July 2023 Newsletter
Prescribing support newsletters aim to inform readers of work done by the unit and work in progress, to help tailor local work plans and highlight any ‘topical’ issues in prescribing or medicines management.
If you have any suggestions for future topics for the newsletter, then please contact nuth.nyrdtc.rxsupp@nhs.net
This month’s edition focuses on the budget impact of methylphenidate modified release tablet choice, the effect of price concessions on prescribing budgets, and changes to the shingles vaccination programme. It also includes another in the series of “Meet the Team” where you can get to know the people behind the work we do. There is also information on serious shortage protocols, some key medicines availability, new and updated NICE guidance, and UK product launches.
View the preview below on desktop, or click here to download a copy.
Security warnings in Excel files
Following a recent change Microsoft has introduced new security measures to protect users against malicious Excel macros. Previously users may have seen the following message when opening RDTC Excel reports and by selecting Enable Content would allow users to use the spreadsheet with full functionality.

Following the recent change some users may receive the following message when opening our reports:

Many of our reports use macros to update when the viewing options are changed to select the appropriate ICB or sub-ICB. Stakeholders can address the security message by following the instructions by clicking on the Learn More option when the message appears. These options are summarised below, and a downloadable copy is available here.
Unblock all files from a specific network share or website
A preferable option is to set a network location or website as a trusted site in Windows so a macro from the site won’t be checked (this may require assistance from local IT services as Trusted sites may be blocked).
- Tap the start button or Windows key and type Internet Options.
- Select Internet Options from the search results and the Internet Properties dialog box will appear.
- On the Security tab, select Trusted Sites, then select Sites.
- Type the URL of the site or server that contains the Microsoft 365 files with the macros you want to run, and then select Add.
- Select Close and then OK.

Unblock a single file
- After downloading the file, open the Windows File Explorer and go to the folder where you saved the file.
- Right-click the file and choose Properties from the context menu.
- At the bottom of the General tab, select the Unblock checkbox and select OK.

A downloadable version of these instructions is available here. If you have any questions or have difficulties in opening reports, please email us on nuth.nyrdtc.rxsupp@nhs.net.
Budget impact of methylphenidate modified release tablet choice
The latest in the RDTC’s prescribing bulletin series covers methylphenidate, and highlights the difference in cost between bioequivalent methylphenidate modified release (MR) tablets. It considers the budget impact of MR tablet choice and shows the yearly primary care spend on all methylphenidate XL tablets, and the proportion of this spend on each of the available brands.
This bulletin, and our others, are available from the Prescribing Bulletins page.
April 2023 Newsletter
Prescribing support newsletters aim to inform readers of work done by the unit and work in progress, to help tailor local work plans and highlight any ‘topical’ issues in prescribing or medicines management.
If you have any suggestions for future topics for the newsletter, then please contact nuth.nyrdtc.rxsupp@nhs.net
This month’s edition focuses on semaglutide for managing overweight and obesity, Familial Hypercholesterolaemia Gene Testing Workshops, a new NHSE short course on working with people and communities, recent publications from the RDTC, and an update on the RDTC prescribing support team attendance at the GNPRC Conference in July 2023. It also includes another in the series of “Meet the Team” where you can get to know the people behind the work we do. There is also information on some key medicines availability, new and updated NICE guidance, and UK product launches.
Monthly formulary amendments – March 2023
A Monthly Formulary Amendments document covering guidance and alerts published in March 2023 is now available.
The purpose of the document is to support consistent decision making by APCs. This information is produced for use by NHS healthcare professionals and RDTC stakeholders.
This document is available alongside previous editions on the formulary amendments page.
Transfer of prescribing from private provider to NHS GP – RDTC of prescribing from private provider to NHS GP – RDTC
Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services.
This publication aims to provide guidance on what NHS prescribers need to be aware of when they are asked by a private healthcare provider, and/or patient, to take on the regular prescribing of a medication for a patient, including medicines supplied under formal shared care agreements. Based on suggested best practice it discusses the principles which underpin the transfer of patients from private to NHS provision and highlights Shared Care specific, and ethical considerations.
Medicines in Practice: Considerations for Sustainable Inhaler Prescribing
Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services.
Inhalers account for approximately 3% of all NHS carbon emissions. Reducing the carbon impact from inhaler prescribing has been identified as a significant area of focus for delivering a net zero NHS. This document aims to outline strategies that can be considered to promote optimal respiratory care, while minimising the environmental impact from inhalers and consequences of suboptimal disease management.
A briefing for ICSs regarding NICE TA875: Semaglutide for managing obesity
In March 2023 NICE published TA875: Technology Appraisal guidance for semaglutide (Wegovy®) for managing overweight and obesity. The guidance recommends semaglutide as an option for weight management when prescribed by a specialist service alongside a reduced-calorie diet and increased physical activity in adults if they meet the criteria specified. This briefing aims to provide advice to prescribers on how the treatment can be accessed and which patient groups are eligible to receive Wegovy®. The document explains some of the limitations of the treatment and the evidence base, as described by NICE and may help to manage patient expectations.
Formulary Assessment Tool: Tacalcitol (Curatoderm) Lotion and Ointment
Formulary assessment tools are templates to support local decision making. They list NICE guidance, MHRA safety advice, and other relevant high quality advice and guidelines relevant to making decisions for local formularies.
The templates are pre-populated with useful information to reduce duplication of effort, with space for the addition of local information as appropriate. The purpose of the document is to support consistent decision making by formulary groups and APCs.
The Formulary Assessment tool for tacalcitol (Curatoderm) can be found here.
Prescribing for Population Health: Problematic Polypharmacy: Prescribing Cascades Evidence Evaluation
Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve.
Problematic polypharmacy is a significant concern with overprescribing and occurs where the prescribing of multiple medicines is either inappropriate or where the intended benefit of the medication is not realised.
The publication aims to raise awareness of potential prescribing cascades and to highlight resources, tools, and strategies to help identify, prevent, and resolve inappropriate cascades.