What is the Derbyshire Primary Care Formulary?
The Derbyshire Primary Care Formulary (DPCF) is a curated list of medicines and related products recommended for use within primarycare services across Derbyshire. It supports clinicians in prescribing safely, costeffectively, and in line with national guidelines while addressing local health priorities.
It is not a binding legal document but a practical tool that reflects the best available evidence, regional prescribing patterns, and the specific needs of Derbyshires population.
Governance and Responsibility
Responsibility for the DPCF rests with the Derbyshire Clinical Commissioning Group (CCG) in partnership with the Medicines Management Team, local pharmacy leads, and the Clinical Effectiveness Unit. Governance includes:
- Regular evidence review by multidisciplinary panels.
- Stakeholder consultation GPs, practice pharmacists, nurses, and patient representatives.
- Financial oversight to ensure alignment with the local formulary budget.
- Compliance with NHS England and NICE guidance.
Structure of the Formulary
The DPCF is organised into therapeutic sections, each containing:
- Preferred drugs firstline agents with proven efficacy and costeffectiveness.
- Alternatives secondline options for patients who cannot tolerate or do not respond to preferred agents.
- Restricted items medicines that require prior approval or specialist input.
| Therapeutic Area | Preferred | Alternatives | Restricted |
|---|---|---|---|
| Hypertension | ACE inhibitors, calciumchannel blockers | Thiazidetype diuretics | Novel agents (e.g., neprilysin inhibitors) |
| Type 2 Diabetes | Metformin, SGLT2 inhibitors | DPP4 inhibitors | GLP1 receptor agonists (specialist review) |
| Asthma | Lowdose inhaled corticosteroids | Combination inhalers (ICS/LABA) | Biologic therapies |
How to Use the Formulary in Practice
Clinicians can access the DPCF through the Derbyshire NHS intranet or the dedicated mobile app. Key steps include:
- Check the therapeutic area for the patients condition.
- Select a preferred drug unless contraindicated.
- Document any deviation and the clinical justification.
- For restricted items, complete the electronic priorapproval form.
Updates, Review Cycle, and Feedback
The formulary is reviewed twice a year in March and September with an adhoc update process for urgent safety alerts.
Feedback mechanisms:
- Online feedback form on the formulary portal.
- Quarterly stakeholder meetings.
- Annual survey of prescribers to capture practical challenges.
All changes are published with a version number, date, and a short rationale, ensuring transparency for all users.
Clinical Impact and Benefits
Since its introduction in 2018, the DPCF has contributed to:
- A 12% reduction in average drug spend per patient.
- Improved prescribing consistency across the county.
- Lower rates of medicationrelated adverse events, particularly in the elderly.
- Enhanced patient confidence through clearer medication explanations.
These outcomes are monitored through the Derbyshire Prescribing Dashboard, which provides realtime data for CCG leads and individual practices.
