-in-liver-impairment/
Symptom control in adults with advanced liver disease
https://www.basl.org.uk/index.cfm/content/page/cid/33 (available under Resources)
Prescribing weight adjusted oral paracetamol in adults BASL position statement
https://www.basl.org.uk/index.cfm/content/page/cid/20 (available under Resources)
LiverTox
https://www.ncbi.nlm.nih.gov/books/NBK547852/
Memorial Sloan Kettering Cancer Center's About Herbs database
https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search -
Kieran Reynolds talks to Naz Kanani Alviri about liver cirrhosis. Discussion includes what cirrhosis is, and how it is diagnosed, the difference between compensated and decompensated cirrhosis, complications of decompensated cirrhosis and initiatives being undertaken to improve the earlier diagnosis of liver disease. (19m 16s)
Naz Kanani Alviri - Principal Pharmacist -Hepatology & Liver transplantation, Royal Free Hospital, London
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS
Useful Links
Calculating and using the Child-Pugh score
https://www.sps.nhs.uk/articles/calculating-and-using-the-child-pugh-score/
Prescribing weight-adjusted oral paracetamol in adults BASL position statement
https://www.basl.org.uk/index.cfm/content/page/cid/20 (available under Resources)
NHS mobile testing scheme finds thousands of new cases of liver damage
https://www.england.nhs.uk/2023/10/nhs-mobile-testing-scheme-finds-thousands-of-new-cases-of-liver-damage/ -
Kieran Reynolds talks to Sital Shah in our introductory podcast about liver disease. Discussion includes the functions of the liver, difference between liver disease and liver impairment, liver blood tests and how to classify severity of cirrhosis (scarring of the liver) (17m 38s)
Sital Shah - Consultant Hepatology Pharmacist, King’s College Hospital London and Chair of the British Hepatology Pharmacy Group (BHPG)
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS
Useful Links
Assessing liver function and interpreting liver blood tests
https://www.sps.nhs.uk/articles/assessing-liver-function-and-interpreting-liver-blood-tests/
British Liver Trust - about the liver
https://britishlivertrust.org.uk/information-and-support/liver-health-2/abouttheliver/
NHS conditions - liver disease
https://www.nhs.uk/conditions/liver-disease/
Calculating and using the Child-Pugh score
https://www.sps.nhs.uk/articles/calculating-and-using-the-child-pugh-score/
British Liver Trust - liver blood tests
https://britishlivertrust.org.uk/information-and-support/living-with-a-liver-condition/liver-blood-tests/ -
Rakhi talks to Catherine and Kavan about optimising lipid management in patients who have had a haemorrhagic stroke. They discuss the importance of confirming diagnosis, risks of statin use in haemorrhagic stroke, how to use QRISK scores in this patient group, and when to seek specialist advice.
This is a follow up podcast to our 'Primary care discussions: Lipid management' webinar. You can find the webinar recording here: https://www.sps.nhs.uk/articles/primary-care-discussions-lipid-management/
Speakers:
Catherine Tucker, Senior Clinical Pharmacist Lipid Clinic and Integrated Care Team, Northumbria Healthcare NHS Foundation Trust and CVD Medicines Optimisation Pharmacist, CVD Prevention Network, North East and North Cumbria Integrated Care Board
Kavan Nagi, Lead Cardiovascular Pharmacist, Buckinghamshire Healthcare Trust and Lead ICS Lipid Specialist Pharmacist, NHS Frimley Integrated Care Board
Rakhi Aggarwal, Primary Care Lead, Medicines Use and Safety, NHS Specialist Pharmacy Service
Resources discussed by the speakers:
NHSE Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD
https://www.england.nhs.uk/aac/wp-content/uploads/sites/50/2020/04/lipid-management-pathway-v7.pdf
Stroke Association
https://www.stroke.org.uk/
QRISK
https://www.qrisk.org/
SPARCL trial
The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549–559 https://www.nejm.org/doi/full/10.1056/NEJMoa061894 -
Rakhi talks to Catherine and Kavan about optimising lipid management in patients who have had an ischaemic stroke. They discuss the importance of confirming diagnosis, treatment targets, how to prioritise patient for review, and when to seek specialist advice.
This is a follow up podcast to our 'Primary care discussions: Lipid management' webinar. You can find the webinar recording here: https://www.sps.nhs.uk/articles/primary-care-discussions-lipid-management/
Speakers:
Catherine Tucker, Senior Clinical Pharmacist Lipid Clinic and Integrated Care Team, Northumbria Healthcare NHS Foundation Trust and CVD Medicines Optimisation Pharmacist, CVD Prevention Network, North East and North Cumbria Integrated Care Board
Kavan Nagi, Lead Cardiovascular Pharmacist, Buckinghamshire Healthcare Trust and Lead ICS Lipid Specialist Pharmacist, NHS Frimley Integrated Care Board
Rakhi Aggarwal, Primary Care Lead, Medicines Use and Safety, NHS Specialist Pharmacy Service
Resources discussed by the speakers:
NHSE Summary of National Guidance for Lipid Management for Primary and
Secondary Prevention of CVD
https://www.england.nhs.uk/aac/wp-content/uploads/sites/50/2020/04/lipid-management-pathway-v7.pdf
UCL Partners Proactive Care Framework: Lipid Management including
Familial Hypercholesterolaemia
https://uclpartners.com/wp-content/uploads/Lipids-and-FH-Framework_UCLPartners-LTCs-April-2021-v4.1.pdf -
Two of our experienced Medicines Advice Pharmacists, John Minshull and Iram Husain, discuss how medicines advice pharmacists answer queries safely.
Quick Links
Swallowing difficulties
https://www.sps.nhs.uk/home/guidance/swallowing-difficulties/
Covert administration of medicines: legal issues
https://www.sps.nhs.uk/articles/covert-administration-of-medicines-legal-issues/
Covert administration of medicines: pharmaceutical issues
https://www.sps.nhs.uk/articles/covert-administration-of-medicines-pharmaceutical-issues/
UKMi Recommended Resource Lists and Tools
https://www.ukmi.nhs.uk/Resources?ContentID=3df605e3-ec43-47b7-99ff-aabc3cd91765
SPS MA contact details
https://www.sps.nhs.uk/home/about-sps/get-in-touch/medicines-information-services-contact-details/ -
Kieran Reynolds talks to Dr Alicia Demirjian and James Milner about some of the clinical issues you may encounter when providing the new Pharmacy First service to children. Discussion includes practical hints and tips for examining children, how to manage parents’ expectations as well as reassure them about their child’s treatment. (13m 41s)
Dr Alicia Demirjian – Paediatric infectious diseases consultant, Evelina Children’s Hospital
James Milner – ICD Community Pharmacy Clinical Lead, NHS Shropshire, Telford and Wrekin
Kieran Reynolds – Specialist Pharmacist (Medicines Governance), SPS
Useful links:
NHS England Pharmacy First resources
https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Healthier Together guidance (otitis media (earache)) for pharmacists
https://www.what0-18.nhs.uk/professionals/pharmacists/safety-netting-documents-parents/earacheotitis-media-advice-sheet
Medicines for Children – how to give different types of medicines
https://www.medicinesforchildren.org.uk/advice-guides/giving-medicines/ -
Kieran Reynolds talks to Naomi Fleming and Reena Barai about some of the clinical issues you may encounter when providing the uncomplicated urinary tract infection (UTI) service under Pharmacy First. Discussion includes measures taken to limit the impact of antimicrobial resistance from Pharmacy First and why urine dipsticks aren’t recommended in the uncomplicated UTI service in Pharmacy First. (13m 08s)
Useful links:
NHS England Pharmacy First Resources: https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Community Pharmacy England (CPE) FAQs: https://cpe.org.uk/national-pharmacy-services/advanced-services/pharmacy-first-service/pharmacy-first-service-faqs/
TARGET Treating your infection UTI leaflet: https://elearning.rcgp.org.uk/pluginfile.php/172235/mod_book/chapter/465/TARGET%20TYI-UTI%20leaflet%20V23.5.pdf -
Kieran Reynolds talks to Professor Nick Francis and Rahul Sharda about some of the clinical issues you may encounter when providing the otitis media service under Pharmacy First. Discussion includes information to provide patients who don’t require antibiotics, signposting to resources to help with otoscope examination and why the otitis media service is limited to individuals aged 1-17 years. (15m 50s)
Professor Nick Francis – GP & Head of School at School of Primary Care, Population Sciences and Medical Education, University of Southampton
Rahul Sharda - Community pharmacist, Butt Lane Pharmacy
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS
Useful links:
NHS England Pharmacy First resources
https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Healthier Together guidance (otitis media (earache) for pharmacists
https://www.what0-18.nhs.uk/professionals/pharmacists/safety-netting-documents-parents/earacheotitis-media-advice-sheet
NICE otitis media (acute) antimicrobial prescribing guidance
https://www.nice.org.uk/guidance/ng91
Otoscope examination resources:
CliniSkills: Clinical Examination Skills Training for Community Pharmacists
https://www.cliniskills.com/community-pharmacists/
CPPE: Ear, nose and throat examination – advancing clinical assessment skills workshop
https://www.cppe.ac.uk/programmes/l/ent-w-01/
CPPE: NHS Pharmacy First: Otitis Media e-learning
https://www.cppe.ac.uk/programmes/l/nhsphfrst-e-01/
British Society of Audiology Recommended ear examination procedure
https://www.thebsa.org.uk/wp-content/uploads/2023/10/OD104-54-BSA-Recommended-Procedure-Ear-Examiniation-February-2022.pdf -
Kieran Reynolds talks to Professor Paul Little and Simran Sirpal about some of the clinical issues you may encounter when providing the sore throat service under Pharmacy First. Discussion includes the FeverPAIN score, information to provide patients who don’t require antibiotics, strep A antigen tests, and exclusions from the PGDs. (11m 58s)
Professor Paul Little - GP & Professor of Primary Care
Simran Sirpal – Community Pharmacist, Sirchem Pharmacy Group
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS
Useful links:
NHS England Pharmacy First resources
https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Healthier Together guidance (tonsillitis/sore throat) for pharmacists
https://www.what0-18.nhs.uk/professionals/pharmacists/safety-netting-documents-parents/sore-throat-advice-sheet
NICE sore throat (acute) antimicrobial prescribing guidance
https://www.nice.org.uk/guidance/ng84
Community Pharmacy England Pharmacy First FAQs
https://cpe.org.uk/national-pharmacy-services/advanced-services/pharmacy-first-service/pharmacy-first-service-faqs/
NHS England Direct-to-consumer point-of-care in vitro diagnostic devices for group A streptococcal infections
https://www.england.nhs.uk/long-read/direct-to-consumer-point-of-care-in-vitro-diagnostic-devices-for-group-a-streptococcal-infections/ - Show more
