Discharge letters should be printed and signed and the TRAK IDL should be sent to pharmacy at REH.

Short term leave prescriptions should be completed on HEPMA and if you have a clinical pharmacist they should be paged. The pharmacist will clinically verify the prescription and send to pharmacy on your behalf. If you don't have a clinical pharmacist these should be sent to REH pharmacy.

Please note the Green 'Send to Pharmacy' button on HEPMA is not functional, all this does is generate a PDF. It has NOT been sent to pharmacy.

* Prescriptions with controlled drugs need printed and signed in ink*

Clozapine is an antipsychotic mainly used in treatment resistant schizophrenia.

Initiation

For patients starting on clozapine they need to have undergone a full 'work up' (see handbook), be registered with the national monitoring service (CPMS), prescribed the escalation protocol on HEPMA and have the paper titration chart (which can be found below) signed and sent to pharmacy.

Repeat (Also used for Pirenzipine, Risperidal Consta, Self-Administration, Unlicensed medicines, Cytotoxics)

For inpatients established on clozapine a repeat prescription is required (\MHREPEAT). To do this you must first prescribe the clozapine on HEPMA and prescribe this on the discharge tab and complete. Then on TRAK use \MHREPEAT and select the note type as 'immediate discharge letter'. This should source the prescribed clozapine from HEPMA. The repeat prescription should be printed, signed and sent to pharmacy at REH. Dose changes must be communicated to pharmacy by updating the HEPMA discharge tab and re-printing the repeat prescription and sending to pharmacy.

Pharmacy can only legally dispense clozapine up to the validity of their current blood result.

The out-of-hours cupboard for the Royal Edinburgh Hospital is located in the Reception back room, Royal Edinburgh Building and for Astley Ainslie Hospital in Millbank Pavilion.

The cupboard contains a limited supply of drugs including a selection of outpatient pre-packs for emergency use.  To gain access, contact the CCN.

The on-call pharmacist can help with the emergency provision of:

• Essential medicines not available from local emergency cupboards (or via ward borrowing procedures) and defined as being required before the next pharmacy department opening time.

• Controlled drugs.

To speak to the pharmacist, contact Lauriston switchboard and ask them to contact the emergency duty pharmacist for REAS.

The on-call service will not provide discharge or pass medicines that could have been organised within pharmacy opening hours.