NHS Specialist Pharmacy Service

Jenna Murray talks to Ali Cracknell, Philippa Duggan-Carter and Jeremy Robson from Leeds University Hospital NHS trust in this podcast about a time critical medicines quality improvement project that has been successfully implemented and sustained, it is now part of everyday practice. Discussion includes the background to the project, how the team used what could have been a significant roadblock as catalyst for change and how the team knew that new practices had become business as usual. Jenna Murray - Senior Specialist Pharmacy Technician Medication Safety (NHS SPS) Ali Cracknell - Consultant in Acute and Elderly Medicine (Leeds Teaching Hospitals NHS Trust) Phillipa Duggan-Carter - Lead Nurse Parkinson's Disease Specialist (Leeds Teaching Hospitals NHS Trust) Jeremy Robson - Advanced Clinical Pharmacist for Neurology (Leeds Teaching Hospitals NHS Trust)

Gary Hodgson, Medicines Advice Pharmacist at SPS, presents a summary of the resources published by SPS between 20th and 26th June.   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:     Prescribing with confidence podcast series Exploring real-world prescribing through expert insights, practical tools, and lived experiences to support prescribers in developing safe, confident practice. https://www.sps.nhs.uk/articles/prescribing-with-confidence-podcast-series/ Share your feedback on this podcast series We would really appreciate your views, whether you’ve listened to one or multiple episodes of our Prescribing with confidence podcast series. https://forms.office.com/pages/responsepage.aspx?id=VpftQ_9Bv0yVm0BqQIO3i22A1OMYp8xGqlAGgUanSedUNktDMUdNTlRTNDZaSk5DRUdMSEZaV1g0Mi4u&route=shorturl SPS Screensavers A collection of screensavers designed by SPS for healthcare professionals to save and use on workplace computers. https://www.sps.nhs.uk/articles/screensavers/ Managing fire risk with emollients and other skin products Emollient residue can increase the risk of fatal burns. This article outlines how fire risk occurs, which patients may be at increased risk, and harm reduction. https://www.sps.nhs.uk/articles/managing-fire-risk-with-emollients-and-other-skin-products/ Prescribing and administering intravenous paracetamol safely Guidance on safe prescribing and administration of IV paracetamol, including dosing, infusion, risk mitigation, and monitoring to prevent errors. https://www.sps.nhs.uk/articles/using-intravenous-paracetamol-preparations-safely-in-paediatrics/ Influenza vaccine written instruction template for adoption An IM influenza vaccination written instruction template is published annually for adoption by organisations providing flu vaccination to employees. https://www.sps.nhs.uk/articles/influenza-vaccine-written-instruction-templates-for-adoption/ Minocycline monitoring New sections have been added, including ‘requirements for treatment lasting longer than six months’, and considerations where minocycline may be ‘less suitable for prescribing’ https://www.sps.nhs.uk/monitorings/minocycline-monitoring/ Next events – forthcoming webinars and conferences            https://www.sps.nhs.uk/home/events/next-events/            Join our WhatsApp channel to stay up to date with our latest news and updates      https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i      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'.

In this podcast Emma Bryant (Mental Health Lead at NHS Specialist Pharmacy Service) speaks with Dr Rania Ward, Principal Pharmacist for Sleep Medicine, who answers some of the questions posed in the chat during our recent webinar, SMRs in problematic polypharmacy: insomnia focus (14 April 2026). 00.45 - Sleep cycle and shift patterns 03.23 - Cumulative sleep 04.45 - Red flags 10.22 - Treat the underlying cause or start hypnotics 12.34 - Pharmacological options 15.07 - Melatonin 20.11 - Serious mental illness (SMI) and insomnia 22.22 - New medicines for insomnia (daridorexant) 26.46 - Non-pharmacological treatments 31.12 - More information and training Dr Rania Ward; Principal Pharmacist for Sleep Medicine, Queen Victoria Hospital NHS Foundation Trust Emma Bryant; Mental Health Lead, Medicines Use and Safety, NHS Specialist Pharmacy Service Useful links SMRs in problematic polypharmacy: case based discussions https://www.sps.nhs.uk/articles/smrs-in-problematic-polypharmacy-case-based-discussions/ National Sleep Pharmacy Network https://nspn.co.uk/ RCGP Learning (Insomnia) https://elearning.rcgp.org.uk/course/info.php?id=824 PCPharm (Insomnia Learning Programme) https://courses.learning.rpharms.com/product?catalog=RCP-Clinical-19

Penny Daynes, Associate Regional Pharmacy Procurement Specialist at SPS, presents a summary of the resources published by SPS between 13th and 19th June.   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:     Prescribing with confidence podcast series Exploring real-world prescribing through expert insights, practical tools, and lived experiences to support prescribers in developing safe, confident practice. https://www.sps.nhs.uk/articles/prescribing-with-confidence-podcast-series/ Share your feedback on this podcast series We would really appreciate your views, whether you’ve listened to one or multiple episodes of our Prescribing with confidence podcast series. https://forms.office.com/pages/responsepage.aspx?id=VpftQ_9Bv0yVm0BqQIO3i22A1OMYp8xGqlAGgUanSedUNktDMUdNTlRTNDZaSk5DRUdMSEZaV1g0Mi4u&route=shorturl Change management in aseptic services All changes in pharmacy aseptic service units must be formally controlled, assessed and reviewed to ensure product quality and patient safety. https://www.sps.nhs.uk/articles/change-management-in-nhs-aseptic-units/ Deviation management in NHS aseptic units Effective deviation management helps identify, investigate, and resolve unexpected events that could affect product quality, compliance, or patient safety. https://www.sps.nhs.uk/articles/deviation-management-in-nhs-aseptic-units/ 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/ Next events – forthcoming webinars and conferences            https://www.sps.nhs.uk/home/events/next-events/             Join our WhatsApp channel to stay up to date with our latest news and updates      https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i      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'.

Rakhi Aggarwal speaks with Karoline Brennan from the SPS Medicines Advice team. Karoline highlights key SPS written resources for prescribers, explains how to effectively search for information on the SPS website, and outlines the SPS clinical enquiry answering service available to primary care professionals.

Rakhi Aggarwal speaks with Hayley Berry, Lead for Learning Development at the Centre for Pharmacy Postgraduate Education (CPPE). The discussion focuses on how to navigate CPPE resources designed for prescribers and includes practical tips drawn from her experience.

John Oliver, a quality assurance specialist at SPS, presents a summary of the resources published by SPS between 6th and 12th June.   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:     Prescribing with confidence podcast series Exploring real-world prescribing through expert insights, practical tools, and lived experiences to support prescribers in developing safe, confident practice. https://www.sps.nhs.uk/articles/prescribing-with-confidence-podcast-series/ Responding to medication incidents Practical guidance to support those responding to medication incidents. https://www.sps.nhs.uk/articles/conducting-a-medication-incident-investigation/ Answers to frequently asked questions about Evergreen Assessments We have provided guidance on the recurrent themes or topics of enquiry raised, to support implementation of the Evergreen assessment process. https://www.sps.nhs.uk/articles/answers-to-frequently-asked-questions-about-evergreen-assessments/ Drug interactions: resources to support clinical decisions Suggested resources to help healthcare professionals find information on drug interactions https://www.sps.nhs.uk/articles/drug-interactions-resources-to-support-clinical-decisions/ Managing the risk of confusion between injectable iron products Minimising the risk of confusion between different injectable iron products may prevent inadvertent harm. https://www.sps.nhs.uk/articles/managing-the-risk-of-confusion-between-injectable-iron-products/ Job opportunity Senior Specialist Pharmacy Technician in Medication Safety. https://careers.uhliverpool.nhs.uk/current-vacancies/liverpool-university-hospitals-vacancies#!/job/v7991819 We want to hear from you about – safety challenges with medicines used for mental health conditions https://forms.office.com/Pages/ResponsePage.aspx?id=VpftQ_9Bv0yVm0BqQIO3izrIdNxdvTBGiYJBhRu93FdUNFZZSkNXNjlKT0Q3T0JDQzRWVlcxNzVPNi4u Next events – forthcoming webinars and conferences            https://www.sps.nhs.uk/home/events/next-events/           Join our WhatsApp channel to stay up to date with our latest news and updates      https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i      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'.

Rakhi Aggarwal speaks with Ben Rehman, Lead for Digital at SPS about how prescribers can maximise the use of SPS digital tools, including the medicines monitoring and medicines supply tools. We invite you to share your feedback on our podcast series via a short survey. We would really appreciate your views, whether you’ve listened to one podcast or multiple. The survey will take approximately 5-10 minutes to complete. Responses will be anonymised and used for research and/or service evaluation purposes. https://forms.office.com/e/ZuSGD1PxVF

Rakhi Aggarwal speaks with Maria Yousif, Pharmacist and Associate Safety and Learning Lead at NHS Resolution. Maria discusses a hypothetical case scenario, explores duty of candour, and outlines the appropriate steps to take when a prescribing error occurs. We invite you to share your feedback on our podcast series via a short survey. We would really appreciate your views, whether you’ve listened to one podcast or multiple. The survey will take approximately 5-10 minutes to complete. Responses will be anonymised and used for research and/or service evaluation purposes. forms.office.com/e/ZuSGD1PxVF

Penny Daynes, Associate Regional Pharmacy Procurement Specialist at SPS, presents a summary of the resources published by SPS between 30th May and 5th June.   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:     Prescribing with confidence podcast series Exploring real-world prescribing through expert insights, practical tools, and lived experiences to support prescribers in developing safe, confident practice. https://www.sps.nhs.uk/articles/prescribing-with-confidence-podcast-series/ Etonogestrel (e.g. Nexplanon®) implant for contraception SPS PGD template for the insertion of etonogestrel (e.g. Nexplanon®) 68mg subdermal implant for contraception. https://www.sps.nhs.uk/articles/etonogestrel-nexplanon-implant-for-contraception/ Medication safety update – May 2026 A resource collating the latest medication safety communications and publications to inform, support and inspire medication safety improvements. https://www.sps.nhs.uk/articles/medication-safety-update/ Understanding aseptic services in the NHS Pharmacy aseptic services make ready-to-administer injectable medicines to ensure safe and timely treatment for patients. https://www.sps.nhs.uk/articles/understanding-aseptic-services-in-the-nhs/ Job opportunity Senior Specialist Pharmacy Technician in Medication Safety. https://careers.uhliverpool.nhs.uk/current-vacancies/liverpool-university-hospitals-vacancies#!/job/v7991819 We want to hear from you about – safety challenges with medicines used for mental health conditions https://forms.office.com/Pages/ResponsePage.aspx?id=VpftQ_9Bv0yVm0BqQIO3izrIdNxdvTBGiYJBhRu93FdUNFZZSkNXNjlKT0Q3T0JDQzRWVlcxNzVPNi4u Next events – forthcoming webinars and conferences            https://www.sps.nhs.uk/home/events/next-events/           Join our WhatsApp channel to stay up to date with our latest news and updates      https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i      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'.

Rakhi Aggarwal interviews Shane Sweeney, Clinical Pharmacist, North Liverpool PCN, about his experience as a newly qualified prescriber. The discussion explores the professional networks he has developed, how he established them, and his transition from community pharmacy into general practice while undertaking his prescribing course. We invite you to share your feedback on our podcast series via a short survey. We would really appreciate your views, whether you’ve listened to one podcast or multiple. The survey will take approximately 5-10 minutes to complete. Responses will be anonymised and used for research and/or service evaluation purposes. forms.office.com/e/ZuSGD1PxVF

Rakhi Aggarwal speaks with Clair Huckerby, Consultant Pharmacist in Primary Care Medicines Optimisation, about her prescribing journey. Clair shares her experience of over 20 years as a prescriber, including how she developed confidence and competence and expanded her scope of practice. We invite you to share your feedback on our podcast series via a short survey. We would really appreciate your views, whether you’ve listened to one podcast or multiple. The survey will take approximately 5-10 minutes to complete. Responses will be anonymised and used for research and/or service evaluation purposes. forms.office.com/e/ZuSGD1PxVF

Hannah Miller, Deputy Regional Quality Assurance Pharmacist at SPS, presents a summary of the resources published by SPS between 23rd and 29nd May.   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:     Spotlight – May 2026 A digest of NHS Specialist Pharmacy Service support for professionals working in all areas of the healthcare system for May 2026. https://www.sps.nhs.uk/articles/spotlight-may-2026/ Managing off-contract claims Best practice guidance for NHS hospital pharmacy procurement teams on managing a successful off-contract claims process. https://www.sps.nhs.uk/articles/managing-off-contract-claims/ Using chloramphenicol during breastfeeding Topical chloramphenicol can be used with caution and monitoring. Systemic chloramphenicol is not recommended. Advice applies to full term and healthy infants. https://www.sps.nhs.uk/articles/using-chloramphenicol-during-breastfeeding/ Managing peripheral oedema caused by calcium channel blockers All calcium channel blockers (CCBs) can cause peripheral oedema. Incidence varies by choice and patient factors. Several management options are available. https://www.sps.nhs.uk/articles/managing-peripheral-oedema-caused-by-calcium-channel-blockers/ Use of injectable medicines for multiple doses Using injectable medicines for multiple doses increases the risk of contamination, error and patient harm. https://www.sps.nhs.uk/articles/use-of-injectable-medicines-for-multiple-doses/ Next events – forthcoming webinars and conferences            https://www.sps.nhs.uk/home/events/next-events/           Join our WhatsApp channel to stay up to date with our latest news and updates      https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i      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'.

This episode introduces the Prescribing with Confidence podcast series as trainee pharmacists and a final-year pharmacy student share their key insights from selected episodes. They highlight the value of SPS tools and resources in supporting safe, evidence-based prescribing, the importance of Centre for Pharmacy Postgraduate Education (CPPE) learning materials, and key lessons from exploring prescribing errors and professional responsibility. The conversation also emphasises the importance of building support networks, starting prescribing gradually, and recognising that gaining confidence takes time. Practical tips are offered to those beginning their prescribing journey, encouraging them to seek support and trust their training as they transition into practice. We invite you to share your feedback on our podcast series via a short survey. We would really appreciate your views, whether you’ve listened to one podcast or multiple. The survey will take approximately 5-10 minutes to complete. Responses will be anonymised and used for research and/or service evaluation purposes. forms.office.com/e/ZuSGD1PxVF

Gary Hodgson, one of the medicines advice pharmacists at SPS, presents a summary of the resources published by SPS between 16th and 22nd May.   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:     Have your say: biosimilar and patent resources We are reviewing Specialist Pharmacy Service (SPS) resources on biosimilars and patents to ensure they meet the needs of NHS services. https://www.sps.nhs.uk/articles/have-your-say-biosimilars-and-patents-resources/ Vaccines and immunisation: resources to support clinical decisions Suggested resources to help healthcare professionals find information regarding medicines and vaccines. https://www.sps.nhs.uk/articles/vaccines-and-immunisation-resources-for-answering-questions/ Next events – forthcoming webinars and conferences            https://www.sps.nhs.uk/home/events/next-events/           Join our WhatsApp channel to stay up to date with our latest news and updates      https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i        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'.

Dav Manku, Associate Regional Pharmacy Procurement Specialist at SPS, presents a summary of the resources published by SPS between 2nd and 8th May.   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:     Embedding the safer use of insulin Implementation of national safety standards, alerts and guidance can help reduce preventable harm from insulin use. https://www.sps.nhs.uk/articles/embedding-the-safer-use-of-insulin/ Using transdermal patches safely in healthcare settings Practical guidance for safe application, monitoring, removal, disposal, documentation and storage of transdermal patches to reduce risk of medication errors. https://www.sps.nhs.uk/articles/using-transdermal-patches-safely-in-healthcare-settings/ Medication Safety Update A resource collating the latest medication safety communications and publications to inform, support and inspire medication safety improvements. https://www.sps.nhs.uk/articles/medication-safety-update/ National PGD, protocol and written instruction templates National templates are developed with experts for clinical specialties. They reduce duplication and variation, and improve consistency of care. https://www.sps.nhs.uk/home/guidance/patient-group-directions-and-legal-mechanisms/national-pgd-protocol-and-written-instructions-templates/   Next events – forthcoming webinars and conferences            https://www.sps.nhs.uk/home/events/next-events/           Join our new WhatsApp channel to stay up to date with our latest news and updates      https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i      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'.

5 May: Embedding medication safety, Benztropine, & Medication compliance aid stability tool guidance Penny Daynes, Associate Regional Pharmacy procurement specialist at SPS, presents a summary of the resources published by SPS between 25th and 1st May. 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:    Embedding medication safety improvement within an organisation The Patient Safety Incident Response Framework (PSIRF) can support effective prioritisation and delivery of medication safety improvements. https://www.sps.nhs.uk/articles/embedding-medication-safety-improvement-within-an-organisation/ Benztropine injection for acute dystonic reactions SPS has developed this resource to support healthcare professionals in managing the discontinuation of procyclidine injection. https://www.sps.nhs.uk/articles/benztropine-injection-for-acute-dystonic-reactions/ Using the Medicines Compliance Aid Stability Tool Guidance to support using information in the Medicines Compliance Aid (MCA) Stability Tool https://www.sps.nhs.uk/articles/using-the-medicines-compliance-aid-stability-tool/ Spotlight, April 2026 A digest of NHS Specialist Pharmacy Service support for professionals working in all areas of the healthcare system for April 2026. https://www.sps.nhs.uk/articles/spotlight-april-2026/ Gowning in pharmacy aseptic services A short video about gowning in pharmacy aseptic services. https://www.sps.nhs.uk/articles/gowning-in-aseptic-services/ The role of the sponsor pharmacy in clinical trials of investigational medicinal products (CTIMPs) A full review and update in line with amendments to trials regulations. https://www.sps.nhs.uk/articles/the-role-of-the-sponsor-pharmacy-in-clinical-trials-of-investigational-medicinal-products-ctimps/ Assessing risks when reconstituting injectable medicines Assess risks of error and contamination when choosing the appropriate location for aseptic manipulation of injectable medicines. Updated version of the preparation risk assessment uploaded. https://www.sps.nhs.uk/articles/assessing-risks-when-reconstituting-injectable-medicines/ Next events – forthcoming webinars and conferences           https://www.sps.nhs.uk/home/events/next-events/          Join our new WhatsApp channel to stay up to date with our latest news and updates     https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i       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'.

Gary Hodgson, Medicines Advice pharmacist at SPS, presents a summary of the resources published by SPS between 18th and 24th April. 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:    Preparing to use omalizumab biosimilar Adcomfo, a second omalizumab biosimilar alongside Omlyclo, is now licensed. We offer general information and implementation advice. https://www.sps.nhs.uk/articles/preparing-to-use-omalizumab-biosimilar/ The licence and supporting evidence for omalizumab biosimilar Adcomfo, a second omalizumab biosimilar alongside Omlyclo, is now licensed. Review its indications, evidence, and main differences. https://www.sps.nhs.uk/articles/the-licence-and-supporting-evidence-for-omalizumab-biosimilar/ The licence and supporting evidence for denosumab 60mg biosimilars Denosumab 60mg biosimilars are licensed. Learn about indications, formulations, supporting evidence and differences. https://www.sps.nhs.uk/articles/the-licence-and-supporting-evidence-for-denosumab-60mg-biosimilars/ Managing pharmaceutical waste Guidance and principles for managing waste generated from the use of medicines. https://www.sps.nhs.uk/articles/managing-pharmaceutical-waste/ Next events – forthcoming webinars and conferences           https://www.sps.nhs.uk/home/events/next-events/          Join our new WhatsApp channel to stay up to date with our latest news and updates     https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i     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'.

John Oliver, one of the quality assurance specialists at SPS, presents a summary of the resources published by SPS between 11th and 17th April. 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:    Contraception: resources to support clinical decisions Suggested resources to help healthcare professionals find information on medicines for contraception and reproductive health https://www.sps.nhs.uk/articles/contraception-resources-to-support-answering-questions/ SMRs in problematic polypharmacy: case based discussions Recordings of case-based discussions about structured medication reviews (SMRs) in problematic polypharmacy, each focussing on a different condition. https://www.sps.nhs.uk/articles/smrs-in-problematic-polypharmacy-case-based-discussions/ Shelf lives of aseptically prepared medicines in NRFit syringes Provision of intrathecal and epidural injections in NRFit syringes may involve extrapolation of stability data from luer lock systems https://www.sps.nhs.uk/articles/shelf-lives-of-aseptically-prepared-medicines-in-nrfit-syringes/ Next events – forthcoming webinars and conferences           https://www.sps.nhs.uk/home/events/next-events/          Join our new WhatsApp channel to stay up to date with our latest news and updates     https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i     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'.

Emma Kirk and Anna Bischler talk about what you can expect from attending the upcoming webinar ‘Embedding medication safety in the Patient Safety Incident Response Framework (PSIRF)’. The webinar will be held on Wednesday 25 March from 12.30-2pm. Emma Kirk, Medication Safety Officer Network Lead, NHS Specialist Pharmacy Service Anna Bischler, Associate Director – Medication Safety, NHS Specialist Pharmacy Service Register for the webinar here: https://www.sps.nhs.uk/articles/effectively-embedding-medication-safety-into-psirf/

Kieran Reynolds talks to Fatema Jessa about liver transplant. Discussion includes what liver transplant is, why it is performed, how patients are managed post liver-transplant and the role of pharmacy professionals (both secondary and primary care) in managing these patients. Fatema Jessa - Consultant Pharmacist – Hepatology and Liver Transplant and NCL Digital Pharmacy Network at the Royal Free London NHS Foundation Trust Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS Useful links: The British Liver Trust’s information on Liver transplant https://www.nhsbt.nhs.uk/organ-transplantation/liver/living-with-a-liver-transplant/liver-transplant-medicines/%22HYPERLINK%20%22https://britishlivertrust.org.uk/information-and-support/liver-transplant/ The British Liver Trust’s information on life after liver transplant https://britishlivertrust.org.uk/information-and-support/liver-transplant/life-after-liver-transplant/%22%20/l%20%22Immunosuppression%20medicines The NHS Blood and Transplant’s information on liver transplantation medicines https://www.nhsbt.nhs.uk/organ-transplantation/liver/living-with-a-liver-transplant/liver-transplant-medicines/ SPS Drug monitoring tool https://www.sps.nhs.uk/home/tools/drug-monitoring/ The Pharmaceutical Journal (PJ) article on medicines management in adult patients undergoing liver transplantation https://pharmaceutical-journal.com/article/ld/medicines-management-in-adult-patients-undergoing-liver-transplantation The Green Book: information on vaccines for vaccine preventable diseases  https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book#the-green-book NHS Business Services Authority information on NHS Prescription Prepayment Certificate (PPC) https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/nhs-prescription-prepayment-certificate-ppc

Kieran Reynolds talks to Leslie Wong, Advanced Clinical Pharmacist in Hepatology in the Eastern Liver Network and Communications Officer at the British Hepatology Pharmacy Group (BHPG) about alcohol related liver disease (ARLD). Discussion includes what ARLD is, screening tools to help identify possible alcohol misuse, treatment of ARLD; including medicines used in medically assisted alcohol withdrawal and medicines used to help support abstinence, as well as long term vitamin supplementation. Leslie Wong - Advanced Clinical Pharmacist in Hepatology in the Eastern Liver Network and Communications Officer at the BHPG Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS Useful links: The British Liver Trust’s information on alcohol and liver disease https://britishlivertrust.org.uk/information-and-support/risks-and-causes/alcohol/#:~:text=Regularly%20drinking%20over%20the%20recommended%20limit%20increases%20the,their%20health.%20Alcohol%20is%20broken-down%20by%20the%20liver. The British Liver Trust’s information on alcohol-related liver disease (ARLD) https://britishlivertrust.org.uk/information-and-support/liver-conditions/alcohol-related-liver-disease/ MD+CALC AUDIT-C calculator https://www.mdcalc.com/calc/2021/audit-c-alcohol-use Drinkaware’s Drinking Check https://www.drinkaware.co.uk/tools/drinking-check/#/overview DrinkAware information on Cutting your drinking with alcohol-free or low alcohol drinks https://www.drinkaware.co.uk/advice-and-support/alcohol-free-drinks/cutting-your-drinking-with-alcohol-free-or-low-alcohol-drinks/ SPS article on using and prescribing thiamine in alcohol dependence https://www.sps.nhs.uk/articles/using-and-prescribing-thiamine-in-alcohol-dependence/ Regional Medicines Optimisation Committee (RMOC) position statement on oral vitamin B supplementation in alcoholism (PDF) https://www.wyicsapc.co.uk/wp-content/uploads/2020/02/RMOC-Position-Statement-Oral-Vitamin-B-supplementation-in-alcoholism-November-2019.pdf NICE Clinical Guideline 115 on Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence https://www.nice.org.uk/guidance/CG115 UKHSA Alcohol structured advice tool https://khub.net/web/phe-national/public-library/-/document_library/v2WsRK3ZlEig/view_file/377334553?_com_liferay_document_library_web_portlet_DLPortlet_INSTANCE_v2WsRK3ZlEig_redirect=https%3A%2F%2Fkhub.net%3A443%2Fweb%2Fphe-national%2Fpublic-library%2F-%2Fdocument_library%2Fv2WsRK3ZlEig%2Fview%2F261816192%3F_com_liferay_document_library_web_portlet_DLPortlet_INSTANCE_v2WsRK3ZlEig_redirect%3Dhttps%253A%252F%252Fkhub.net%253A443%252Fweb%252Fphe-national%252Fpublic-library%252F-%252Fdocument_library%252Fv2WsRK3ZlEig%252Fview%252F174103489 e-learning for healthcare Alcohol Identification and Brief Advice programme https://www.e-lfh.org.uk/programmes/alcohol/

Kieran Reynolds talks to Helen Boothman, Lead Hepatology Pharmacist and past chair of the British Hepatology Pharmacy Group (BHPG) about hepatitis C. Discussion includes what hepatitis C (hep C) is, risk factors, diagnosis, treatment and the efforts ongoing to help find undiagnosed patients. Helen Boothman - Lead Hepatology Pharmacist, St. George’s University Hospitals NHS Foundation Trust London and previous char of the BHPG Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS Useful links: The British Liver Trust’s information on hepatitis C https://britishlivertrust.org.uk/information-and-support/liver-conditions/hepatitis-c/ NHS information on free home testing for hepatitis C https://hepctest.nhs.uk/

Kieran Reynolds talks to Helen Boothman, Lead Hepatology Pharmacist and past chair of the British Hepatology Pharmacy Group (BHPG) about hepatitis B. Discussion includes what hepatitis B (hep B) is, incidence, link with hepatitis D, risk factors, diagnosis and treatment. Helen Boothman - Lead Hepatology Pharmacist, St. George’s University Hospitals NHS Foundation Trust London and previous char of the BHPG Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS Useful links: The British Liver Trust’s information on how hepatitis B is passed on and who is risk https://britishlivertrust.org.uk/information-and-support/liver-conditions/hepatitis-b/risk/ The British Liver Trust’s information on how to test for hepatitis B https://britishlivertrust.org.uk/information-and-support/liver-conditions/hepatitis-b/hepatitis-b-tests/ NICE Clinical Knowledge Summaries information on which tests can help make a diagnosis of hepatitis B https://cks.nice.org.uk/topics/hepatitis-b/diagnosis/how-to-test-for-hepatitis-b/ The British Liver Trust’s information on treatment for hepatitis B https://britishlivertrust.org.uk/information-and-support/liver-conditions/hepatitis-b/treatment/ The Hepatitis B Foundation information on patient support groups https://www.hepb.org/resources-and-support/online-support-groups/ The British Liver Trust’s information on patient support https://britishlivertrust.org.uk/information-and-support/support-for-you/ Information on Hep B Companion - a peer led hepatitis B organisation https://www.hepbcompanion.org/

In our final episode, we explore frailty, a state of reduced resilience that makes people—particularly older adults—more vulnerable to adverse drug effects and prescribing cascades. Those living with frailty often have multiple long-term conditions, take polypharmacy, and benefit from a more personalised, “less is more” approach. (12m59s) We discuss what frailty looks like in everyday community pharmacy encounters, which medicines to look out for, and how to identify potentially inappropriate medicines prescribed. Through practical examples, we show how to ask the right questions, focus on what matters most to patients, and collaborate with general practice to reduce overprescribing through Structured medication review referrals. We highlight why, in frailty, taking fewer medicines can reduce harm and improve outcomes. Lelly Oboh, Consultant Pharmacist (Care of Older People) and Older People Lead (NHS Specialist Pharmacy Service) Rakhi Aggarwal, Primary Care Lead (NHS Specialist Pharmacy Service)

Here we focus on non-adherence, which often signals that medicines may no longer be appropriate, wanted, or manageable. The reasons are multifactorial and can include side effects, motivation and beliefs, or cognitive, capacity and physical barriers. We discuss how community pharmacy teams, through everyday interactions with patients, relatives and carers, can use curious, patient-centred questions to uncover the real causes of non-adherence and identify any additional support needed. We also explore how, alongside practical interventions such as adjusting formulations or offering compliance aids, pharmacy teams should recognise when deprescribing may be appropriate, advice and refer for a Structured Medication Review- aiming to ensure that solutions always align with the patient’s changing needs, context and priorities. (13m0s) Lelly Oboh, Consultant Pharmacist (Care of Older People) and Older People Lead (NHS Specialist Pharmacy Service) Rakhi Aggarwal, Primary Care Lead (NHS Specialist Pharmacy Service)

This episode explores repeat dispensing and repeat supply as key moments to start meaningful conversations about medicines. When patients or carers order or collect prescriptions, these touchpoints create space to ask about side effects, check whether medicines are working, still wanted, and being taken as intended We share simple conversation starters, ways to involve the whole pharmacy team, and when to signpost patients for a Structured Medication Review to reduce pill burden, improve adherence, minimise waste, and avoid efficiently dispensing medicines that are no longer needed. (9m52s) Lelly Oboh, Consultant Pharmacist (Care of Older People) and Older People Lead (NHS Specialist Pharmacy Service) Rakhi Aggarwal, Primary Care Lead (NHS Specialist Pharmacy Service)

In this episode, we focus on significant changes, especially after hospital discharge or when new, uncontrolled or worsening symptoms appear. For older people, these are times when medicines often change and when adverse effects, drug interactions or prescribing cascades can easily be missed. We discuss how simple, everyday community pharmacy conversations can uncover medicine-related problems early, how to recognise when symptoms may be drug-related, and why transitions are the ideal time to rethink, review and realign treatment with what matters most to patients as their needs change. (14m08s) Lelly Oboh, Consultant Pharmacist (Care of Older People) and Older People Lead (NHS Specialist Pharmacy Service) Rakhi Aggarwal, Primary Care Lead (NHS Specialist Pharmacy Service)

In this episode, we look at returned medicines as a key moment to spot potential overprescribing. When patients or carers bring back unwanted items, Rather than simply accepting them back, it opens the door to curious, non-judgemental conversations about why medicines weren’t taken and whether they’re still needed, inappropriate or causing harm. Through examples and simple open questions, we show how this everyday moment can reveal prescribing cascades, side effects and unmet needs—and how the whole pharmacy team can frame sensitive conversations to support safer, more appropriate prescribing. (14m52s) Lelly Oboh, Consultant Pharmacist (Care of Older People) and Older People Lead (NHS Specialist Pharmacy Service) Rakhi Aggarwal, Primary Care Lead (NHS Specialist Pharmacy Service)

An ‘on the couch’ discussion on the practical implementation of biosimilar insulin in primary care, focusing on hints and tips to consider should your system be considering this, and debunking some of the myths around biosimilar insulin. (50m30s). This is the audio of a webinar that was held on the 30 September 2025. A range of speakers from SPS and other organisations will run this event. Carolyn Barton Head of Medicines Management (Knowsley Place); NHS Cheshire and Merseyside Chris Haigh Deputy Chief Pharmacist; NHS Cheshire and Merseyside Jole Hannan Head of Medicines Management (Wirral Place); NHS Cheshire and Merseyside Georgia Lane Senior Clinical Pharmacist (Knowsley Place); NHS Cheshire and Merseyside Rakhi Aggarwal Primary Care Lead, NHS Specialist Pharmacy Service

Jo Clarke (Advanced Specialist Pharmacist - Palliative and End of Life Care, Medicines Use and Safety in SPS) explores some of the known issues which challenges the safe use of medicines in services and, the impact these have for patient, carers and loved ones. Gaining a better understanding of these challenges can support the implementation of safety initiatives to address some of these issues.

Kieran Reynolds talks to Yun Jung Kim, Senior Specialist Pharmacist in Hepatology about primary biliary cholangitis (PBC). Discussion includes what PBC is, symptoms (and symptom control), diagnosis, treatment and how pharmacy professionals can contribute to the management of patients with PBC. Yun Jung Kim - Senior Specialist Pharmacist in Hepatology University Hospital Southampton NHS Foundation Trust and Vice-Chair, BHPG Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS Useful links: The British Liver Trust’s information on primary biliary cholangitis https://britishlivertrust.org.uk/information-and-support/liver-conditions/primary-biliary-cholangitis/ The British Liver Trust’s information on diagnosing primary biliary cholangitis https://britishlivertrust.org.uk/information-and-support/liver-conditions/primary-biliary-cholangitis/diagnosis/ The British Liver Trust’s information on treating primary biliary cholangitis https://britishlivertrust.org.uk/information-and-support/liver-conditions/primary-biliary-cholangitis/diagnosis/ PBC Foundation website https://www.pbcfoundation.international/ The British Society of Gastroenterology primary biliary cholangitis (PBC) care bundle https://www.bsg.org.uk/clinical-resource/primary-biliary-cholangitis-(pbc)-care-bundle

Kieran Reynolds talks to Sonal Patel, Lead Hepatology Pharmacist about autoimmune hepatitis (AIH). Discussion includes what AIH is, prevalence, diagnosis, treatment and how pharmacy professionals can contribute to the management of patients with AIH. Sonal Patel - Lead Hepatology Pharmacist, Guy’s and St. Thomas’ Trust and Chief Pharmaceutical Officer’s Clinical Fellow 2024/25 at the General Pharmaceutical Council (GPhC) Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS Useful links: SPS article on assessing liver function and interpreting liver blood tests https://www.sps.nhs.uk/articles/assessing-liver-function-and-interpreting-liver-blood-tests/ NHS website information on prednisolone https://www.nhs.uk/medicines/prednisolone/ NHS website information on budesonide https://www.nhs.uk/medicines/budesonide-tablets-capsules-and-granules/about-budesonide-tablets-capsules-and-granules/ NHS website information on azathioprine https://www.nhs.uk/medicines/azathioprine/ The Society of Endocrinology information on adrenal crisis https://www.endocrinology.org/clinical-practice/clinical-guidance/adrenal-crisis/ SPS Medicines Monitoring tool https://www.sps.nhs.uk/home/tools/drug-monitoring/ The Green Book: information on vaccines for vaccine preventable diseases https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book#the-green-book AIH support website https://aihsupport.org.uk/ The British Liver Trust’s information on autoimmune hepatitis https://britishlivertrust.org.uk/information-and-support/liver-conditions/autoimmune-hepatitis/

Kieran Reynolds talks to Arron Jones, Lead Hepatology Pharmacist about metabolic dysfunction associated steatotic liver disease (MASLD). Discussion includes what MASLD/MASH stands for, prevalence, diagnosis, treatment; including advice to give to patients accessing GLP-1 RAs online, and emerging therapies. Arron Jones - Lead Hepatology Pharmacist, Bart’s Health Trust Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS Useful links: The British Liver Trust’s information on MASLD, NAFLD and fatty liver disease https://britishlivertrust.org.uk/information-and-support/liver-conditions/masld-nafld-and-fatty-liver-disease/ The NHS Eatwell Guide https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/the-eatwell-guide/ The South Asian Eatwell Guide https://mynutriweb.com/the-south-asian-eatwell-guide/ SPS article on using statins in liver impairment https://www.sps.nhs.uk/articles/using-statins-in-liver-impairment/ The General Pharmaceutical Council’s FAQs on weight loss medications (including a guide for patients on how to keep safe when getting medicines or treatment online: scroll to bottom of page to access) https://www.pharmacyregulation.org/patients-and-public/standards-you-can-expect-using-pharmacy-services/weight-loss-medications-faq

Emma Kirk discusses with Claire Davies her experiences and learnings from speaking with people living with diabetes as part of the NHS SPS insulin safety project. In this podcast Claire shares conversations with Abdul, Sarah, Charlie and Toby including the impact of their diabetes diagnosis, diabetes devices, faith, hypoglycaemia and admissions to hospital on their diabetes journey. (48m 41s) This podcast is part of the Medication Safety Across The System (MSATS) series, aimed at healthcare professionals working in any sector with a role or passion for medication safety and/or involved in medicines use.

In this episode John Oliver speaks to expert guests about evaluating the suitability of unlicensed medicines for the patient. We discuss practical considerations for managing them in dispensaries, performing a quality assessment and good governance frameworks. (29m:55s) Speakers: John Oliver, Quality Assurance Specialist; NHS SPS Dr. Andrew Lowey, Lead Clinician, Pharmacy Preparative Services Leeds Teaching Hospitals, and chair of the NHS Pharmacy Production Committee Penny Daynes, Associate Regional Pharmacy Procurement Specialist; NHS SPS, North East and Yorkshire Katherine Cullen, Divisional Director Clinical Support Services, Chief Pharmacist; Tameside and Glossop Integrated Care NHS Foundation Trust Lynn Morrison, Regional Quality Assurance Specialist; NHS Scotland Amanda Cooper, Assistant Head of NHS SPS Useful links: MHRA guidance https://www.gov.uk/government/publications/supply-unlicensed-medicinal-products-specials (MHRA guidance on unlicensed medicinal products – specials, including Guidance Note 14) SPS guidance https://www.sps.nhs.uk/home/guidance/unlicensed-medicines/ https://www.sps.nhs.uk/articles/understanding-excipients-in-medicines/ https://www.sps.nhs.uk/articles/searching-for-presence-or-absence-of-an-excipient-in-medicines/ https://www.sps.nhs.uk/articles/navigating-a-potential-supply-issue/ (SPS log-in required) https://www.sps.nhs.uk/articles/managing-complexities-of-medication-use-across-care-boundaries/ (Medication Safety across the System providing resources that include valuable real-world examples of safely managing unlicensed liquid medicines)

Audio from our webinar held on the 4 March 2025 which featured a facilitated case-based discussion about the complexities of polypharmacy and deprescribing. This was a follow on from our first webinar, which lays the foundations of some of the deprescribing tools available. (57m02s) Speakers: Lelly Oboh: Older people lead, NHS SPS Jasvir Singh Dhillon: Clinical pharmacist, Shropshire, Telford & Wrekin ICB, & GP practices Rakhi Aggarwal: Primary care lead, NHS SPS

Claire Davies chats with Toby, a person living with diabetes, as to why it is essential that the voice of those with lived experience is heard and is central to any system-wide discussions about insulin safety and what is important to him to ensure his insulin therapy is safe alongside visual impairment.

Claire Davies chats to Neera Shah about the challenges and considerations with insulin safety in health and justice and secure settings. Claire Davies – Advanced Specialist Pharmacist, SPS – Project Lead, Insulin Safety Neera Shah - Area pharmacist, Offender Health

In this episode John Oliver speaks to expert guests about the information and assurance needed to support the use of unlicensed medicines. We discuss the procurement process in different care settings, and explore considerations for quality assurance, packaging and labelling and formulation. (20m:05s) Speakers: John Oliver, Quality Assurance Specialist; NHS SPS Penny Daynes, Associate Regional Pharmacy Procurement Specialist; NHS SPS, North East and Yorkshire Sharon Jackson, Quality Assurance Specialist; NHS SPS Linda Hardy, Regional Quality Assurance Pharmacist, NHS SPS, North East and Yorkshire Dr. Andrew Lowey, Lead Clinician, Pharmacy Preparative Services Leeds Teaching Hospitals, and chair of the NHS Pharmacy Production Committee Useful links: MHRA guidance https://www.gov.uk/government/publications/supply-unlicensed-medicinal-products-specials (MHRA guidance on unlicensed medicinal products – specials, including Guidance Note 14) SPS guidance https://www.sps.nhs.uk/home/guidance/unlicensed-medicines/ https://www.sps.nhs.uk/articles/understanding-excipients-in-medicines/ https://www.sps.nhs.uk/articles/searching-for-presence-or-absence-of-an-excipient-in-medicines/ https://www.sps.nhs.uk/articles/navigating-a-potential-supply-issue/ (SPS log-in required) https://www.sps.nhs.uk/articles/managing-complexities-of-medication-use-across-care-boundaries/ (Medication Safety across the System providing resources that include valuable real-world examples of safely managing unlicensed liquid medicines)

In this episode John Oliver speaks to expert guests who define unlicensed medicines and explain why we need them. We discuss the shared responsibility for their use and the role of pharmacy in managing them safely. (20m28s) Speakers: John Oliver, Quality Assurance Specialist; NHS SPS Emma Kirk, Medication Safety Officer Network Lead, Medicines Use and Safety Pharmacist; NHS SPS Linda Hardy, Regional Quality Assurance Pharmacist, NHS SPS, North East and Yorkshire Nicola Husain, Education and Training Lead for the Neonatal and Paediatric Pharmacy Group Tim Root, Specialist Pharmacist (NHS SPS) and a former Chief Pharmacist Useful links: MHRA guidance https://www.gov.uk/government/publications/supply-unlicensed-medicinal-products-specials (MHRA guidance on unlicensed medicinal products – specials, including Guidance Note 14) SPS guidance https://www.sps.nhs.uk/home/guidance/unlicensed-medicines/ https://www.sps.nhs.uk/articles/understanding-excipients-in-medicines/ https://www.sps.nhs.uk/articles/searching-for-presence-or-absence-of-an-excipient-in-medicines/ https://www.sps.nhs.uk/articles/navigating-a-potential-supply-issue/ (SPS log-in required) https://www.sps.nhs.uk/articles/managing-complexities-of-medication-use-across-care-boundaries/ (Medication Safety across the System providing resources that include valuable real-world examples of safely managing unlicensed liquid medicines)

Rakhi talks to Antonio about newer therapies for lipid management, incliseran and bemepdoic acid. They discuss their place in therapy and how they may be initiated in primary care. This is the final part of our three-part series. Antonio Ochoa-Ferraro: Consultant Pharmacist, Inherited Metabolic Disorders; University Hospitals of Birmingham Rakhi Aggarwal: Primary Care Lead, Medicines Use and Safety; NHS SPS Useful links Cholesterol and Cholesterol levels https://www.heartuk.org.uk/cholesterol/overview NICE guidance Inclisiran: https://www.nice.org.uk/guidance/TA733 Bempedopic acid with ezetimibe: https://www.nice.org.uk/guidance/ta694 NHS England summary of national guidance for lipid management https://www.england.nhs.uk/aac/publication/summary-of-national-guidance-for-lipid-management/ NHS Birmingham and Solihull ICB procurement & prescribing of inclisiran https://www.birminghamandsurroundsformulary.nhs.uk/docs/files/Procurement%20and%20Prescribing%20of%20Inclisiran.pdf?UNLID=93161104220252141045 Novartis inclisiran resources https://www.pro.novartis.com/uk-en/medicines/cardio-metabolic/leqvio/resources Open Access Articles Harnessing RNA Interference for Cholesterol Lowering: The Bench-to-Bedside Story of Inclisiran https://pubmed.ncbi.nlm.nih.gov/38456415/ Inclisiran administration potently and durably lowers LDL-C over an extended-term follow-up: the ORION-8 trial https://pubmed.ncbi.nlm.nih.gov/38753448/ Bempedoic Acid for Prevention of Cardiovascular Events in People With Obesity: A CLEAR Outcomes Subset Analysis https://pubmed.ncbi.nlm.nih.gov/39921511/ Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society https://pubmed.ncbi.nlm.nih.gov/23956253/

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/

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