COVID-19

COVID-19 virus and medicines

COVID-19 vaccination

Information on COVID-19 vaccines is changing as the vaccination programme develops. Please use the links below to ensure the most up-to-date guidance is accessed and followed.

NHS England NHS Improvement Covid-19 vaccination programme

NHS England NHS Improvement Legal mechanisms

Specialist Pharmacy Services (SPS) COVID-19 vaccines

SPS has produced information and guidance on pharmaceutical aspects of COVID-19 vaccines use, including standard operating procedures (SOPs).

Training

eLearning can be accessed from your ESR or via e-Learning for Health (e-LfH);

Resources to support medicines optimisation during COVID-19 

We have had a large number of queries about COVID-19 and medicines use. There are also a large number of resources published nationally to support and advise on issues around prescribing. This page aims to bring all these resources together. Where available we will link to national guidance and websites so that it reflects the most up to date information, if and when things change.

Practices are reminded to follow guidance which has been sent out regarding issue of prescription quantity and duration. Stockpiling will exacerbate pressures on prescribed medicine stocks and may create shortages. The current advice is for patients to continue ordering prescriptions as usual (via phone or on-line), maintaining current prescription length.

NHS England coronavirus advice page is available here

  • NHSE are hosting speciality guides - available here

NICE rapid guidelines and evidence reviews are hosted here

PressPortal See Covid-19 information on the PressPortal here

RCGP Guidance on workload prioritisation during COVID-19 can be found here (For further information on the warfarin to DOACs switch see under 'Cardiovascular System' also see ‘Nutrition & Blood ‘section for advice on Vitamin B12 below)

Some general evidence reviews available here, these are not national recommendations but may help in the management of individual patients https://www.cebm.net/oxford-covid-19/

RCGP's COVID-19 e-learning resource hub​

SPS COVID-19 resources here. They have produced a general principles document around blood monitoring and a number of individuals ones for high risk medicines.

Community pharmacy

If needed, the following pharmacies have been commissioned to hold stocks of palliative care medicines - Palliative Care Pharmacies

eRD

Please see link for some hints and tips on EPS & RD produced by Sheffield CCG. This provides some suggestions on patients who may be suitable for RD. 

How to guides;

 

Drug/condition specific national/local advice;

*Due to the speed of trying to get advice to local clinicians, these documents have not been through APG, but all are based on local expertise / national advice.

Those annotated with ** have been approved during the COVID-19 pandemic under delegated authority and when the pandemic is over they will be reviewed and potentially stood down.

Acute Kidney Injury (AKI)

Palliative Care

See link for End of Life Care resources to support practices

General principles:

For all patients who are dying in the community;

  • Continue with usual palliative care practice including advanced care planning
  • Use the Sheffield palliative care formulary.  
  • Complete the pink card as usual. Community nurses can now take verbal instructions to amend (SOP in place)
  • Saf-T-Intima Lines can now be used for PRN sub cut meds

For those at end of life with COVID-19 (suspected or confirmed)

For symptoms caused by COVID or suspected COVID, national guidance is available here:

Prescribing smaller quantities of anticipatory medicines

When prescribing anticipatory medicines at the end of life, take into account any medicines shortages or lack of administration equipment/staffing, prescribing of smaller quantities may be appropriate. 

If your local pharmacy does not have EOL medicines in stock the following pharmacies have been commissioned to keep the following medicines in stock.

See link for information on suggested flow of how to access end of life medicines in the community.

NHSE/NHSI/DHSC - Coronavirus (COVID-19) - Re-use of medicines in a care home or hospice: This is a national SOP to support the re-use of medicines during the COVID-19 pandemic, in the event of a medicines shortage please contact the Medicines Optimisation Team if you are considering the re-use of medicines.

 

Cardiovascular System

  • ACEi / ARBs – Position statements have been released from the European Society of CardiologyBritish Cardiovascular SocietyBritish Society for Heart Failure and the Renal Association highlighting that there is no evidence to support an increased risk to patients taking ACEi or ARB. It is strongly recommended that all patients on these medications for systemic hypertension, heart failure, post-myocardial infarction or for those with diabetes and diabetic nephropathy should continue on their therapy.
  • **Hypertensionlocal guidance to support ongoing review and management of hypertension during COVID-19.

Respiratory

  • *COVID-19 and respiratory illness (asthma and COPD) - current knowledge and advice as at 7 May 2020​ here 
  • *Advice on shielding for respiratory Patients during COVID-19 outbreak - advice as at 23 April 2020 here

Central Nervous System

Infections

Refer to NICE NG191 COVID-19 rapid guideline: managing COVID-19

 Endocrine

  • Community sexual & reproductive health services - Sexual Health Sheffield are scaling back the community sexual & reproductive health services they provide in order to protect those aspects of the service considered critical, such as emergency contraception. Please see their webpage for up-to-date details.
  • Sexual health bulletin: COVID edition: PCS has compiled a newsletter of resources to support clinicians managing sexual and reproductive health during COVID-19. The current edition (07/05/20) is here. These resources have not been through the APG approval process and where treatments are recommended, prescribers are requested to prescribe in line with Sheffield Formulary, wherever possible.​
  • Corticosteroids, replacement therapy The Society for Endocrinology  have developed a template letter for patients who are on long term steroids and includes advice about steroid management during a coronavirus infection.
    See: Pituitary and Adrenal Insufficiency/ Letter Template updated advice for AI patients.

  • Denosumab - The Royal Osteoporosis Society have developed practical advice around administration and monitoring of denosumab.

  • Primary Care Diabetes Society (PCDS) Quick Guide: Undertaking a remote diabetes review.  This quick reference guide provides the essential information and resources on conducting a safe and effective remote diabetes review; helping healthcare professionals to continue provide high quality care during coronovirus restrictions.

  • LARCs - The Faculty of Sexual and Reproductive Healthcare (FSRH) have developed a webpage where they aim to share the most up to date information to help with questions about SRH delivery during the Covid-19 outbreak.​
  • National Diabetes Prevention Programme – Covid-19 Update here
  • Testosterone injectionguidance for the administration and monitoring of testosterone injections during COVID-19 for androgen deficiency in adults

Malignant disease and immunosuppression  

  • Hydroxycarbamide – see here for updated advice.  Note  - if prescribing is being directed back to secondary care, please retain hydroxycarbamide as a specialist issued drug within the patients records so you are alerted to drug/disease interactions.

Musculoskeletal & Joint Diseases

  • SPS provides a useful resource to aid assessment if considering a delay in blood monitoring of DMARDS in stable patients– see link 
  • NSAIDS - see link to CAS alert here - (advice around the use of NSAIDs updated 15.04.20)

 Dermatology

  • SPS provides a useful resource to aid assessment if considering a delay in blood monitoring of DMARDs in stable patients– see link
  • To determine the level of risk to dermatology patients of COVID-19 and advice on what precautions to take  - see link

 Nutrition

  • See the British Dietetic Association's advice re: COVID-19 and diet here 
  • Vitamin B12: The British Society of Haematology have produced advice around vitamin B12 supplements during the COVID pandemic here (updated 06.05.20)

 

Medicines for use in the treatment or prevention of COVID-19

Covid-19 primary care prescribing briefing: NICE NG191 Covid-19 rapid guideline: managing COVID-19

For more information on current treatments to manage symptoms and complications of COVID which are approved by NICE see here.

NHSE/I COVID-19 community-based treatments (nMABs and antivirals)

CAS alert Neutralising monoclonal antibodies (nMABs) or antivirals for non-hospitalised patients with COVID-19 (8 Dec 2021)

 

Stock Shortages

Specialist Pharmacy Service list of stock shortages available here

A list of stock shortages can be found on the Medicines Supply Issues page here

 

 

 

Last updated on 11/04/2022 by shreen.howson@nhs.net