Medicines and pharmacy services

At AWP, we work together with two different Integrated Care Systems in South West England:

• Bath and North East Somerset, Swindon and Wiltshire (BSW)
• Bristol, North Somerset and South Gloucestershire (BNSSG) 

Each CCG has its ‘formulary’. This is their agreed list of medicines they’ve approved to be prescribed for NHS patients. The main aim of a formulary is to promote safe, effective and economic prescribing both in hospital settings and general practice.

Traffic light status

Local formularies use a traffic light system to indicate who can prescribe any given medication:

• Red medicines can only be prescribed in secondary care. This could be in hospitals and specialist care settings.
• Amber medicines can only be prescribed as suggested by a specialist, as with many medications used in psychiatry.
• Green medicines can be prescribed by any competent prescriber.
• Blue medicines can be prescribed as an alternative (often in specific conditions) in both primary and secondary care.

You can check the formulary status of a specific medicine in the AWP Formulary working document. Please note that the status of a medicine can vary depending on whether it’s prescribed in the BSW or BNSSG area, so please check this carefully.

Shared care agreements 

A ‘shared care agreement’ (SCA) sets out suggested ways that a specialist and a primary care provider, such as a GP, can share responsibility for prescribing medication. The way each medicine should be prescribed is written in a document called a ‘shared care protocol’ (SCP). Some of these medicines can only be handed over to a GP if there’s a formal shared care agreement in place.

When professionals agree to sharing of care, it’s important that: 

• there’s clear communication between the specialist, GP and service user/patient (and/or their carer).
• the prescriber starting off a service user’s/patient’s treatment explains the shared care agreement.
• professionals ask the service user/patient for their opinion about treatment and everyone agrees to it.
• professionals regularly follow up with service users/patients to discuss how their medicine therapy is working.

You are welcome to look at the  shared care agreements in place in your Clinical Commissioning Group (CCG) area by visiting the CCG’s formulary websites here:

• Bath & North East Somerset, Swindon and Wiltshire CCG SCA page
• Bristol, North Somerset and South Gloucetsershire CCG SCP page (Adult)
• Bristol, North Somerset and South Gloucestershire CCG SCP page (Children and Young People)

Adding a new medicine to the formulary

AWP has a Medicines Optimisation Group. This manages the reviews and entry of new medicines on both the AWP formulary and the CCG formularies as needed. 

Non-formulary medicines

The Medicines Optimisation Group uses AWP’s ‘procedure for the use of non-formulary medication’ (Med19) to review any medicines not listed in the AWP formulary. Our Chief Pharmacist, Medical Director or a professional authorised by them needs to approve the use of non-formulary medicine in AWP.

Prescribing guidance and alerts

This section contains downloadable information and advice.

Prescribing guidance 

• High dose and combination prescribing 
  • Guideline: When required psychotropic medication (MG04)
  • Guideline: High-dose antipsychotic prescribing (MG01)
• Physical health and monitoring 
  • Procedure For Monitoring Psychotropic Medication – A Guide To Essential Tests And Investigations (Med37)
  • Antipsychotic Induced Hyperprolactinaemia (MG12)
• Formulary
  • Procedure for the Use of Non-Formulary Medication (Med19)
• Adherence Aids 
  • Assessment, Supply and Use of Adherence Aids (Med46)
• Clozapine
  • Medicines Guidance: Management of clozapine in acute hospital settings (MG32)
  • Procedure for the care of patients taking clozapine in primary care settings (Med42)
  • Summary page: Procedure for the care of patient taking Clozapine in primary care (Med42 - summary page) 

Medicines Information and Safety Bulletins

• 2024-01 Managing ADHD Medicine Shortages in ADULTS: BNSSG Advice for Primary Care
• 2023-10 Managing ADHD Medicine Shortages in ADULTS: BSW Advice for Primary Care
• 2023-10 Managing ADHD Medicine Shortages in CAMHS: Advice for Primary Care
• 2023-03 Antimicrobial Resistance and Stewardship
• 2022-05 False Positive and False Negative Urine Drug Tests
• 2021-05 Choice and Medication© Website and Share Decision Making 

The Specialist Pharmacy Services provide a Medicines Advice service, which can be contacted via a single contact number, or email, by professionals working in primary care. Information and contact details can be found on the SPS web page here. 

You are always welcome to talk to one of our specialist mental health pharmacists. Just ask your community mental health team or a member of ward staff to put you in touch with us.

At AWP, we have two in-house pharmacies in Bristol and Wiltshire serving our inpatient and community service users. We do also prescribe on FP10 (green) prescriptions, which allow service users to get their medicines from their local community pharmacy.

For more information about mental health and the medicines used by AWP, visit the ‘Choice and Medication’ website. By finding out more about your medicine, you can decide whether it’s right for you. The website has been designed to help answer your questions about medicines prescribed to treat mental health conditions.

Medicines change all the time. For reliable information about your medicine, we encourage you to avoid general internet searches which can lead to unreliable sources. Instead, you can rely on the most up-to-date information on the ‘Choices and Medication’ site and via the following websites:

• The Royal College of Psychiatrists - Under the mental health information page, detailed information is available about diagnoses and medicines. There are also leaflets especially written for carers.
• NICE (National Institute for Health and Care Excellence) - NICE is an independent organisation providing national guidance on promoting good health, and preventing and treating illness. Their website has information on a wide range of topics, including medicines.
• Electronic Medicines Compendium (EMC) - This website is owned and managed by Datapharm, working with the NHS and companies making and selling medications to help people looking for information about individual medicines. The information is up-to-date, reliable and understandable.