Civic Centre
Arnot Hil Park
Arnold
Nottingham
NG5 6LU
Direct Dial: 0115 8831838
Email:
xxxxxxxx.xxx@xxx.xxx
Date: 4th December 2017
Dear Requestor,
RE: Freedom of Information Request NNE/17/1526
With reference to your request for information I can confirm in accordance with Section 1 (1) of the
Freedom of Information Act 2000 that we do hold the information that you have requested. A
response to your request is outlined in blue typeface below on behalf of NHS Nottingham North
and East Clinical Commissioning Group.
In your request you asked:
Do you have a formulary used by primary care prescribers? If so, what is the current status
of nitrofurantoin and trimethoprim with respect to urinary tract infections (e.g. first line,
second line, etc?)
Formulary information can be found at the following link:
http://www.nottinghamshireformulary.nhs.uk/chaptersSubDetails.asp?FormularySectionID=
5&SubSectionRef=05.01.13&SubSectionID=A100
Has the status of either nitrofurantoin or trimethoprim changed in the formulary since
November 2014? If so, can you please provide the previous status (es) and details of the
date(s) of change?
Yes, please see information below and guidelines at:
http://www.nottsapc.nhs.uk/media/1044/antimicrobial-
guidelines.pdf?UNLID=1033696972017117162459
Have you had any work plans in place with respect to nitrofurantoin and trimethoprim
prescribing since 2014? If so, can you please provide documents and start date.
The information below was circulated and discussed with practices in 2016:
The 2015 update of the Nottinghamshire antimicrobial guidelines saw some key changes.
The most significant of which was around the choice of antibiotics for the treatment of
UTI’s. Due to increasing resistance trimethoprim is NO longer recommended as empiric
therapy; Nitrofurantoin is now first line treatment, however before prescribing, risk factors
for resistance should be considered:
•
Older than 65 years,
•
A care home resident
•
Previous treatment failure
•
Recurrent UTI hospitalisation in the last six months
•
Recent travel to a country with increased antimicrobial resistance
•
Previously resistant organism in urine
Second line treatment:
•
Trimethoprim in a patient under 65 years, with no risk factors for resistance
•
Pivmecillinam in patients over 65years or with risk factors
Training support was provided at practice meetings (annual and monthly) about the
guideline changes. Prescribing is monitored and the clinical system (System One)
formulary has all the antibiotics on it from the guidelines.
Have you had any GP prescribing incentive schemes or similar which relate to trimethoprim
or nitrofurantoin prescribing since November 2014? If so, can you please provide the
documents.
No
I trust this information answers your request. Should you have any further enquiries or queries
about this response please do not hesitate to contact me. However, if you are unhappy with the
way in which your request has been handled, you have the right to ask for an internal review.
Internal review requests should be submitted within two months of the date of receipt of the
response to your original letter and should be addressed to:
Freedom of Information Officer
Nottingham North & East CCG
Civic Centre
Arnot Hil Park
Arnold
Nottingham
NG5 6LU
If you are dissatisfied with the outcome of the complaints procedure, you can apply to the
Information Commissioner’s Office, who will consider whether the organisation has complied with
its obligations under the Act, and can require the organisation to remedy any problems. Generally,
the ICO cannot make a decision unless you have exhausted the complaints procedure provided by
the CCG. You can find out more about how to do this, and about the Act in general, on the
Information Commissioner’s Office website at:
https://ico.org.uk/for-the-public/
Complaints to the Information Commissioner’s Office should be sent to: FOI/EIR Complaints
Resolution, Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire,
SK9 5AF
telephone 0845 630 6060, email
xxxx@xxx.xxx.xxx.xx
Yours sincerely
Freedom of information Officer
xxxxxxxx.xxx@xxx.xxx
Direct Line: 0115 8831838
Nottingham North and East Clinical Commissioning Group
Civic Centre, Arnot Hil Park, Arnold, Nottingham NG5 6LU
www.nottinghamnortheastccg.nhs.uk
Al information we have provided is subject to the provisions of the Re-use of Public Sector
Information Regulations 2015. Accordingly, if the information has been made available for re-use
under the Open Government Licence (OGL) a request to re-use is not required, but the licence
conditions must be met. You must not re-use any previously unreleased information without having
the consent from NHS Nottingham North & East CCG. Should you wish to re-use previously
unreleased information then you must make your request in writing (email wil suffice) to the FOI
Lead via xxxxxxxx.xxx@xxx.xxx
. Al requests for re-use wil be responded to within 20 working days
of receipt.