Dear 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

  • 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needing to be withdrawn or replaced with other agents takes place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