NHS Specialist Pharmacy Service

See Mun Wong, Digital and Quality Improvement Specialist, at SPS, presents a summary of the resources published by SPS between 25th and 31st October.  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:    Polypharmacy and Structured Medication Review Explainer Videos These animated videos explain the 7 steps of structured medication review, using a person-centred approach to managing polypharmacy https://www.sps.nhs.uk/articles/polypharmacy-and-structured-medication-review-explainer-videos/ Ex-Vivo and In-Vivo Non-GMO Gene Therapy Medicinal Products This document outlines key areas for focus of pharmacy expertise prior to an organisation implementing Ex-Vivo Non-Genetically Modified Organism Gene Therapies. https://www.sps.nhs.uk/articles/ex-vivo-non-gmo-gene-therapy-medicinal-products-pharmacy-institutional-readiness-guidance/ Prescribing Outlook Our annual medicines planning publication, Prescribing Outlook was updated on October 30th. Please note that Sacubitril-valsartan has been added to the patent expiries tab. To view the correction in the spreadsheet, pleas log in to the website https://www.sps.nhs.uk/wp-content/uploads/2025/10/Prescribing_Outlook_2025_amended_October_2025_v2.xlsx#:~:text=Prescribing_Outlook_2025_(amended_October_2025)_v2 New Spotlight Digest A digest of NHS Specialist Pharmacy Service support for professionals working in all areas of the healthcare system for October 2025. https://www.sps.nhs.uk/articles/spotlight-october-2025/ National PGD template updates Updated PGD templates for Doxycycline, oral Azithromycin in sexual health services, and Emtricitabine and tenofovir disoproxil for PrEP use. https://www.sps.nhs.uk/wp-content/uploads/2025/10/Azithromycin-chlamydia-National-PGD-template-V3.0.docx#:~:text=National%20PGD%20template%20updates https://www.sps.nhs.uk/wp-content/uploads/2025/10/Doxycycline-chlamydia-National-PGD-template-V3.0.docx#:~:text=National%20PGD%20template%20updates TD-FTC Pre-Exposure Prophylaxis PrEP National PGD template V3.0 · 85.93 KB Six intrathecal risk assessments have also been reviewed and updated, including those for Diamorphine, Etoposide, Methotrexate, gentamicin, rituximab and thiotepa. https://www.sps.nhs.uk/articles/thiotepa-informing-intrathecal-risk-assessment/#:~:text=%20six%20intrathecal%20risk%20assessments Etoposide: informing intrathecal risk assessment – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Rituximab: informing intrathecal risk assessment – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Methotrexate: informing intrathecal risk assessment – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Gentamicin: informing intrathecal risk assessment – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Diamorphine hydrochloride: informing intrathecal risk assessment – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice 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'.

Dav Manku, Associate Regional Pharmacy Procurement Specialist, at SPS, presents a summary of the resources published by SPS between 18th and 24th October.  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:    Considerations and Interactions with GLP-1 Receptor Agonists Signposting key risks and interactions of GLP-1 receptor agonists in diabetes, obesity, and weight management. https://www.sps.nhs.uk/articles/considerations-and-interactions-with-glp-1-receptor-agonists/ New Product Evaluations – log in required A list of new product evaluations that are freely available to NHS staff. https://www.sps.nhs.uk/articles/new-product-evaluations/ National PGD template updates National PGD 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-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'.

Nicola Wake, Associate Director, Medicines Use and Safety at SPS, presents a summary of the resources published by SPS between11th and 17th October.  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 Outlook This is our annual output to support managed entry and budget planning for new medicines, new indications and patent expiries in the NHS. https://www.sps.nhs.uk/wp-content/uploads/2025/10/Prescribing-Outlook-2025.xlsx#:~:text=Prescribing%20Outlook Golimumab biosimilar If you’re preparing to use golimumab biosimilar, we’ve added phase 2 and phase 3 checklists to our website. https://www.sps.nhs.uk/wp-content/uploads/2025/05/Golimumab-Biosimilar-Patient-Information-Sheet-version-2-FINAL-1.docx#:~:text=golimumab%20biosimilar PGD templates for trimethoprim and/or nitrofurantoin for UTI Version 2 of the templates have been published. They are valid from January 2026, but we publish them a few months in advance so organisations can take them through local governance processes in a timely manner. https://www.sps.nhs.uk/wp-content/uploads/2025/10/Nitrofurantoin-PGD-template-UTI-V2.0-1.docx#:~:text=PGD%20templates%20for%20trimethoprim%20and/or%20nitrofurantoin%20for%20UTI https://www.sps.nhs.uk/wp-content/uploads/2025/10/Trimethoprim-PGD-template-UTI-V2.0-1.docx#:~:text=PGD%20templates%20for%20trimethoprim%20and/or%20nitrofurantoin%20for%20UTI Next events – forthcoming webinars and conferences       https://www.sps.nhs.uk/home/events/next-events/      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'.

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

John Oliver, a quality assurance specialist at SPS, presents a summary of the resources published by SPS between 6th and 12th September. 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:     Ensuring time critical use of rasburicase Timely use of rasburicase for treatment of tumour lysis syndrome is essential. Mitigation strategies can minimise harm associated with delayed therapy. https://www.sps.nhs.uk/articles/ensuring-time-critical-use-of-rasburicase/ Preparing to use denosumab 60mg biosimilar Biosimilars of denosumab 60mg (Prolia) are expected soon. We offer general information and implementation advice. https://www.sps.nhs.uk/articles/preparing-to-use-denosumab-60mg-biosimilar-for-osteoporosis/ Understanding biosimilar and generic market entry – explainer video New medicines have several protections against competition. Other factors influence availability of biosimilars or generics after loss of exclusivity. https://www.sps.nhs.uk/articles/understanding-biosimilar-and-generic-market-entry/ SPS Vacancies: Senior Specialist Pharmacist Medicines Advice & Medicines Use and Safety (closing date 24 September) https://www.jobs.nhs.uk/candidate/jobadvert/C9287-25-1466?keyword=pharmacist&location=Liverpool&distance=5&language=en&page=2 Senior Specialist Pharmacist, Medicines Use and Safety (closing date 24 September) https://www.jobs.nhs.uk/candidate/jobadvert/C9287-25-1470 Next events – forthcoming webinars and conferences https://www.sps.nhs.uk/home/events/next-events/     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'.

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/