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Message from Dr Fionna Moore, Medical Director

20 April 2017

MedicinesDear Colleagues,

I am aware that over the past few days there has been some concern regarding the use of the SECAmb Clinical Guidelines Pocket Book (Green Book).

I am sorry that there has been misunderstanding over this issue – communications issued previously were done with the best of intentions but I recognise may have caused confusion.

An external, independent medicines review is currently being undertaken, which is highlighting a number of changes which we will need to make to our medicines practice over coming weeks. More information on this will follow.

But please can I begin by clarifying the following:

  • All staff should continue to use JRCALC and the ‘Green Book’ as needed
  • Additionally, paramedics may also use any relevant PGDs as currently

Over coming weeks, we will be moving away from the current ‘Green Book’ and emphasising the use of JRCALC as the primary reference source for all but a few medicines. Medicines which aren’t listed in JRCALC will have Medicines Administration Protocols and/or PGDs updated.

We are ensuring that all staff have access to the JRCALC pocket book, and that all stations have access to the full reference version of JRCALC. If you do not have a JRCALC pocket book, please report this to your line manager in order for your Operating Unit administrator to order replacements.

We are also considering adopting the iCPG app for smartphones and iPads. iCPG is the JRCALC app with additional functions that will allow us to publish local guidelines in a seamless way on a single platform.

Once we have established the consistent use of JRCALC and the revised local guidance, we will then withdraw the Green Book from practice.

Please can I also draw all staff’s attention to an important change, happening this week, clarifying the quantities of morphine and diazepam injection which each paramedic can legally possess. A Clinical Instruction is being published today (attached) which provides detailed information on these CD quantities, and also includes general guidance on safe, legal possession of CDs.

Longer term will see the completion of the revised SECAmb medicines formulary and ensure that any medicines needing to be withdrawn or replaced with other agents takes place in a transparent and managed way.

Please can I suggest that all operational staff refresh their knowledge on medicines legislation by watching this video:



Thank you for your co-operation with this. The changes being made to practice are being undertaken to ensure that we all practice safely and legally.  We are working to ensure that changes are done so in a minimally disruptive way and that we engage as widely as possible as the work progresses

Dr Fionna Moore, Medical Director

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