IMPORTANT COVID-19 ACTION SUBSTANCE MISUSE TREATMENT – LIVEWELL PRESCRIBING CHANGES

If a patient cannot come to the pharmacy

• They can nominate an individual to collect on their behalf – we will email you letter of authorisation
• If they have no-one to support them then Harbour will collect the prescription and deliver to the patient

If a pharmacy cannot dispense the relevant medication

• Inform Livewell prescribers at Harbour on:
• Rachel Greep 01752 434297 greep@nhs.nhs.net
• Karen Bell 01752 435222 bell3@nhs.net

Until 30^th March 2020:

• Do not offer supervised consumption – prescriptions will be changed to reflect this.
• We are reducing Saturday dispensing.
• We are moving those most settled and stable to weekly or fortnightly dispensing as we might with a brief holiday prescription.
• We are reviewing on a case by case basis all those on 3 x per week or 2 x per week dispensing to weekly dispensing with Harm reduction advice
• We are reviewing all our daily collections on a case by case basis following a risk assessment.
• Where we are making decisions on take home doses with people that have families with young children and will be prioritising medicines safe storage boxes as standard.

From 30^th March 2020:

• Remove all Saturday dispensing for all OST prescriptions as you have no ability to contact prescribers
• Reduce daily collections to every other day unless significant risks then consider scenario for staff to deliver.
• All Buprenorphine prescriptions unless there are significant risks to people in hostels/ person safety or medicines safety issues to weekly dispensing with Harm reduction advice info
• All weekly OST prescriptions to fortnightly dispensing with safe storage advice
• All 2 x per week  and 3 x per week dispensing to weekly with harm reduction advice
• Review all daily dispensed and if appropriate move to interval dispensing with harm reduction advice Please note that there may be people we choose to leave on daily dispensing that currently as of 24/03 /2020 can leave their places of residence safely with social distancing advice to collect medical/ essential food supplies whilst exercising and getting fresh air as per GOVT guidelines issues on 23/03/2020.
• All our changes will be on green prescriptions allowing us to keep changes on our batch runs to a minimum. This is a resource intervention as the medical secretaries are overwhelmed with change requests.

Please be aware that some prescriptions may be re-issued more often than under normal circumstances.  We apologise for this and will try to communicate changes as best we can via phone and or email. 

We may have prescribing admin shortages and may move to hand written prescriptions. We will let you know if we need to do this and by which prescribers and for whom and duration. 

Please in addition continue to tell us about people who have missed 3 days or more and place prescriptions on hold as is usual practice. We may have to make difficult decisions on balance of risk not to restart at this time of crisis and change pace.  If we do this we will give all relevant harm reduction and opiate withdrawal advice to people.