West Essex Red List

The General Medical Council Good Medical Practice states ‘prescribe drugs or treatment, including repeat prescriptions, only when you have adequate knowledge of the patient’s health, and are satisfied that the drugs or treatment serve the patient’s needs. It also says provide effective treatments based on the best available evidence’. By prescribing a medication a GP is taking clinical responsibility.

What Is The Red List?

The Red list contains medicines which have been discussed at the Medicines Management Board/Area Prescribing Committee Stakeholders/Locality and it has been agreed are not normally recommended for prescribing in primary care

• Medicines may be low priority, because they are not the most clinically or cost effective or for which there are safer alternatives and are NOT RECOMMENDED ON THE WECCG FORMULARY
• 'Specialist Only' medicines should only be prescribed in secondary / tertiary care by or under the supervision of a specialist and will need to be prescribed on an on-going basis by the initiating provider.

Most GPs should not normally be asked or agree to prescribe these medicines. This is because these treatments require specialist knowledge, monitoring or dose adjustment or they may be used for conditions which GPs rarely encounter.

• Some medicines may be both specialist only (RED List) and shared care (YELLOW List) depending on the condition they are used to treat.
• Medicines listed by NHSE as specialist commissioned services exclusively from secondary/tertiary care are automatically included in the list, e.g. Metabolic disorders, Specialised services for infectious diseases (TB hepatitis, malaria)
•  Others may be on the specialist only list as they are part of a package of treatment provided by specialists in secondary or tertiary care, e.g. chemo therapy adjuvant therapies, LMWH, erythropoetins, specialised formulas BNF A2.3.1.
• Intravenous fluids and anaesthetic agents are all assigned specialist only classification by default, and are not included on the list.
• Injectable products would generally be specialist only, unless an agreement had been made between the GP and the specialist for an individual patient, as part of an agreed course of treatment where the trained patient / carer or health care professional administers the medicine at home or in the surgery, and/or specifically commissioned for Primary Care prescribing. This should not preclude a GP from use in urgent treatment where oral treatment is not appropriate.

These recommendations are made without prejudice to established longstanding prescribing and are not intended to disrupt the care of patients already receiving any of the drugs in the list.

Adding a Hospital only medication to patient’s Primary Care Medical Record

EMIS

• Select the Medication page on the patients record
• Add the medication in the usual way
• When you have completed this click on “issue”
• Select the option “Change all”
• A list appears select “Record Hospital(no print)”
• Select “Approve and Complete”

SystmOne

• Select the patient
• Select the medication screen
• On the tool bar below “Medication (All Medication) select “?”
• This will allow you to record non printable dental or hospital medication
• Select the medication to be added
• By clicking on the green flag and adding the ‘clinical indication’