Practice agreement for QIPP Switch work (Oct-Dec 2015)
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It is good practice to have an agreement in place with each individual practice detailing the specifics of
how the switch process will be completed.
The following areas should be agreed with each practice before any switch process begins.
The agreement should then be signed by both the practice manager and prescribing lead and any
members of the Pharmacy and Medicines Management Optimisation Team (PMOT) who will be
involved in the switch process such as the pharmacist and/or technician.
A copy should be left with the practice manager and a copy saved in the PMOT file at the practice.
How will the patients be informed of the decision?
(e.g. letter/PIL sent to patient, telephone or screen
note). If letter, please indicate which switches a
letter is required for.
If by letter, has the GP prescribing lead seen the
letter and in agreement with it?
Will the letter be linked to a patient consultation?
If not, how will the switch be recorded?
It is requested that practice admin staff support the
Pharmacists in sending letters out; Please provide
the name of the personnel who will aid this process.
Once the list of patients has been generated, who
will authorise the patient list?
Who will be discontinuing the medication?
What read code should be used to record the
switch?
How will the practice team (including all prescribers,
practice nurses and admin staff involved with
prescriptions) be informed of the changes and who
is responsible for this?
Who will inform the local community
pharmacy(cies) and how?
When the medication is switched by the
Pharmacist, how long should the medication then
be authorised for, before a review is required?
Other Comments
Vensir®
Sastravi®
/ Stanek®
Sirdupla®
Venlafaxine MR 75mg/150mg caps/tabs (branded and generics) TO Vensir XL 75mg/150mg capsules
Switch process approved by:
Practice Manager
Practice GP Prescribing
Lead
PMOT Pharmaceutical
Adviser
Date
Stalevo® all strengths (branded and generics) TO Stanek tablets OR Sastravi tablets
Sastravi® tablets
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Current choice of WHHT
Contains Soya oil (hence allergy
status for patients needs to be
thoroughly checked)
Stanek® tablets
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Community Pharmacist’s loose out
financially by dispensing this brand
Does NOT contain any soya oil
Two options are available for the
Stalevo® switch. Both are the
same price. Please tick which
option you wish to opt to switch to.
Switch process approved by:
Practice Manager
Practice GP Prescribing
Lead
PMOT Pharmaceutical
Adviser
Date
Seretide Evohaler 125mcg/250mcg (branded and generics) TO Sirdupla MDI
125mcg/250mcg for adult patients with asthma (18 years and above)
YES
NO
Is the practice happy for Seretide evohaler (125mcg and 250mcg)
prescribed for COPD (unlicensed indication) to be switched to Sirdupla
MDI (also unlicensed indication)
Switch process approved by:
Practice Manager
Practice GP Prescribing
Lead
PMOT Pharmaceutical
Adviser
Date
I, the CCG Pharmacist/Pharmacy Technician, hereby agree to comply with the Data Protection Act 1998
and to ensure that patient confidentiality is maintained at all times with a duty of care equivalent to that
required by the GPhC standards of conduct, ethics and performance.
Name
Signature
Date