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The products listed within the continence formulary have been chosen as fit for purpose according to evidence available and current prescribing practice. Where appropriate, national and local guidelines and formularies have been used to inform the choice.
Within community hospitals products for patient's use will be ordered via Web Basket or EROS. It is important to ensure that sufficient supplies are available for patient use but not stock piled.
It is recommended that at least 80% of prescribing is from this formulary. It is accepted there will always be individual patient needs which will form the other 20% of prescribing decisions.
Ensure when you are ordering or prescribing continence related products you order sufficient supplies to meet the patients' needs but reduce any unnecessary waste.
The prescribed continence products are the property of the named patients to whom they have been dispensed and must not be used for another patient.
Patients with long term catheters, sheaths or who require leg and night bags should have one month's supply.
Patients who require continence products for time limited periods should have the quantities adjusted accordingly to ensure sufficient supplies but to reduce the possibility of waste.
Patients requiring continence or stoma appliances can have these dispensed either by a dispensing appliance contractor (DAC), a pharmacy contractor or a dispensing doctor.
For items that every dispensing appliance contractor and pharmacy contractor in England supplies in the normal course of their business, they are required to provide the following as part of essential services. (Full details are in The National Health Service (Pharmaceutical Services) Regulations 2012 - Regulation 11(2)(a)(i) -Terms of service of NHS appliance contractors) Some points to note:
Patients may obtain their supplies from either:
When prescribing or recommending products for prescribing, the patient's needs must be considered and the quantities should be sufficient to reflect the patient's requirements but minimise waste.
Patients requiring continence appliances can have these dispensed either by a DAC, a pharmacy contractor or a dispensing doctor.
Retrospective prescribing i.e. requesting delivery of a product before the prescription is submitted to the contractor must not occur.
On discharge from hospital you will have been supplied with the products and accessories required for immediate use. Your stoma, continence or ward nurse will have discussed the options available to you for obtaining future supplies and will also give you a list of your products and their relevant order code so that you are able to obtain prescriptions from your GP. They will also provide a catheter passport where necessary. Additionally they will provide product and code details to your GP surgery and/or community nurse.
Please bear in mind that in all cases, a prescription needs to be obtained before any supplies can be sent out. To arrange repeat prescriptions there are a number of options out lined below:
Dispensing Appliance Contractors (DACS) must supply all ostomy and urology products which are on the official NHS drugs and appliances list (The NHS Drug Tariff). If they do not have them in stock, medical product wholesalers can supply the DACs with these products at short notice.
DACs are often integrated within stoma care product manufacturers/companies, such as:
There are several other independent DACs, e.g. Wilkinson Healthcare. If the DAC or Chemist (also called a Pharmacy Contractor) cannot dispense the item prescribed or cannot prescribe the required stoma appliance customisation, they must, with the patient's consent, refer the prescription form or repeatable prescription to another DAC or Chemist. If the patient does not consent to this, then the DAC or Chemist must provide contact details for at least two other contractors who may be able to dispense the required item or service.
In an emergency you can get supplies from a DAC or a Chemist without them being in possession of a prescription as long as your GP has agreed to give them a prescription for the items within 72 hours. If you can't get hold of your GP then the DACs will very likely help you out and get you some supplies to tide you over, although without a prescription and unable to get a retrospective prescription they would have to bear the cost.
Note: please allow a sufficient period of time from placing the order with a DAC until it is delivered to your home.
Colostomates living in the UK whose stoma is permanent are entitled to apply for a Medical Exemption Certificate, which entitles them to obtain all prescriptions free. Ask your GP, specialist nurse or pharmacy for Form FP92A.
Colostomates with a temporary stoma DO have to pay prescription charges for stoma appliances unless they are otherwise exempt from prescription charges. It may be worth considering a Prepayment Certificate to save money. See the NHS prescriptions web page http://www.nhs.uk/NHSEngland/Healthcosts/Pages/pre... for more detail.