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The NHS Norfolk and Waveney Integrated Care Board (ICB) regularly review local prescribing practice based on the latest evidence available and in line with guidance from The National Institute for Health and Care Excellence (NICE).
You can find your local pharmacy online.
GLP-1 RA Shortages Support Hub update
News from 6 March 2024
The GLP-1 RA Shortages Support Hub has reached capacity for providing new patient clinical reviews. Norfolk and Waveney Integrated Care Board are awaiting national guidance to be released on current availability of medications.
Norfolk and Waveney Integrated Care System clinical leads are creating a local guidance protocol, which will include options and actions which can be used by all Healthcare Professionals in response to GLP-1 medication shortages. This will be shared imminently.
Any patients who have been supported by the hub will be contacted directly for follow up if required, however the hub will no longer be able to support any new patients, and options for these patients will be outlined in the new guidance protocol.
Bank Holiday Opening hours for your pharmacy
NHS England publishes regular updates about pharmacy opening hours on their website.
Prescription Ordering Direct (POD)
Learn more about how you can easily order your repeat prescriptions in Norfolk and Waveney. You can view the practices currently using this service and how to contact them on the POD webpage.
Prescription exemptions
There are a number of schemes, support and exemptions in place to help people with the cost of NHS prescriptions.
If you are prescribed one or more items each month, a Prescription Prepayment Certificate could save you money. You can pay for this annually or via monthly direct debit (10 monthly payments covering the year).
If you receive Universal Credit, you may be eligible for help with NHS costs. Check what help you could get.
If you are struggling with the cost of prescriptions, you may be eligible for help, including free NHS prescriptions, dental treatment and eye tests. Apply online for help with NHS costs.
If you receive some types of income support, you are automatically entitled to free NHS prescriptions.
If you have a Medical Exemption Certificate, make sure you regularly check the expiry date. Continuing to use your Exemption certificate after its expiry date may result in penalty charges of up to £100.
Antibiotics
Antibiotics are used to treat or prevent some types of bacterial infection. They work by killing bacteria or preventing them from spreading. But they do not work for everything.
The Integrated Care Board has set up a dedicated page with more information about Antibiotics and Antimicrobial Resistance, including an FAQ guide to antibiotics.
Green Inhalers
The Norfolk and Waveney Integrated Care System (ICS) is supporting the roll-out of environmentally-friendly, greener inhalers. Choose a green inhaler and help fight against climate change.
Suitable patients will be offered a dry powder inhaler (DPI) instead of a metered dose inhaler (MDI)*, which work just as effectively, but do not use powerful greenhouse gases to propel medication into your lungs. By making a swap, you could cut your carbon footprint by the equivalent of driving around 1,740 miles a year (that’s a trip from London to Moscow).
Ask for more information at your next respiratory review.
Download our Green Inhaler poster for display in your health or care setting.
For videos on how to use your inhaler, search for your prescribed type on Asthma + Lung UK.
For more resources including videos, leaflets, FAQs and infographics, visit PrescQIPP.
Opioids
Opioids are very strong pain killers and are used to treat pain after surgery, serious injury and cancer pain, for example. They usually contain morphine or codeine. Research tells us taking opioids long-term for chronic pain is not a good idea. Opioids aren’t very effective when taken for more than a few months.
You can find a selection of resources for clinicians and patients on the Knowledge Anglia website. Further resources can be found on Norfolk and Waveney STP Formulary which includes Guidelines for tapering opioids for chronic primary pain.
Diabetes
Prescribing medicines for the treatment of Hypoglycaemia in Norfolk and Waveney
The NHS in Norfolk and Waveney has long standing guidelines on the treatment of hypoglycaemia which were last reviewed in September 2021 and are in line with national recommendations. These guidelines have not changed. Recommendations from NICE and Diabetes UK suggest the following ways to treat an episode of hypoglycaemia:
- five glucose or dextrose tablets
- five jelly babies
- a small glass of a sugary (non-diet) drink
- a small carton of pure fruit juice
- two tubes of a glucose gel such as GlucoGel®.
These items are readily available and can be purchased from local supermarkets, pharmacies or online.
Glucose gels and glucagon injections are available on prescription for Type 1 diabetes hypoglycaemia episodes if deemed clinically appropriate. Other products available to purchase are not supported locally under NHS prescription, including glucose Lift drinks shots and glucose or dextrose tablets, which are available over the counter.
We are aware that glucose Lift drinks shots have been prescribed by general practice in the past and we will be working with colleagues to ensure that treatment prescribed for Type 1 diabetes hypoglycaemia falls in line with our prescribing recommendations going forward.
A link to Norfolk and Waveney’s recommendations on the management of an acute episode of hypoglycaemia can be found here.
Continuous Glucose Monitoring
On Thursday 31 March 2022, the National Institute for Health and Care Excellence (NICE), updated the recommendations in their Diabetes guidance in relation to glucose monitoring.
In September 2022, NHS Norfolk and Waveney ICB announced it will fund glucose monitoring technologies in line with NICE guidance. Implementation of these devices will be distributed in a phased way, with an initial focus on:
- under 18s with type 1 diabetes mainly receiving continuous glucose monitoring at their next routine appointment,
- adults with type 1 diabetes mainly receiving intermittent scanned glucose monitoring at their next routine appointment,
- and adults with type 2 identified as a priority and agreed at MDT, with a view to full implementation when affordable.
Implementation plans covering phase one of the programme can be found below.
Further implementation plans and cohort groups covered will be announced and shared in due course. Every effort will be made by NHS Norfolk and Waveney ICB to provide eligible patients with continuous glucose monitoring in due course.
*Pregnant people with type 1 diabetes will be able to access real time Continuous Glucose Monitoring (rtCGM) such as Dexcom G7 once a viable pregnancy is confirmed on scan. People will be able to express a preference to use intermittently scanned Continuous Glucose Monitoring (isCGM) such as Freestyle Libre 2 if they so wish. Access to rtCGM will be continued for up to 15 months and reviewed by the person’s diabetes team.
Pregnant people with non-type 1 diabetes will be able to access isCGM if their diabetes is managed with more than one insulin injection daily and have a need to monitor glucose levels intensively (more than 8 fingerprick capillary tests daily), and/or have issues with recognising hypoglycaemia (low blood glucose level) symptoms or have recurrent episodes of hypoglycaemia and/or have a condition that means it is difficult for them to monitor their glucose levels independently. Some people may be eligible for rtCGM if they have ongoing problems with recognising hypoglycaemia. Access to monitoring will be continued for up to 12 months and will be reviewed by the person’s diabetes team.
Hybrid Closed Loop Systems
Norfolk and Waveney ICB are working collaboratively across the system to develop localised guidance in line with the NHS England » Hybrid closed loop technologies: 5-year implementation strategy.
There are still a number of areas to be agreed at national level.
We will keep this page updated as we receive more information.
For more information, please see the following link: Project information | Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes | Guidance | NICE
Norfolk and Waveney Formulary
If you’re a healthcare professional, you can access the Norfolk and Waveney STP Formulary for formularies, information and key contact details.