Standard Operating Procedure for the administration of Red and Amber Drugs within Integrated Community Care Services
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1 Standard Operating Procedure for the administration of Red and Amber Drugs within Integrated Community Care Services Reference No: Version: 1 Author: Emma Baggaley First Issued On: 1 st March 2018 Latest Issue Date: Review Date: March 2019 Referenced Documents: Hull and East Riding Prescribing Committee Ratified By: Distribution: Document Revisions Date Author Nature of Change Reference Emma Baggaley New SOP created This document can be found on Please check you have the most current version City Health Care Partnership CIC is a not for profit Community Interest Company responsible for providing NHS Services in Hull and the East Riding. Registered in England No:
2 Traffic Light Classification Within Hull and East Riding drug treatments are classified as follows Red specialist prescriber only Amber prescribed in accordance with approved shared care framework Green other items listed on formulary suitable for initiation and prescribing by any prescriber Red Drugs Red drugs are only to be prescribed by a specialist. Red drugs include those; Requiring long-term specialist monitoring of efficacy Requiring long-term specialist monitoring of toxicity (either because of difficulty in recognising side effects or high cost/availability of investigations to identify toxicity) Designated as hospital only by product licence, by DOH or by the company. That are new or a new indication for an existing drug that needs evaluation to be undertaken to establish the place in therapy, with a recommendation that a formal review process be undertaken That are hospital initiated unlicensed or clinical trial materials That are not licensed for any indication in the UK A list of red drugs can be found at Amber Drugs Amber drugs require initiation by a specialist, but with the potential to transfer to primary care, within written and agreed shared care frameworks, and according to the agreed process for transfer of care. Transfer to primary care is expected to be the normal practice. Amber drug include those; Requiring short or medium term specialist monitoring of efficacy Requiring short or medium term specialist monitoring of toxicity Requiring specialist assessment to enable patient selection A list of Amber Drugs and a copy of the shared care framework for each drug can be found at
3 Housebound patients requiring administration of red or amber drugs may be referred to Community Nursing Services. The purpose of this document is to clarify the responsibilities of the clinicians involved in the patients care when administering red or amber drugs to such patients. Red Drugs Responsibilities of Clinicians Involved Hospital Specialist Community Nurse Refer the patient through who will check the following information is provided by the hospital when referring the patient. Prescribe medication for the patient and complete a CHCP Medication Authorisation and Administration Record (Drug Chart) Confirm: Date medication needs administering All necessary blood tests/monitoring have been undertaken Hospital specialist has reviewed the results and patient can receive the next dose of medication Detail the information on patients record on S1 Date medication needs administering on caseload planner/visit All blood tests/monitoring as detailed by hospital specialist have been undertaken Hospital specialist has reviewed the results and patient can receive the next dose of medication Ensure competence to administer the medication. Any concerns must be discussed with line manager. Be aware of correct disposal of medication e.g. cytotoxic medication requires disposal in purple lidded DOOP bin Create management plan for the patient on SystmOne for - when medication is due - when bloods are due - when to review bloods with consultant prior to next visit to ensure the medication is safe to administer Ensure regular liaison with Hospital consultant after each administration. Refer to Hospital Consultant if patient has any side effects.
4 If unable to administer medication i.e. patient is in hospital, communicate with the hospital for seamless transfer of care for patient informing when medication needs to be administered and ask for re-referral via when patient is discharged. Amber Drugs Responsibilities of Clinicians Involved GP Community Nurse Refer the patient through ( will check the following information is provided by the GP when referring the patient) Confirm they have a SIGNED Shared Care Framework (SCF) in place. Ensure have a copy of the SCF detailing monitoring requiring requirements and any considerations for administration of the medication Confirm: Date medication needs administering All blood tests/monitoring as detailed in the SCF have been undertaken GP has reviewed the results and patient can receive the next dose of medication Detail the information on patients record on S1 Date medication needs administering on caseload planner/visit All blood tests/monitoring as detailed in the SCF have been undertaken GP has reviewed the results and patient can receive the next dose of medication Prescribe medication for the patient and complete a Medication Authorisation and Administration Record (Drug Chart) Ensure competence to administer the medication. Any concerns must be discussed with line manager. Be aware of correct disposal of medication e.g. cytotoxic medication requires disposal in purple lidded DOOP bin Create management plan for the patient on SystmOne for - when medication is due - when bloods are due
5 - when to review bloods with GP prior to next visit to ensure the medication is safe to administer Refer to GP if patient has any side effects. Ensure regular liaison with GP after each administration. For GP practices on SystmOne, phone the GP to notify of administration and they can view the notes For GPs practices which do not use SystmOne notification of administration of the medication must be sent to the GP practice. Information should be sent utilising secure NHS Mail to a designated practice account, provided by the practice. If unable to administer medication i.e. patient is in hospital, communicate with the hospital for seamless transfer of care for patient informing when medication needs to be administered and ask for re-referral via when patient is discharged.
6 Appendix 1 Notification of administration by community nursing staff Please ensure that this information is entered onto the patient s records and brought to the attention of the General Practitioner. Thank you for your assistance. PATIENT DETAILS Name: Date of Birth: NHS Number: Address: GP Name of Medication: Details of Medication Administered Dose of Medication administered: Date Administered: Date of next administration: Date next blood tests due: ADDITIONAL INFORMATION Community Nurse Details Name: Base: Tel No:
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