The Joint Formulary
Statement on Liothyronine prescribing
Currently, Liothyronine can only be prescribed in specific conditions by a specialist prescriber in Brighton and Hove and High Weald Lewes Havens.
This can only be prescribed for the treatment of myxedematous coma and pre-radioiodine treatment for thyroid cancer. It is not routinely funded for any other conditions.
The Brighton Area Prescribing Committee (APC) is aware of the NHS England guidance on Liothyronine, and that the current formulary position is different to the final recommendations.
It is important to note that this guidance from NHS England has to be ratified locally by the APC as the responsible commissioner for this medicine.
August 2019 Update: The Brighton APC has considered the latest NHS England guidance and agreed to defer making a decision until NICE guideline on ‘Thyroid disease: assessment and management’ has been published.
Once this information is available, the Brighton APC will review this position, in line with its responsibility to make sure we use NHS resources well.
Brighton and Hove CCG and High Weald Lewes Havens CCG does not support the prescribing of medication that is available to buy from local pharmacies or supermarkets for children or adults. See link above for the full position statement.
We are currently reviewing the Brighton Joint Formulary platform.Please fill in this short survey which will influence any future developments. https://www.surveymonkey.co.uk/r/F82HSMJ
The Brighton and Hove and High Weald Lewes Haven Joint Formulary is a list of everything which can be prescribed.
The Joint Formulary is overseen by the Brighton Area Prescribing Committee, and is developed and maintained with the collaboration of the following organisations:
- Brighton and Sussex University Hospitals NHS Trust
- Sussex Partnership NHS Foundation Trust
- Sussex Community NHS Foundation Trust
- Brighton and Hove CCG
- High Weald Lewes Havens CCG
Patients and public
If you are a patient or member of the public and would like information about the Joint Formulary, please get in touch using the details below.
Patients registered with a Brighton and Hove practice
Patients registered with a High Weald Lewes Havens practice
How to use the Joint Formulary
The Joint Formulary is broken down into chapters, based upon the categories used in the British National Formulary (BNF). It comprises a list of drugs recommended in each section. Each drug is colour-coded in a traffic-light system to facilitate prescribing choice. For more details on the Joint Formulary traffic light system, please see the drop down list below below.
Before any treatment is recommended or initiated (in any healthcare setting), a patient centred discussion relating to the risks and benefits of treatment, and patient consent to the treatment plan must have taken place. This should be documented in all clinic letters and / or patient medical record.
The prescriber should always ensure they have the expertise to prescribe an agent before making a selection. In its guidelines on responsibility for prescribing between hospitals and general practitioners, the Department of Health has advised that legal responsibility for prescribing lies with the doctor who signs the prescription.
Please follow the link for Palliative Care for local and national guidance including the support folder and drug instruction chart.
All medicines listed in the palliative care folder are available for GP prescribing and can be found in their respective BNF categories in the Joint Formulary.
Supporting Information for the Joint Formulary
Please see the Supporting Information on the Joint Formulary or click on the below links for information on:
Introduction Joint Formulary Traffic Light System
Green - Non-Specialist Drugs
Suitable for non-specialist initiation.
Blue - Specialist Initiation WITHOUT Shared Care Guidelines
For drugs that do not require significant drug monitoring or where required monitoring is on-going by the specialist. The drugs are recommended or initiated by a specialist and GPs continue to prescribe on specialist advice without the need for a formal shared care guideline but a shared care information sheet setting out responsibilities may be available. A minimum of one month's supply of medication will be provided by the consultant if initiating. Information on the initiation process and whether a shared care information sheet will be supplied will be detailed on the Joint Formulary.
Amber - Specialist Initiation WITH Shared Care Guidelines
For drugs which require specialist initiation and/or dose titration and specific ongoing monitoring. For initiation, dose stabilisation and prescribing (including monitoring) by a specialist until the patient is stabilised (usually for a minimum 3 months but see individual shared care protocols) after which the GP should receive the approved shared care guidance documents to safely continue prescribing the medicine. Primary care will be expected to undertake some specific drug monitoring under these shared care guidelines.
Red - Specialist ONLY drugs
For initiation and continuation (including monitoring) by a specialist only. A specialist is not necessarily a consultant, rather a practitioner with specialist skills e.g. specialist registrar, nurse specialist, GP with specialist interest, community psychiatric nurse, tissue viability nurse.
Black - Not routinely supported
Drugs that have been considered by the APC and are not routinely supported for initiation in any health setting for NHS patients.
- BH CCG: Click here for further information on the Individual Funding Request process.
- HWLH CCG: for further information email - firstname.lastname@example.org
Non-Formulary - Drugs which do not appear in the Joint Formulary
Any drugs not listed in this formulary have NOT been considered by the Area Prescribing Committee and therefore are NOT routinely supported for initiation in any health setting for NHS patients.
Appendix 1 Borderline Substances
Appendix 2 Stoma Care Accessories
Appendix 3 Blacklist Drugs not routinely supported
Appendix 4 Wound Management Products and Elasticated Garments
Appendix 5 Continence
Chapter 1 Gastrointestinal
Chapter 2 Cardiovascular
Chapter 3 Respiratory
Chapter 4 Central Nervous System
Chapter 5 Infections
Chapter 6 Endocrine
Chapter 6 of the Joint Formulary is for use by prescribers.
If you have any questions about this document, please contact the Medicines Management Team.
Please see Clinical Prescribing Documents and Resources - Endocrine for Formulary Blood Glucose Monitors and Test Strips