In this episode John Oliver speaks to expert guests about evaluating the suitability of unlicensed medicines for the patient. We discuss practical considerations for managing them in dispensaries, performing a quality assessment and good governance frameworks. (29m:55s)

Speakers: 

John Oliver, Quality Assurance Specialist; NHS SPS 
Dr. Andrew Lowey, Lead Clinician, Pharmacy Preparative Services Leeds Teaching Hospitals, and chair of the NHS Pharmacy Production Committee 
Penny Daynes, Associate Regional Pharmacy Procurement Specialist; NHS SPS, North East and Yorkshire 
Katherine Cullen, Divisional Director Clinical Support Services, Chief Pharmacist; Tameside and Glossop Integrated Care NHS Foundation Trust 
Lynn Morrison, Regional Quality Assurance Specialist; NHS Scotland 
Amanda Cooper, Assistant Head of NHS SPS 

Useful links:

MHRA guidance 
https://www.gov.uk/government/publications/supply-unlicensed-medicinal-products-specials (MHRA guidance on unlicensed medicinal products – specials, including Guidance Note 14) 

SPS guidance 
https://www.sps.nhs.uk/home/guidance/unlicensed-medicines/ 

https://www.sps.nhs.uk/articles/understanding-excipients-in-medicines/ 

https://www.sps.nhs.uk/articles/searching-for-presence-or-absence-of-an-excipient-in-medicines/ 

https://www.sps.nhs.uk/articles/navigating-a-potential-supply-issue/ (SPS log-in required) 

https://www.sps.nhs.uk/articles/managing-complexities-of-medication-use-across-care-boundaries/ (Medication Safety across the System providing resources that include valuable real-world examples of safely managing unlicensed liquid medicines)

Unlicensed medicines: good practice principles

Emma Kirk discusses with Claire Davies her experiences and learnings from speaking with people living with diabetes as part of the NHS SPS insulin safety project. In this podcast Claire shares conversations with Abdul, Sarah, Charlie and Toby including the impact of their diabetes diagnosis, diabetes devices, faith, hypoglycaemia and admissions to hospital on their diabetes journey. (48m 41s) 

This podcast is part of the Medication Safety Across The System (MSATS) series, aimed at healthcare professionals working in any sector with a role or passion for medication safety and/or involved in medicines use.

MSATS: People living with diabetes and what insulin safety means to them

Kieran Reynolds talks to Arron Jones, Lead Hepatology Pharmacist about metabolic dysfunction associated steatotic liver disease (MASLD). Discussion includes what MASLD/MASH stands for, prevalence, diagnosis, treatment; including advice to give to patients accessing GLP-1 RAs online, and emerging therapies.  

Arron Jones - Lead Hepatology Pharmacist, Bart’s Health Trust 
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS 

Useful links:  
The British Liver Trust’s information on MASLD, NAFLD and fatty liver disease 
https://britishlivertrust.org.uk/information-and-support/liver-conditions/masld-nafld-and-fatty-liver-disease/
The NHS Eatwell Guide 
https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/the-eatwell-guide/
The South Asian Eatwell Guide  
https://mynutriweb.com/the-south-asian-eatwell-guide/
SPS article on using statins in liver impairment   
https://www.sps.nhs.uk/articles/using-statins-in-liver-impairment/
The General Pharmaceutical Council’s FAQs on weight loss medications (including a guide for patients on how to keep safe when getting medicines or treatment online: scroll to bottom of page to access) 
https://www.pharmacyregulation.org/patients-and-public/standards-you-can-expect-using-pharmacy-services/weight-loss-medications-faq

Metabolic dysfunction associated steatotic liver disease (MASLD)

Kieran Reynolds talks to Sonal Patel, Lead Hepatology Pharmacist about autoimmune hepatitis (AIH). Discussion includes what AIH is, prevalence, diagnosis, treatment and how pharmacy professionals can contribute to the management of patients with AIH.  

Sonal Patel - Lead Hepatology Pharmacist, Guy’s and St. Thomas’ Trust and Chief Pharmaceutical Officer’s Clinical Fellow 2024/25 at the General Pharmaceutical Council (GPhC)  
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS 

Useful links:  
SPS article on assessing liver function and interpreting liver blood tests 
https://www.sps.nhs.uk/articles/assessing-liver-function-and-interpreting-liver-blood-tests/
NHS website information on prednisolone  
https://www.nhs.uk/medicines/prednisolone/
NHS website information on budesonide  
https://www.nhs.uk/medicines/budesonide-tablets-capsules-and-granules/about-budesonide-tablets-capsules-and-granules/
NHS website information on azathioprine  
https://www.nhs.uk/medicines/azathioprine/
The Society of Endocrinology information on adrenal crisis 
https://www.endocrinology.org/clinical-practice/clinical-guidance/adrenal-crisis/
SPS Medicines Monitoring tool 
https://www.sps.nhs.uk/home/tools/drug-monitoring/
The Green Book: information on vaccines for vaccine preventable diseases 
https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book#the-green-book
AIH support website  
https://aihsupport.org.uk/
The British Liver Trust’s information on autoimmune hepatitis 
https://britishlivertrust.org.uk/information-and-support/liver-conditions/autoimmune-hepatitis/

Autoimmune hepatitis (AIH)

Kieran Reynolds talks to Yun Jung Kim, Senior Specialist Pharmacist in Hepatology about primary biliary cholangitis (PBC). Discussion includes what PBC is, symptoms (and symptom control), diagnosis, treatment and how pharmacy professionals can contribute to the management of patients with PBC.  

Yun Jung Kim - Senior Specialist Pharmacist in Hepatology University Hospital Southampton NHS Foundation Trust and Vice-Chair, BHPG 
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS 

Useful links: 
The British Liver Trust’s information on primary biliary cholangitis  
https://britishlivertrust.org.uk/information-and-support/liver-conditions/primary-biliary-cholangitis/
The British Liver Trust’s information on diagnosing primary biliary cholangitis 
https://britishlivertrust.org.uk/information-and-support/liver-conditions/primary-biliary-cholangitis/diagnosis/
The British Liver Trust’s information on treating primary biliary cholangitis 
https://britishlivertrust.org.uk/information-and-support/liver-conditions/primary-biliary-cholangitis/diagnosis/
PBC Foundation website  
https://www.pbcfoundation.international/
The British Society of Gastroenterology primary biliary cholangitis (PBC) care bundle
https://www.bsg.org.uk/clinical-resource/primary-biliary-cholangitis-(pbc)-care-bundle 

Primary biliary cholangitis (PBC)

Jo Clarke (Advanced Specialist Pharmacist - Palliative and End of Life Care, Medicines Use and Safety in SPS) explores some of the known issues which challenges the safe use of medicines in services and, the impact these have for patient, carers and loved ones. Gaining a better understanding of these challenges can support the implementation of safety initiatives to address some of these issues.  

Understanding safe use of medicines challenges in palliative and end of life care

John Oliver, a quality assurance specialist at SPS, presents a summary of the resources published by SPS between 6th and 12th September. 

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.   

Quick links to highlighted resources:     

Ensuring time critical use of rasburicase 
Timely use of rasburicase for treatment of tumour lysis syndrome is essential. Mitigation strategies can minimise harm associated with delayed therapy. 
https://www.sps.nhs.uk/articles/ensuring-time-critical-use-of-rasburicase/ 

Preparing to use denosumab 60mg biosimilar 
Biosimilars of denosumab 60mg (Prolia) are expected soon. We offer general information and implementation advice. 
https://www.sps.nhs.uk/articles/preparing-to-use-denosumab-60mg-biosimilar-for-osteoporosis/  

Understanding biosimilar and generic market entry – explainer video 
New medicines have several protections against competition. Other factors influence availability of biosimilars or generics after loss of exclusivity. 
https://www.sps.nhs.uk/articles/understanding-biosimilar-and-generic-market-entry/  

SPS Vacancies:  

Senior Specialist Pharmacist Medicines Advice & Medicines Use and Safety (closing date 24 September) 
https://www.jobs.nhs.uk/candidate/jobadvert/C9287-25-1466?keyword=pharmacist&location=Liverpool&distance=5&language=en&page=2 

Senior Specialist Pharmacist, Medicines Use and Safety (closing date 24 September) 
https://www.jobs.nhs.uk/candidate/jobadvert/C9287-25-1470  

Next events – forthcoming webinars and conferences      
https://www.sps.nhs.uk/home/events/next-events/     

Podcast description:    
NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.   

16 September: time critical use of rasburicase, biosimilars, & upcoming events

An ‘on the couch’ discussion on the practical implementation of biosimilar insulin in primary care, focusing on hints and tips to consider should your system be considering this, and debunking some of the myths around biosimilar insulin. (50m30s). This is the audio of a webinar that was held on the 30 September 2025.

A range of speakers from SPS and other organisations will run this event.
Carolyn Barton
Head of Medicines Management (Knowsley Place); NHS Cheshire and Merseyside

Chris Haigh
Deputy Chief Pharmacist;  NHS Cheshire and Merseyside

Jole Hannan
Head of Medicines Management (Wirral Place); NHS Cheshire and Merseyside

Georgia Lane
Senior Clinical Pharmacist (Knowsley Place); NHS Cheshire and Merseyside

Rakhi Aggarwal 
Primary Care Lead, NHS Specialist Pharmacy Service

Primary care discussions: biosimilar insulin

Nicola Wake, Associate Director, Medicines Use and Safety at SPS, presents a summary of the resources published by SPS between11th and 17th October.  

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.     

Quick links to highlighted resources:    

Prescribing Outlook  
This is our annual output to support managed entry and budget planning for new medicines, new indications and patent expiries in the NHS.
https://www.sps.nhs.uk/wp-content/uploads/2025/10/Prescribing-Outlook-2025.xlsx#:~:text=Prescribing%20Outlook  

Golimumab biosimilar 
If you’re preparing to use golimumab biosimilar, we’ve added phase 2 and phase 3 checklists to our website.
https://www.sps.nhs.uk/wp-content/uploads/2025/05/Golimumab-Biosimilar-Patient-Information-Sheet-version-2-FINAL-1.docx#:~:text=golimumab%20biosimilar  

PGD templates for trimethoprim and/or nitrofurantoin for UTI  
Version 2 of the templates have been published. They are valid from January 2026, but we publish them a few months in advance so organisations can take them through local governance processes in a timely manner.   
https://www.sps.nhs.uk/wp-content/uploads/2025/10/Nitrofurantoin-PGD-template-UTI-V2.0-1.docx#:~:text=PGD%20templates%20for%20trimethoprim%20and/or%20nitrofurantoin%20for%20UTI  
https://www.sps.nhs.uk/wp-content/uploads/2025/10/Trimethoprim-PGD-template-UTI-V2.0-1.docx#:~:text=PGD%20templates%20for%20trimethoprim%20and/or%20nitrofurantoin%20for%20UTI   

Next events – forthcoming webinars and conferences       
https://www.sps.nhs.uk/home/events/next-events/      

Podcast description:     
NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.    

  

21 October: Prescribing Outlook, Golimumab Biosimilar, & CPC North

Dav Manku, Associate Regional Pharmacy Procurement Specialist, at SPS, presents a summary of the resources published by SPS between 18th and 24th October.  

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.     

Quick links to highlighted resources:    

Considerations and Interactions with GLP-1 Receptor Agonists 
Signposting key risks and interactions of GLP-1 receptor agonists in diabetes, obesity, and weight management. 
https://www.sps.nhs.uk/articles/considerations-and-interactions-with-glp-1-receptor-agonists/  

New Product Evaluations – log in required 
A list of new product evaluations that are freely available to NHS staff. 
https://www.sps.nhs.uk/articles/new-product-evaluations/ 

National PGD template updates 
National PGD templates are developed with experts for clinical specialties. They reduce duplication and variation, and improve consistency of care. 
https://www.sps.nhs.uk/home/guidance/patient-group-directions-and-legal-mechanisms/national-pgd-templates/ 

Next events – forthcoming webinars and conferences       
https://www.sps.nhs.uk/home/events/next-events/      

Join our new WhatsApp channel to stay up to date with our latest news and updates 
https://whatsapp.com/channel/0029VbBslvuJpe8aH3n7Zu1i  

Podcast description:     
NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.    

28 October: GLP-1 receptor agonists, New Product Evaluations, & PGD template updates

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines.  Our motto is 'do once and share'.

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