News

2000

THIORIDAZINE LICENSE RESTRICTIONS - the not unexpected news that thioridazine is being restricted significantly came on 12th December. There has been much discussion on the e-mail group. Some local advice leaflets are available on this site by clicking here.
15.12.00

The UKPPG Bulletin Board (Lynn Haygarth, Siobhan Drummond, Graham Parton, Dave Branford and Stephen Bazire) met on Tuesday 12th December and planned the next years activites, as well as making a start on reviewing the Clinical Standards Document (as requested widely). Thanks to Janssen-Cilag for funding the room and accomodation.
15.12.00

CMHP Board - the CMHP Board met on 8.12.00 in Luton, except for David Taylor (still recovering from a severe Rugby injury) and Evelyn McPhaill (more of this later). Rapid progress was made with the viva, portfolio and other issues. The next meeting is planned for early January.
15.12.00

NEW CHIEF PHARMACEUTICAL OFFICER APPOINTED AT THE DEPARTMENT OF HEALTH The Department of Health today announced the appointment of Dr Jim Smith as the new Chief Pharmaceutical Officer.

Welcoming the appointment, Health Minister Lord Philip Hunt said "This is a particularly important time for pharmacy in the NHS. Pharmacy in the Future - the modernisation programme for pharmacy in the NHS - set out a clear vision and programme for the next five years. It will mean better services for patients, better use of pharmacists skills and universally high standards throughout the profession.
"Implementing it will require knowledge and understanding, a clear sense of purpose and strong leadership. Jim Smith has an in-depth knowledge of pharmaceuticals, pharmacy and the NHS, and high standing in his own profession. He is also highly regarded by other associated professions. He has all the qualities required for implementing Pharmacy in the Future.

"His first tasks will be to establish and lead a taskforce on partnership in prescribing and to take forward the debate on the respective roles of pharmacists and their staff, so that the talents and skills of pharmacy technicians and other support workers are fully utilised."

Dr Smith said: "I am delighted to be taking up the post of Chief Pharmaceutical Officer at this very important time for the NHS and for pharmacy. I look forward to working with the profession to meet the opportunities and challenges set out by the Government in Pharmacy in the Future.
He will take up appointment on 15 January.

Notes to members:
1. Dr Smith is 55. He is currently Regional Pharmaceutical Adviser to the NHS Executive Northern and Yorkshire Region and Director of Pharmacy at the Regional Drug and Therapeutics Centre, University of Newcastle upon Tyne. He is a Fellow of the Royal Pharmaceutical Society of Great Britain and even spoke at the UKPPG conference in 1998.

He has worked in community, hospital, industrial and academic pharmacy, with particular interests in community pharmacy development, in medicines information and adverse drug reaction monitoring, and in the management of prescribing and medicines use.

He has also worked extensively for the pharmaceuticals programme of the World Health Organisation Regional Office for Europe.

2. Pharmacy in the Future, the modernisation programme for pharmacy services, was announced by Lord Hunt at the British Pharmaceutical Conference on September 12, 2000 (Press Release 2000/0512 refers).
6.12.00

The UKPPG committee met in Birmingham on 23-24th November, the venue being supported by Lundbeck through Chris Sutton. Friday evening was a Public Relations Session, facilitated by Lou Jones and Anne Parry from C3 Consulting. The conclusion (with my notes in brackets) was the following:

Our PR objective should be that the UKPPG should be the first point of call in the UK for mental health drug issues.

The UKPPG thus needs a:

  1. PR plan and strategy
  2. more professional website developed, with a members area and a developed flagship public area (good site for members but not much promotional for visitors, and perhaps there is too much "free" to any visitors - some should perhaps be for members only)
  3. Media strategy and media pack
  4. sponsorship strategy (i.e. ethics, purpose and aims)
  5. better general information pack about the organisation

As a group we need to:

At the committee meeting the next day, the following was discussed by Stephen, Celia, Morag, Alan, Siobhan, Graham N, Graham P, Peter, Gill, Diane, Lynn and Juliet:

(25.11.00)

The UKPPG committee met in Birmingham on 23-24th November, the venue being supported by Lundbeck through Chris Sutton. Friday evening was a Public Relations Session, facilitated by Lou Jones and Anne Parry from C3 Consulting. The conclusion (with my notes in brackets) was the following:

Our PR objective should be that the UKPPG should be the first point of call in the UK for mental health drug issues.

The UKPPG thus needs a:

  1. PR plan and strategy
  2. more professional website developed, with a members area and a developed flagship public area (good site for members but not much promotional for visitors, and perhaps there is too much "free" to any visitors - some should perhaps be for members only)
  3. Media strategy and media pack
  4. sponsorship strategy (i.e. ethics, purpose and aims)
  5. better general information pack about the organisation

As a group we need to:

At the committee meeting the next day, the following was discussed by Stephen, Celia, Morag, Alan, Siobhan, Graham N, Graham P, Peter, Gill, Diane, Lynn and Juliet:

(25.11.00)

The UKPPG committee met in Birmingham on 23-24th November, the venue being supported by Lundbeck through Chris Sutton. Friday evening was a Public Relations Session, facilitated by Lou Jones and Anne Parry from C3 Consulting. The conclusion (with my notes in brackets) was the following:

Our PR objective should be that the UKPPG should be the first point of call in the UK for mental health drug issues.

The UKPPG thus needs a:

  1. PR plan and strategy
  2. more professional website developed, with a members area and a developed flagship public area (good site for members but not much promotional for visitors, and perhaps there is too much "free" to any visitors - some should perhaps be for members only)
  3. Media strategy and media pack
  4. sponsorship strategy (i.e. ethics, purpose and aims)
  5. better general information pack about the organisation

As a group we need to:

At the committee meeting the next day, the following was discussed by Stephen, Celia, Morag, Alan, Siobhan, Graham N, Graham P, Peter, Gill, Diane, Lynn and Juliet:

(25.11.00)

The UKPPG committee met in Birmingham on 23-24th November, the venue being supported by Lundbeck through Chris Sutton. Friday evening was a Public Relations Session, facilitated by Lou Jones and Anne Parry from C3 Consulting. The conclusion (with my notes in brackets) was the following:

Our PR objective should be that the UKPPG should be the first point of call in the UK for mental health drug issues.

The UKPPG thus needs a:

  1. PR plan and strategy
  2. more professional website developed, with a members area and a developed flagship public area (good site for members but not much promotional for visitors, and perhaps there is too much "free" to any visitors - some should perhaps be for members only)
  3. Media strategy and media pack
  4. sponsorship strategy (i.e. ethics, purpose and aims)
  5. better general information pack about the organisation

As a group we need to:

At the committee meeting the next day, the following was discussed by Stephen, Celia, Morag, Alan, Siobhan, Graham N, Graham P, Peter, Gill, Diane, Lynn and Juliet:

(25.11.00)

RPSGB Council Dinner. Your Chairman spent a very interesting evening in 3rd October (what a way to spend your birthday!) as a guest at the Council dinner at HQ in Lambeth. Among the 40 or so guests (in addition to Council members) were many well known names from politics and pharmacy. Christine Glover, RPSGB President, welcomed guests. In her speech, she made a particular mention of the Task Force's producing guidelines on mental health (amongst others), and specifically mentioned the UKPPG, it's telephone helpline, website and peer support. The keynote speech was made by Lord Hunt, Parliamentary Under Secretary of State for Health. He made a passionate speech about the recently published Pharmacy plan, and made a particular mention of CPD and competence to practice. This will be a key aspect of future development. Despite being a long day (and for all those who think we do it for the money, I got home at 2am, had to be in at work in the morning and had to pay my own expenses) some very useful ideas and contacts came out from informal discussion, so there may be some developments soon.
12.10.00

KPPG Conference 2000 was, by many people's reaction, at the least one of the very best ever. The new venue and facilities were as good as we hoped, plenty of space, plenty of staff to help, the venue organisers were as helpful as they could be and accomodated our needs and worked well with us. The sessions went very well, with lots to think about and get going on. Inspiration and ideas all round. The food was good and socialising better than ever. The barn dance followed by disco worked really well. The result was a real "buzz" about the whole conference. Denny Humphries and Celia Feetam, ably assisted particularly by Morag Martin (workshops and money), Diane Booth (Medical exhibition), Graham Parton (posters) and the rest of the committee, must take most of the responsibility for all this. If you were there, or not, these are just some random thoughts from your Chairman after the conference of things to think about and act upon:

The results of the postal election for members of the 2000-2001 committee were:

Wendy Davies - 49
Siobhan Drummond - 50
Gwawr Faulconbridge - 18
Ian Maidment - 36
Graham Newton - 52
Juliet Shepherd - 50

Siobhan Drummond, Graham Newton and Juliet Shepherd are thus elected to the committee for a three year term. As well as the 91 returns, there were a surprisingly high number of spoiled voting papers, members failing to sign the return envelope and adding membership numbers. Thanks to Alan Pollard and Denny Humphries for organising the voting.
9.10.00

Lorazepam injection NOT NOW TO BE DISCONTINUED. Wyeth have reversed their decision to discontinue Ativan injections. However there will be a short term problem as they have discontinued production and it will take up to 3 weeks to bring it back on line (what with sterility testing etc.) They ask that we exercise restraint in ordering to conserve stocks. If you do run out, I think IDIS have a source. (From Jeff Green)
29.9.00

Lorazepam injection discontinued. Wyeth have announced the discontinuation of lorazepam injection for "commercial reasons" and because of the stringent storage requirement which is between 2 and 6 degrees as opposed to the usual 4 to 8 degrees. They have been having problems with this apparently. They have about a months supply left. IDIS will be importing a product (unlicensed of course) on a named patient basis, really handy in an acute medical emergency. If this discontinuation occurs, it will cause severe difficulties for many Trusts, for use in status epilepticus or acute psychiatric emergency. If you fall into this category, and would like to complain to Wyeth and request they reverse their decision, Andy Fuller has drafted a letter that you my like to copy, adapt and post to Wyeth. A copy is available by copying the text below and pasting into a letter format. In addition, next time your local Wyeth rep calls, don't discuss venlafaxine, just talk about lorazepam. If everyone does this, they'll soon get the message:

Ulf Wiinberg,
Managing Director
Wyeth Laboratories
Huntercombe Lane South
Taplow
Maidenhead
Berks. SL6 0PH

Dear Mr Wiinberg,

Re: Lorazepam (Ativan) Injection

We have just discovered that your company intends to discontinue making this product on commercial grounds. I am consequently writing on behalf of this Trust to request that this decision be reconsidered. This preparation is an essential part of our Trust’s Rapid Tranquillisation/status epilepticus policy as it is the only satisfactory benzodiazepine for intramuscular injection on the market in this country.

There cannot be a Mental Health Trust in the country which does not use it in the same way that we do. In addition, I am aware that it is also the mainstay of the treatment of Status Epilepticus in many general medical Trusts.

Your company has indicated that Idis will be importing this product when Ativan is discontinued, and they are just awaiting a licence. Having checked with Idis, the licence they are waiting for is an import licence, not a product licence. This would only be available on a named-patient basis, which would be completely useless (insert your word here) in cases of acute psychiatric emergency or status epilepticus. The delay in the obtaining of the drug would result in harm to patients.

It is totally unacceptable that we should be required to use a drug with no U.K. product licence on such a large scale. The legal implications for our Trust/service of this are immense. Additionally, I understand that the cost of the imported product is expected to be some seven times more expensive than the current preparation.

I make no apology for contacting you personally about this, since the seriousness of the situation merits it.

Yours faithfully,
YOUR NAME
YOUR TITLE

25.9.00

UKPPG committee elections - you should have received your voting papers by now (provided you are a UKPPG member). If not, please contact Denny Humphries. We have a genuine election this year, with six candidates, and I look forward to working with whoever is elected. I hope the committee will continue as a team effort with active, interested and dedicated members working together for the common good. We are on the verge of something big, so we need a committeee to help achieve this.
19.9.00

"Pharmacy in the future - Implementing the NHS Plan" - Lord Hunt's programme for pharmacy has been published, and you can download a copy from the www.doh.gov.uk site. Making better use of technicians and automation is included. At least it actually mentions Pharmacy and future in the same sentence!
15.9.00

Postgraduate education - we understand that the de Montfort Postgraduate Certificate and Diploma are now "on hold" and not taking new students. Our lips are sealed. The Aston Certificate and Diploma in Psychiatric therapeutics are, however, in full operation, taking new students (or at least adding them to the waiting list) and doing very well.
14.9.00

UKPPG Patients advice leaflets - sorry folks, but there are still delays with this. The commissioned text was considered by the final proof readers to need futher review and adaptation and so yet more work has to be carried out. This should now be ready by November 2000 (provided Celia, Peter and Graham Newton can get it done) and the CDs launched early in 2001. This is a pain, but we felt that they had to be right before being released.
(15.9.00)

UKPPG.ORG - The UKPPG site has now moved to www.ukppg.org. The original advice back in 1998 was that we were not a registered charity so couldn't have a " .org " URL name. Thanks to Chris Pugh, we've disproven this, registered the new site name and moved the whole site. Thanks Chris!
15.9.00

The Royal College of Psychiatrists has completed an audit of high-dose and combination antipsychotics, which doesn't make wonderful reading. Carol Paton (involved with the original audit), Stephen Bazire and David Pruce (RPSGB) held a meeting with the College Research unit (Paul Lelliot and Tom Barnes) to discuss the outcome and what pharmacists could do to help improve the situation. There is a possibility of a joint statement between the BAP, RCPsych, UKPPG and RPSGB, and this is being considered at the moment.
(14.9.00)

RPSGB Mental health Task Force
At the British Pharmaceutical Conference in Birmingham on 12.9.00, the "Practice Guidance on the Care of people with Mental Health Problems" produced by the RPSGB Task Force on Mental Health were formally launched. The session, chaired by Hassan Argomandkhah (Task Force Chairman and Council member), featured Task force members Janis Stout (Social worker, NW education consortium), Andrew Curry (CMHN, Dorset) and Stephen Bazire (Norfolk, but not acting on behalf of the UKPPG) to outline the contents. What follows is Steve’s synthesis (or spin) on the contents.

In his presentation, Steve mentioned that there were many problems facing pharmacy e.g. medicines are a "big issue", with a high risk to users of getting medicines wrong, prescribing of psychotropics was frequently poor or non-evidence-based (e.g. antidepressants, antipsychotics), education of users and carers about their medicines is generally poor or non-existent, there is variable and conflicting information available and pharmacists (and many others) are not necessarily up-to-date or assertive enough. An example scenario is that e.g. in secondary care, a new drug is prescribed for a patient on a ward, the patient only finds out about it at the next drug round and then receives little or no information until, if they are lucky, they get "counselling" and/or an information leaflet (or neither) on discharge. The patient and is then left with only a few sources of information and advice e.g. GP, family, friends, Community Pharmacists, Internet etc. In primary care, a GP may prescribe drug during a short consultation, and relies on the community pharmacist to counsel or give out information leaflets. Worse still is the out-patient scenario, where a junior or perhaps staff grade doctor advises, the GP prescribes on this advice, the community pharmacist dispenses and none know what they're doing.
The ideal scenario (delusion might be a more accurate term) for secondary care would be that an RMO agrees a diagnosis and strategy, a pharmacist agrees the drug, dose and monitoring, counsels that patient before starting the drug, follows this with full education about drug (e.g. mode of action, the how and why of side effects, tolerance/dependence/addiction, duration of treatment etc), a comprehensive discharge package is provided, followed by transfer to a Community pharmacist, follow-up by Liaison Pharmacist in conjunction with a Community Pharmacist, with support to the patient, carer, relatives and the community pharmacist by secondary care e.g. helpline, books etc. There is then follow-up from fully trained and supported professionals e.g. CMHNs, advocates, self-help groups, carers etc and referral facility direct from primary to secondary care and vice versa.
The purpose of the RPSGB producing these mental health guidelines was that there are huge problems with the use of medicines in mental health, and that pharmacists can help solve many of them, by promoting "joined up pharmacy", recognising strengths and weaknesses of branches of profession. Subsequently, the guidelines are aimed at all pharmacists, but especially pharmacists with open minds. This would thus include Community pharmacists, Secondary care generalists, Secondary care specialists, LPCs, Commissioners/PCG/PCTs, Academia (Schools and APUs), Specialist groups and Prison pharmacists. The guidance is presented in the format and order of the National Service Framework for mental health (England) standards.

Guidance for the branches of the profession (in no particular order)Secondary care – specialists

Specialist mental health pharmacists should:

Secondary care - generalists

Primary Care Pharmacists

Essential services, should be provided by all:

Extended services:

With a CPD commitment (initial and on-going), more advanced services can be provided e.g.

Commissioners e.g. PCTs, PCGs, Health Boards etc

Specialist Pharmacy Groups

Academia

Continuous Personal Development

The whole premise of the guidance is that if you provide specialist services there must be a CPD commitment. This can be via a number of examples:

The profession

Other prominent pharmacists who were involved in the Task Force included Annie Coppel (NPC), John Donoghue and Portia Omo-Bare (London). Other members included Margaret Edwards (SANE), Prof Rob Kerwin (Maudsley), Dr Chris Manning (GP). Not forgetting Janet Flint and Jane Lapon (Practice Division, RPSGB) for the hard work, plus Hemant Patel, former President RPSGB, who started the ball rolling in the first place. Many other people, e.g. Dave Branford, Susan Abell, Celia Feetam etc contrinuted to the document.

The 75 page document has a summary, practice guidance (ie ways of working, rather than clinical guidelines), examples of good practice and contacts. Celia Feetam is arranging with Christine Gray from the Society to have copies of the full report sent to UKPPG members as soon as available.

For full details (report from PJ, and links to the full document) click here.
13.9.00

The UKPPG has registered as a stakeholder with NICE in their stakeholder request for guidleines to be produced. We just made it in time for the schizophrenia guidelines scoping document, with the depression ones to follow soon. You may register yourself as a "stakeholder" by visiting nice-web.
13.9.00

UKPPG committee meeting 8.9.00
The UKPPG committee met in Manchester on Friday 8.9.00, with accommodation and rooms courtesy of Novartis Pharma, so thanks to them. There was a full turnout (except for Lynn Haygarth and Alan Pollard, with David Taylor representing the CMHP). Steve apologised for not being as organised as he wanted, due to his fathers unexpected illness and subsequent knock-on effects on time. Among the many items discussed were:

9.9.00

The EPPN conference in November is proceeding well, with presentations booked from USA, Norway, France, Spain, Netherland, Scotland and Belgium. They are looking forward to the English/UKPPG presentation. There was also good news, in that the pan-European hypnotics in the elderly survey, organised by the Belgians and presented as a poster at the last CINP, received a poster award. Well done!
10.9.00

Meeting between RPSGB President and UKPPG members. On 9th August at RPSGB HQ, RPSGB President Christine Glover and Philip Green met Dr. Dave Branford, Celia Feetam and Stephen Bazire from the UKPPG. The reasons for the meeting, held at the invitation of Christine Glover in response to letters from Dave, Stephen and John Donoghue, were:

Points made in discussion:

Comments

Things UKPPG can do to help its profile and raise awareness of problems with medicines in people with mental health problems:

Overall, this was a fruitful meeting and we came to the conclusion that Mrs Glover (an original member of the (UK)PPG) was on-the-ball.
(9.9.00)

Pharmaceutical Care Awards 1999. Congratulations are due for two teams who won prizes this year.

Pharmaceutical Care Awards 1999

Winners in the hospital section for "Managing patients on high-dose antipsychotics" receive a plaque and a cheque for £1,000 from Professor Hepler. Left to right: Pat Murray (chief pharmacist, Royal Edinburgh hospital) and Joy Nicholson (principal pharmacist, Royal Edinburgh hospital)

By designing aide-mémoires, monitoring sheets and a new prescription chart, pharmacists at the Royal Edinburgh hospital improved the supervision and review of patients who had been prescribed high doses of antipsychotics. Presenting the winning entry in the hospital section, Mrs JOY NICHOLSON (principal pharmacist) said that she and a project team of pharmacists and psychiatrists had set up the scheme after a survey of prescribing of high-dose antipsychotic drugs within the trust showed that recommendations from the Royal College of Psychiatrists were not being followed. Documentation was poor, laboratory monitoring was not being requested and patients who were taking high doses of drugs were not being reviewed. The team put together documentation, which included a summary of the main recommendations from a Royal College of Psychiatrists consensus statement on the use of high-dose antipsychotic drugs, a chart that identified patients taking high doses of drugs, a new prescription chart that showed high doses of antipsychotics and a monitoring sheet that was filed in the patient's notes. The consensus statement published by the Royal College in 1994 stated that doses in excess of those recommended by the British National Formulary increased the risk of sudden death and dose-related side effects. The statement recommended that prescribing practice be audited and procedures put in place to manage patients taking high-dose antipsychotics. Of the patients assessed, 29 were identified as needing review of their medicines with a view to reducing the dose or using alternative therapies. One year later, although 19 were still taking high doses of antipsychotic, nine of these had had the dose decreased. Of those remaining on high doses, routine monitoring with the aim of reducing the dose and minimising polypharmacy was continuing. High doses were only continued following agreement by both the health care team and the patient. The documentation was approved by the hospital drug and therapeutics committee and the launch of the new charts was highlighted in a bulletin that was circulated throughout the trust. In addition, the system was introduced to new doctors during their induction training. The monitoring system ensured that the appropriateness of continuing treatment with high doses of drugs was reviewed, that alternative treatments were considered and the patient's response to treatment and any side effects suffered were assessed. The project team was now looking to integrate the process into a new computerised patient information system that was currently being piloted by the trust. In addition, use of the documentation might be extended to patients being treated in the community and a high-dose "early warning" system, which encouraged review before high doses were first prescribed, might be developed.

The production of leaflets on psychiatric medication for patients with learning disabilities was the subject of the runner-up project in the shared care category. The project had been devised by Camden and Islington pharmaceutical services as a multidisciplinary exercise. The aim was to create high quality medicines information leaflets in a form accessible to and acceptable by people with learning disabilities who were using psychotropic medications. The project team consisted of one pharmacist, Ms BETSY WILKIE (principal pharmacist, community services, St Pancras hospital, London), two psychiatrists and two representatives of the Elfrida Society, which exists to support people with moderate learning difficulties. The project was undertaken because of the difficulty people with learning disabilities have in using the information presented in currently available patient information leaflets. The project began with an extensive literature search which found only one simplified publication relating to the use of medicines. It found no medicine-specific leaflets or information in a form which people with learning disabilities could use.
The project team involved people with learning disabilities at all stages of the process. When they used structured interviews to elicit patient perception of medicines use, the team found that 13 of the 21 people interviewed were unable to read the manufacturers' patient information leaflets supplied with their medicines, but 20 of the 21 wanted to receive information in an accessible form.

A number of draft leaflets were produced and piloted with a similar group of people with learning disabilities. One finding was that even those with only basic general reading skills could recognise medical words such as "carbamazepine" and "paranoia". They could also understand concepts such as "side effects" but were confused if there were too many facts. In the light of this consultation, second drafts of the leaflets were produced using large sans serif text, simple sentence construction and illustrations from a picture bank designed for people with learning difficulties. In all, eight leaflets were produced, each concerned with a single drug or no more than three related drugs.

The project team then undertook a randomised controlled trial to examine the effect of introducing the leaflets to people with mild to moderate learning disabilities. This led the team to develop guidelines in the use of the leaflets. Plans are now in hand to make the leaflets available nationally. Distribution has been arranged through the Elfrida Society. The team says that its experience may help others who wish to provide accessible information about medicines for people with other disabilities, such as those with reduced visual capacity, or for older people, who may benefit from an approach other than close print.
4.7.0

UKPPG committee - the committee met on Friday 16th June in Coventry, at the Lilly conference (courtesy of Lilly Psychiatry). Among the many items discussed at the relatively short meeting were:

26.6.00

US action - I thought you might like to see what is happening in USA, and what might happen with concerted action from a group of individuals working as a team...

LEGISLATIVE ACTION ALERT:
IMMEDIATE ACTION IS NEEDED -- WE NEED YOUR SUPPORT
Please call your Representative in the House as soon as possible and encourage him or her to pass a prescription drug benefit that includes a provision to recognize pharmacists as providers.

Election year pressure has turned up the heat on congressional efforts to pass a Medicare prescription drug benefit bill this year. Rep. Bill Thomas (R-CA) in the House Ways and Means Health Subcommittee tentatively scheduled a hearing to finalize H.R. 4680 for today, June 19, and aims for House passage before the Congress recesses for the July 4th holiday.

Currently, the mood on Capitol Hill seems very partisan, with each party criticizing the other's proposal. However, neither party wants to be responsible for not passing legislation this year. As a result, we must take this new effort to pass a Medicare prescription drug benefit very seriously.

ASHP is working hard to use this momentum to seek recognition of pharmacists as providers under the Social Security Act thereby making pharmacists eligible for compensation.
Key Points - When you contact your Representative you should emphasize that:

26.6.00

College of Mental Health Pharmacists Founders Board held it's second meeting on 23rd June, at which the consultation replies were individually discussed (the outcome of the Consultation exercise June 2000 is summarised here). Full details of the new draft constitution, meeting notes etc. is one the CMHP page (link above).
25.6.00

British Journal of Psychiatry has an article in the June edition of the "Effects of a pharmacist's medication review in nursing homes" by Furniss et al. The "et al" including Susan Scobie and Jonathan Cooke, both pharmacists but neither are UKPPG members. The paper indicates that a pharmacist doing active medication reviews reduces drug use and costs (Furniss et al, B J Psych 2000, 176, 563-67).
10.6.00

The Psychotropic Drug Directory 2000 is not an illusion. It really exists, and the first copies were delivered to the author on Spring Bank Holiday Saturday. They should thus be available soon through booksellers. Lundbeck Foundation have also purchased copies again and you may be able to talk one of their representatives into giving you a copy.
29.5.00

UKPPG committee membership - Juliet Shepherd (Gloucester) and Graham Newton (Liverpool) have been co-opted onto the committee until October, to fill the vacancies left by David Taylor and Dave Branford. Elections for the (probably) three vacant posts will take place in September. We understand several people have expressed an interest, which is great, so please carry on, as these are co-options until only October. Graham and Juliet were asked because they had (unsuccessfully) stood for election to the committee recently. We look forward to hearing from you all and having a dynamic new committee.
24.5.00

Postgraduate Diploma from Aston - the first modules went out this week, to the 15 people currently enrolled for the Diploma.
22.5.00

Future Organisation Of Prison Healthcare is a new document, which may have relevance to pharmacy. It is located on www.doh.gov.uk. Anyone care to comment or advise us? Sheena Mitchell?
22.5.00

CPP raises the profile of psychiatry, according to the Pharmaceutical Journal front cover. Perhaps it was a bit of both really (report of 5 speakers at CPP AGM in May, Pharm J 2000, 264, 734-5).
20.5.00

Dr. Gill Hawksworth has been awarded the College of Pharmacy Practice 2000 annual Schering Award for outstanding contribution to pharmacy practice (Pharm J 2000, 264, 740). In the same PJ, there is a photograph of fellow committee member Lynn Haygarth being awarded the Master of Education in clinical pharmacy teaching from the University of Leeds (Pharm J 2000, 264, 739).
20.5.00

College of Mental Health Pharmacists - David Taylor has accepted the challenge of being the first president of CMHP. Now for the consultation exercise!
19.5.00

Two jobs available in Norfolk - there are two C/D++ grade posts available working for Norfolk mental health care in Norfolk. One is a new post (Forensic and community) and the other ward based (potentially "pure" clinical pharmacy, with some vestigial medicine management/prescribing facilities). Details on the NMHC pharmacy website (www.nmhc.co.uk) or contact Helen, John or Stephen on 01603-421212.
9.5.00

UKPPG profile may have received a boost if Lord (Toby) Harris of Haringey (Lab, Brent and Harrow) becomes a key figure in the London Assembly that will have Ken Livingstone as Mayor. Readers may remember that Toby Harris was Chairman for the Sunday session at the 1999 UKPPG Conference (thanks to Chris Sutton from Lundbeck for suggesting him and supporting this!).
8.5.00

RPSGB - some of you in the UK may have been interested to read about the RPSGB response to the Mental Health Act Review in the Pharmaceutical Journal (2000, 264, 583, 15th April). It was clear that this response had been made with no contact with pharmacist specialists in the field e.g. our own Dr. Dave Branford (a MHA Commissioner) nor Alan Milligan (MHAC since 1989) nor did anyone from the UKPPG committee know or were asked. It also appears the RPSGB response to the NSF for mental health is also nearing completion. Again, no one on the committee knows anything about this.

Your Chairman has tonight (19.4.00) spoken to RPSGB President Christine Glover at length and faxed two letters; one from Stephen Bazire and John Donoghue (based on concerns around events at a RPSGB Mental Health Task Force meeting) and another regarding the MHA response, and the level of expertise utilised.

Rest assured that, whilst our concerns (to put it mildly) about the processes within the RPSGB aat present will not appear in the Pharmaceutical Journal, the President is fully aware of them, and is shocked and distressed that the apparent processes have been inadequate. She has a degree of insight and understanding of the problems that would surprise you, and that our concerns are being addressed. It is obviously difficult to say more here, but things are happening. I (Stephen Bazire) shall be meeting with the President soon to try to progess matters.
Very carefully worded on 19.4.00, 22.30

The UKPPG e-mail discussion group has been launched. It is early days yet, but hope this will illustrate the UKPPGs commitment to supporting pharmacists and helping you help yourselves. To join, click on the e-mail discussion group link to the instruction page. It is not as difficult as it looks.
8.4.00

UKPPG committee met on Friday 7th April in Birmingham, a meeting supported by Chris Sutton of Lundbeck, who we thank. Matters discussed included:

Chairman was then persuaded by the remainder of the committee not self-harm at the end of the meeting, went home, downed a bottle of wine and collapsed in a coma.

The COLLEGE OF MENTAL HEALTH PHARMACISTS Founders held their Inaugural Board meeting in Manchester on Tuesday 28th March 2000. Present were Founders David Taylor, David Branford and Trudi Hilton, with UKPPG Vice Chairman Celia Feetam and Chairman Stephen Bazire (who also convened the meeting). Apologies were received from John Donoghue and Evelyn McPhail.

The main points from the meeting were:
1. Board officer roles were identified ie President, Vice president/president elect, treasurer, PR and secretary. Without John and Evelyn these were not appointed.

2. The CMHP is to remain completely separate from the Pharmaceutical Industry, but Founders should still declare any conflicts of interest.

3. A "base" or regular address would be sought
Funding from the UKPPG was assured, but as a short-term "pump priming" and probably a significant sum on an annual basis. Since setting up the CMHP is the UKPPG highest priority this presents little need for discussion.

CMHP Constitution - this was deferred to next meeting
Characteristics of an accreditable person, upon which to base viva

Process of accreditation:
An adjustment of the original was agreed. Some points are that:
  1. Consultation
Targets and key stages:
Early May:
CMHP Board second meeting, on 23.6.00, will discuss:

July/August - presentation of proposals to a variety of bodies, which might include e.g. RPSGB, Chief Pharmacists, Private sector, Regional Clinical Governance leads etc.

Early September:
Third meeting, to fine tune proposals, and if everything is going to plan, prepare for a launch at UKPPG Conference in October.

We hope this is plan for this exciting venture is acceptable to UKPPG members, and we will look forward to constructive comments in May.
30.3.00

F grade post available for a Trust Senior Pharmacist, Grade F, Doncaster and Lincolnshire, Salary £32,980 - £35,811. (You might have missed it first time, as it was titled an Adviser in the advert a few weeks ago.) The advert read: "Created in October 1999 from the merger of three Trusts in Doncaster, North and NorthEast Lincolnshire, we provide a Trust wide Mental Health Service and a wider portfolio of service in Doncaster itself. We are currently seeking an experienced pharmacist to take on the newly created role of pharmaceutical advisor to the Trust.

With a wide ranging brief you will be required to maintain your clinical commitment through developing pharmaceutical input to psychiatric services, and manage the service level agreements for pharmaceutical services to the whole Trust. In addition you will work closely with the Medical Director, supporting the integration of prescribing and medicines management across the organisation and advise the Trust Board on all aspects of pharmaceutical services.

Opportunities also exist to develop working links with local Acute Trusts through tutoring Diploma Pharmacists in their relevant teaching units.

If you are interested in finding out more about the opportunity of shaping pharmaceutical services to this developing Trust or require an application pack, contact Dr David Goodhead, Medical Director or Paul Frosdick, Acting Advisor on 01302 - 366666 extension 3205.

Closing date for receipt of applications: 10 April 2000". (extended from the original)
(29.3.00)

Supervised consumption Kirsty Williams is interested to know if anyone has heard of any schemes set up whereby patients come to the pharmacy on a daily basis and are supervised whilst they take their medication. She is aware that this is done in the community with supervised methadone administration but I wondered if anyone knew anywhere where this has been extended to psychiatric medication from a hospital setting? Please contact me at Springfield Hospital on 0181 6826202 or via the e-mail c/o afuller@swlstg-tr.nhs.uk.
23.3.00

UKPPG Bulletin - well, the January edition, labelled February, eventually came out in late March. This has been unacceptable to Lynn (who had it finished by 4.1.00), myself (as the leader was written in mid-November) and the committee. Changes are afoot.
23.3.00

RPSGB Task Force - Janet Flint (RPSGB) plans to incorprate replies from the consultation exercise into the Task force on mental health document (for a full copy, click here), and I (Stephen Bazire) will be making the UKPPG response and final update. If you have any comments, I will need to have them by Monday 27th March at the very latest. Thanks to Dave Branford and Susan Abell and colleagues for extensive comments.
17.3.00

Psychiatric pharmacy - Guild members will find an interesting letter by Fernand Mathot on the "Recognition of Psychopharmacy" in the European Hospital Pharmacy journal (2000, 5, 169-70).
17.3.00

UKPPG e-mail discussion group - Graham Parton is working on this and the new e-mail group is about to be announced, once the tests have been carried out. You will have to subscribe (we can't do it for you), but we'll publicise what to do and where to log on as soon as possible. Should be great!
14.3.00

UKPPG Bulletin is now a month overdue, complete with a leader I wrote in mid-November. Sorry about this folks. It's not our fault - just think of poor Lynn Haygarth, who slaved over hot proof-reading over Christmas/New Year to have it ready to go (from our point of view) on 4th January. The "news" section should be red hot.....
13.3.00

UKPPG CONFERENCE - BIG NEWS. After much debate, visiting and negotiation, we have decided to go for a new venue this year. The conference will be moving from Latimer House to another venue within the Initial group. This is Wokefield Conference Centre, just off the M4 near Reading. Whilst not having the same atmosphere as Latimer, the facilities are bigger and better, and we now have the opportunity to try to make the conference more interesting, diverse and enjoyable. The posters and medical exhibition will have more space, there are more communal facilities and for those with time to exercise, a swimming pool, jacuzi and sauna. The rooms are a higher specification too. More news soon.
28.2.00

New e-mail for Graham Parton: g.parton@virginnet.co.uk
20.2.00

Postgraduate course in Clinical Pharmacy. Your Chairman received the following letter from Fiona Arris, e-mail PASFA@mailer.rgu.ac.uk, from The Robert Gordon University. She would like to recruit someone to commission the work for their course modules.

The main letter reads:
18th February 2000
Dear Mr Bazire
The postgraduate course in Clinical Pharmacy at The Robert Gordon University is a part-time distance learning course, with short residential periods at the University. Students must successfully complete eight modules for the award of a Postgraduate Diploma in Clinical Pharmacy; a Masters degree is awarded following an additional research project.

The course is structured as follows:

Distance learning study guides are provided containing peer reviewed up-to-date reference articles with self-assessment questions and answers.

We are currently planning modules 7 and 8. We feel it important to involve subject experts in the preparation of these specialist modules. The purpose of this letter is to enquire whether a representative of the United Kingdom Psychiatric Pharmacist group would be willing to be involved in the production of the study guide relating mental health. A fee would be paid for this involvement. This will require identification of suitable reference material, writing self-assessment questions and answers. Further guidance will be provided relating to the style of presentation etc to ensure that it is consistent with the course materials. The postgraduate course team will be responsible for editing the material but obviously full acknowledgement will be made to the contributing author.

I would be grateful if you could nominate a suitable representative from your group in order that we could approach them to determine if they would be willing to help in writing the materials. Please do not hesitate to contact me for any further information.

Yours sincerely
Dr Derek Stewart, Senior Lecturer in Pharmaceutical Public Health, Course Leader, (01224) 262432, e-mail d.stewart@rgu.ac.uk.
18.2.00

UKPPG Committee meeting 11th February - the UKPPG committee met on Friday 11th February in Birmingham, thanks to SmithKline Beecham, who sponsored the accommodation and meeting room. The agenda was huge, to the point of almost being overwhelming, but with some effort by all concerned we all completed the course. The huge number of items discussed included;

If you're still reading, well done!
14.2.00

Primary Care Trust development. Val Shaw from Stamford, Lincolnshire, England, asks "Are you having any problems with PCT development? Areas of our Trust will become PCTs on 1/4/00 and therefore the pharmacy will have to consider a wholesalers licence as business will exceed £30K. The RPSGB has no advice, and I need some urgently." Can anyone help please? If so, please e-mail VShaw@nwahc-tr.anglox.nhs.uk, and then tell the rest of us!
7.2.00

The RPSGB Task Force on mental health has now reached the consultation stage, as mentioned in the Pharmaceutical Journal (2000, Feb 4th, page 208). The document is a bit too difficult to convert to a web page (too big for a start) so I've tried downloading it as a Word file (Word 6.0/Windows 95). With luck, if you have Word on your computer and click here, it should appear here (all 60 pages of it). Comments are needed by 17th March. The document is a bit long at the moment, and will need triming.
4.2.00

College of Mental Health Pharmacists - the results of the voting for the Founder members has been completed. The result is as follows:

  1. John Donoghue, Liverpool - 137 votes
  2. Dr. David Branford, Derby - 131
  3. David Taylor, London - 122
  4. Evelyn McPhail, Dalgety Bay - 118
  5. Trudi Hilton, Uxbridge - 100
  6. Sylvia Otter, Leicester - 79
  7. Joan Miller, Salford - 77
  8. Diana Jones, Somerset - 70
  9. Anthony Oxley, Leicester - 41

The voting included forms returned in the week after 21st January, as an extra week was allowed as some forms were delayed in the post. The late voting papers added to the individual votes, but made no difference to the overall placings, which remained unchanged. 198 forms were received in total, just under 50% of the total membership.

John Donoghue, Dr. David Branford, David Taylor, Evelyn McPhail and Trudi Hilton are thus confirmed as the five Founder members. The first Board meeting is planned for late March, with a view to have the complete system ready for launch at the Conference in October.

Many thanks to Denny Humphries for organising the voting, and also to Sylvia Otter, Joan Miller, Diana Jones and Anthony Oxley for standing for election and making the process meaningful.
2.2.00

Patient Information leaflets. Some of you may be aware that there is a court case likely to take place soon on this issue. As I understand, a general hospital pharmacy in London dispensed a discharge prescription. The patient took this home, took the drugs, suffered a side effect which they were not expecting, and is now taking out a criminal prosection against the Chief Pharmacist. Why? Because the pack of drugs dispensed by the pharmacy did not contain the manufacturers patient information leaflet, and one existed. The RPSGB told us last year that although the law said we had to provide them, since there were difficulties (not all products have them, splitting packs means there aren't enough to go round, it's illegal to photocopy them etc), try what you can and wait for the situation to resolve. As I have been told, this may not be accurate and in fact the Chief Pharmacist may be criminally responsible. If anyone has any additional information or advice, please let us know.

The following appeared on the Drug information discussion page:
Those of you working with mental health patients will be familiar with graduated discharges (e.g. patient goes on leave for a few hours; if this goes well,the next period of leave may be a day; then a few days...a week... then final discharge) rather than a single discharge date with one "TTO" medication supply. This causes obvious problems when trying to work out what to do with "patient packs" of medication, as these people require only single days or a few days medication at a time. Do we split the packs, and not worry about the labelling / patient info. leaflet (with all the potential legal repercussions)? Do we give a full pack which will cover all subsequent periods of leave (even though this may be inappropriate / unsafe with certain psychiatric patients)?

What are others doing out there? Has anyone solved this thorny issue in mental health? Any ideas/suggestions will be gratefully received. (Even if you are dispensing as you always have done, this would be reassuring to know!) Thanks.
Andy Fuller, Drug Information, South West London & St Georges Mental Health NHS Trust

e-mail afuller@swlstg-tr.nhs.uk
29.1.00

The Postgraduate Diploma in Psychiatric Pharmacy by Distance Learning has been launched. It is part-time and offered by Aston University. The entry qualification is the Postgraduate Certificate in Psychiatric Pharmacy from Aston University or, for a limited period, the De Montfort University Certificate, plus regular access to in-patients with psychiatric illnesses and able to take part in multidisciplinary team meetings. Modules 1-3 cover professional expertise and application of knowledge and modules 4-6 are knowledge-based distance learning. The Diploma is awarded after completion of the six modules plus a pass at the final "open book" exam. The fees are £1800 per year (UK) or £3150 (non-UK). Some bursaries form the UKPPG may be available upon application to the UKPPG Treasurer.

Contacts, further information, application forms etc:
Course Tutor -
Celia Feetam,
Course Office,
Postgraduate Certificate in Psychiatric Pharmacy,
School of Life and Health Sciences,
Aston University,
Aston Triangle,
Birmingham B4 7ET
England
Telephone 0121-359-3611 X4751 (+44 121-359-3611 X4751)
Telephone 0121-359-0733 (+44 121-359-0733)
e-mail c.l.feetam@aston.ac.uk
www.aston.ac.uk/pharmacy
There is some further information on this site.

25.1.00

Vacant posts - did anyone else (other than Celia and I) notice that for the two mental health jobs advertised in the Pharmaceutical Journal on 15.1.00 (one for an F Grade in Manchester, the other a C/D in Salford), neither made any mention of further education and training in mental health being required, desirable, advantageous, nor even available?
17.1.00

Mental health Act 1983 reform. The review body has embarked on its second consultation period, and all comments have to be in by the end of March at the latest. Dave Branford, himself a MHA commissioner, has ploughed through the mighty consultation documents and prepared a draft response to this. Please send comments to Dave as soon as possible. When we have formulated a reply, we shall make this available for members to use as a basis for them to make submissions locally, thus enhancing the message.
7.1.00

Liquid formulation of quetiapine - has come up with a liquid formulation of quetiapine? I know Zeneca have no information. Any information gratefully received by Carolyn Zierer, Senior Pharmacist Mental Health, Princess Elizabeth Hospital Guernsey, e-mail czierer@globalnet.co.uk.
6.1.00