NHS Ipswich and East Suffolk Clinical Commissioning Group

NHS West Suffolk Clinical Commissioning Group

Contents:

Catheter, Stoma &

Skincare

Formulary Version 12

July 2019

Catheter products

Stoma accessories

Skin care products

Community nurses/district nurses: Items not listed in this formulary are non-formulary. If needed for a particular patient, an exception

reporting form should be completed (available on SCH website).

Catheters

Initial catheterisation: the catheters listed in this formulary can be ordered by community

nurses through NHS Supply Chain for initial use only.

Long term catheter use: a prescription should be requested from GP practice.

Bowel Irrigation Anal and Ostomy irrigation: irrigation system products – specialist recommendation only

Stoma and skin care products

Stoma products: request a prescription from GP practice.

Skin care products: (excluding stoma skin care products) patients to be advised to purchase

skin care products

GP practice staff

Wherever possible formulary items should be prescribed. If a non-formulary item is required,

an exception reporting form should be completed (available on WSCCG & IESCCG website)

Prescribing Indicator

First Line

Second Line

Special Consideration

Catheter Products

Intermittent Catheters

1. Single-use Intermittent Catheters (single use)

Intermittent catheterisation allows patients to empty their bladder when the normal functioning of the

bladder is impaired. A single use catheter is inserted into the bladder by the patient to drain the bladder and

is then removed. The frequency of use will depend on the patients’ clinical need and in normal

circumstances may be up to 5 times daily for bladder emptying.

*In certain circumstances some patients may require more frequent bladder emptying, including those with

neurological and spinal conditions. This cohort of patients, following assessment by a qualified nurse in this

field, may require bladder draining every 3 hours or up to 10 catheters per day*

Appliance Product

details

Gauge/ CH

size

Cost per pack

(pack size) Comments

Usual

quantity to

order

First Line

Teleflex Flocath Quick

Male

40cm 8-18

£36.95 (30)

Integral saline solution

Protective sleeve for

touch free application

Approx. use in

normal

circumstances

4-5 catheters per

day / 4-5 packs per

month

Female

20cm 8-14

Teleflex Liquick Base

Male 10-16

£85.24 (60)

Higher Quantity Pack

For patients requiring a

more flexible

catheter

Approx. use

4-5 catheters per

day / 2-3 packs per

month

Female 6-14

Paediatric 8-10

Second Line

Coloplast Speedicath

Male

8-16 £45.54 (30)

Quantities may be higher

for patients with

neurological /

spinal conditions Approx. use

4-5 catheters per

day /

4-5 packs per

month

Female

Wellspect Healthcare

LoFric Primo

Male 10-18 £46.80 (30)

For patient self-

catheterisation Female

15cm/20cm 10-14 £48.12 (30)

Paediatric 6-10 £48.12 (30)

Compact Option

Speedicath Compact

Male 12-18 £54.99 Compact size for rapid

use when mobile/out of

home OR poor dexterity

Pre Lubricated

May be a 2nd

product at lower

quantities on

repeat Female 8-14 £47.10

Pathway considerations for Intermittent catheterisation

Patients may be assessed and commenced on intermittent catheterisation from the following settings:

Acute: Ipswich Hospital / West Suffolk Hospital

- Urology Clinic

- Urogynaecology Clinic

Community: Suffolk GP Federation

- Bladder and Bowel Community Service

When considering patient appliance overuse or changes in patient clinical need, patients should be assessed by

their GP and if required referred back to the service which commenced the treatment.

Relevant contacts:

Suffolk GP Federation Bladder and Bowel Service: 0300 123 2425

Ipswich Hospital central number: 01473 712233

- Urology dept. 01473 703689

West Suffolk Hospital central number: 01284 713000

- West Suffolk Hospital website: https://www.wsh.nhs.uk/Services-A-Z/Services.aspx

- WSH Urology contacts link: https://www.wsh.nhs.uk/Services-A-Z/Urology/Urology.aspx

Indwelling Catheters and Accessories

Appliance Product

details

Gauge/ CH

size

Cost per pack

(pack size) Comments

Usual

quantity to

order

2. Long-term indwelling catheters (use for up to 12 weeks)

First Line

Rüsch Sympacath AquaFlate

Hydrogel Coated Latex

with prefilled syringe

Male

12-18 £6.27 (1) 1st Line

*Contains LATEX*

1 catheter every

4-12 weeks

In normal

circumstances 1

catheter can last

12 weeks

Suprapubic

catheters or

complex

conditions may

require more

frequent changes

Female

L.I.N.C All-Silicone catheter

with prefilled syringe and

Lidocaine Gel

Male 12-18

£5.57 (1)

2nd choice or

patients with latex

allergy

*Includes lidocaine gel

with pack* Female 12-16

Second Line

Rüsch Brillant AquaFlate

All-Silicone catheter

With prefilled syringe

Male 12-18

£6.11 (1)

2nd line choice or

patients with latex

allergy Female 12-16

Paediatric use only

Bard Biocath Hydrogel

Coated

Paediatric

5ml 8-10 £8.54 (1) Paediatric only

*Contains LATEX*

3. Catheter maintenance solutions

Sodium chloride 0.9%

OptiFlo S Bard 50ml £3.42 Used to unblock a

catheter

Usually not on

repeat unless

requiring regular

bladder wash outs Uro-Tainer NaCl 0.9% Braun 50ml £3.45

Solution G

OptiFlo G (Suby G) Bard 50ml £3.54

(50ml sachet) For patients prone to

encrustation.

Used as regular

maintenance to prevent

blockage

Usually not on

repeat unless

requiring regular

bladder wash outs Uro-Tainer Twin

(Suby G) Braun

2x30ml

sachets

£4.85

(2 x 30ml sachets)

4. Catheter lubricating gel

Cathejel Lidocain

Female 8.5g £1.10 For catheter insertion

Contains Lidocaine

*Not required for

LINC catheters that

include Lidocaine gel

PRN for use at

each

catheterisation Male 12.5g £1.15

5. Catheter valves (change every 7 days)

Care Flo catheter valve L.I.N.C Lever tap £7.59 (5)

Alternative to leg bag

*Assessment of bladder

function is necessary

before using this

product*

4 valves per Month

Incontinence Sheaths and Accessories

Appliance Product details Gauge/ CH

size

Cost per pack

(pack size) Comments Usual

6. Incontinence Sheaths (External Catheter)

First Line

Prosys Flofit

Self Adhesive Silicone

Sheath

Standard 24mm

28mm

31mm

35mm

40mm

£46.20 (30)

Use 1 sheath per 24 hours

*Ensure patient is correctly

measured prior to use*

Approx. use – 1

sheath per day /

1 pack per

month

Pop-on

Wide Band

Second Line

Jade Ultra Flex Extra Clear

Sheath

Small

25mm

29mm

32mm

36mm

41mm

£47.16 (30)

Medium

Intermediate

Large

Extra large

7. Sheath Accessories

Barrier Film Wipes

Coloplast Conveen Prep

Wipes 1st Line

Contains Alcohol

Sheath prep

wipes Box of 54 £10.81

1 wipe used at each sheath

change

Approx. every 24 hours

High Quantity Pack

2 boxes every 3

months Smith & Nephew

Secura Barrier Film Wipes

(Alcohol-free)

Barrier film

Wipes Box of 50 £23.68

Adhesive Remover

Great Bear

GB Soft Skin No Sting

Medical Adhesive

Remover Spray

Aerosol Spray 50ml £9.32

To aid sheath removal

when required

1 can of spray

per month

Great Bear

GB Soft Skin No Sting

Medical Adhesive

Remover Wipes

Wipes Pack of 30 £15.11 1 box of wipes

per month

Drainage Bags and Accessories

Appliance Product details Gauge/ CH

size

Cost per pack

(pack size) Comments

Usual quantity

to order

8. Leg Drainage Bags

First Line

LINC Medical Systems

LINC Flo Leg Bag

Use for 5-7 days

350ml

T tap only

Direct £20.72 (10)

Each box comes with 10

pairs of leg bag straps

To maintain a closed

system overnight leave the

leg bag connected and

connect a night bag to the

leg bag

Approx. 1 box

every 2-3 months

10cm tube

500ml

Lever tap /

T-tap

Direct

£22.27 - £22.31 (10) 10cm tube

30cm tube

750ml

T-tap only

Direct

£22.28 (10) 10cm tube

30cm tube

Second Line

Teleflex

Rusch Leg Bag

Use for 5-7 days

*Choice of lever tap or slide

tap*

350ml 10cm tube

£21.90 (10) Each bag comes with 2 leg

bag straps

To maintain a closed

system overnight leave the

leg bag connected and

connect a night bag to the

leg bag

Approx. 1 box

every other

month

30cm tube

500ml 10cm tube

£23.94 (10) 30cm tube

750ml 10cm tube

£23.94 (10) 30cm tube

9. Belly bag® (use for up to 28 days)

Teleflex Rusch Belly Bag

B1000

*Patient must have functioning

bladder musculature to use

product*

1 litre Twist tap £10.78 (1)

For patients where a leg

bag cannot be

Connected

*Not suitable for external

catheters or nephrostomy

tubing*

1-2 bags per

month

Appliance Product details Gauge/ CH

size

Cost per pack

(pack size) Comments

Usual quantity

to order

10. Disposable Single Use Night Drainage Bags

First Line

Linc-Flo

Non-sterile

Single use bags

2 litre 100cm tube £2.13 (10) First choice single use

Twist off tap

1 bag per night

3 boxes per

month

Second Line

Teleflex

Non-sterile

Single use bags with slide

tap outlet

120cm kink

resistant tube

£9.55 (30)

*higher quantity*

Single use bag with slide

tap outlet

Includes 1 x bed hanger per

pack

1box

every month

11. Reusable Night Drainage Bags

First Line

Linc-Flo drainage bag with

tap outlet

Use for 5-7 days

2 litre

lever tap /

T-tap

120cm anti-

kink tube £9.52 (10) Change every 5-7 days

1 box every

2-3 months

*If patient using

bags more

frequently –

consider daily

single use bags

as alternative*

Second Line – Reusable Drainage Bag

Teleflex

Rusch night drainage bag

2 Litre

lever /

slide tap

120cm kink

resistant tube £10.78 (10)

Change every 5-7 days

Each bag has integral bed

hanger

1 box every

2-3 months

12. Accessories

Leg bag holders

Clinisupplies Prosys sleeves

Small 24-40cm

£7.61 (4)

Washable

PRN use

Approx. every

4-6 months

Medium 36-50cm

Large 40-65cm

Clinisupplies Prosys

Leg bag straps P10LS £12.88 (10)

G-strap

Clinisupplies Prosys Retainer

Strap

Adult £12.27 (5)

Washable

PRN use

Approx. every

4-6 months Abdominal £13.54 (5)

Long term catheters, drainage bags and accessories

For support in ordering and advice with the catheter and drainage bag products on formulary please see useful

contact details below:

Linc Medical:

- Urology Product Specialist: Alison Naeem alisonnaeem@linc-medical.co.uk

- LINC customer services 01572 717515

- sales@linc-medical.co.uk

Teleflex:

- Urology product advisor: Ketan Vyas Ketan.Vyas@teleflex.com

- Teleflex customer services 01494 532761

A catheter ordering list has been developed to assist healthcare professionals with ordering and prescribing of these

products – To access this with further guidance and information, please see the Continence section on Ipswich & East

Suffolk and West Suffolk CCG websites:

East:http://www.ipswichandeastsuffolkccg.nhs.uk/GPpracticememberarea/Clinicalarea/Medicinesmanagement/CCGF

ormularies/Woundcareandstoma.aspx

West: https://www.westsuffolkccg.nhs.uk/clinical-area/prescribing-and-medicines-management/dressings-and-stoma/

Bowel Irrigation and Accessories

Product Quantity and

code Price Comments

Usual quantity to

order

1. Anal Plugs

These are initiated after specialist recommendation ONLY and not to manage diarrhoea or constipation.

Patients can use 1-2 per day, depending on patient need. They should be left in place for no more than 12

hours.

Renew Insert Anal Plug Pack of 30

Regular: FG730

Large: FG731

£66.87

For management of bowel

incontinence to prevent leakage

Variable quantities

according on individual

patient need

Approx. 30-60 per month Coloplast Peristeen Anal Plug

Pack of 20

Small: 1450

Large: 1451

£47.51

£46.54

2. Anal Irrigation Systems – Peristeen unit, accessory pack and Qufora system

Anal Irrigation is a highly specialist treatment requiring assessment and initiation by a consultant/colorectal/stoma

nurse ONLY. This system can be used as a treatment in the management of bowel disorders i.e. chronic constipation,

bowel incontinence and/or neurogenic bowel dysfunction. This should only be considered where other less invasive

options have been unsuccessful. Comprehensive training for patients and carers, prior to initiating treatment is

essential to ensure safe and effective irrigation technique is undertaken.

Prescribing quantities should be based on individual patient need and take into consideration recommended quantities

for prescribing. If quantities ordered exceed those listed without good reason refer to stoma specialist.

Peristeen System and Accessories: To be prescribed under the recommendation of a specialist

Peristeen System

Includes:

1 control unit (pump and tubes) 2

rectal catheters (single use)

1 water bag (lasting 15 uses)

2 straps (to secure unit)

1 system

Standard:29121

Small: 29196

£77.53 System also available in

smaller size

1 unit every 3-6 months

depending on daily or

alternate day use.

90 uses per unit.

Peristeen Rectal Catheters

Includes:

10 rectal catheters

1 pack

Standard:21923

Small: 21928

£86.39 Available in smaller size

May need additional catheters

Approx. 30 per month if

using one per day.

Single use item

Peristeen Accessory Unit

Includes:

15 rectal catheters (single use)

1 water bag (lasting 15 uses)

1 unit

Standard:29122

Small: 29127

£135.12 System also available in

smaller size

1-2 per month depending on

frequency

Peristeen Tubes Pack of 2

Code: 21925 £7.75

As required in addition to the

Unit PRN

Qufora IrriSedo Mini System

Base set – mini system 15 I hand pump

I cone bag

15 Hydrophilic cones

Waste bags

(15 irrigations)

1 system

Code: 53601-015 £59.00

effective for the low anterior

resection syndrome patients and

those who have incomplete

evacuation issues

1-2 per month

Base set – mini system 30 1 hand pump

1 cone bag

30 Hydrophilic cones

(30 irrigations)

1 system

Code: 53601-030 £118.00

Helps patients in the

management of their bowels 1 per month

Qufora IrriSedo Extension Tube

(15 irrigations)

1 pack

Code: 52715-015 £45.00

For elderly patients with weaker

hands these extension tubes help

manage the system

1-2 per month

Qufora IrriSedo Balloon System

Base set:

1 control unit

1 water bag

2 rectal balloon catheters

1 system

Small: 58102-002

Regular: 58101-002

£70 Available in two different sizes. 6 monthly

Accessory set:

1 water bag

15 rectal balloon catheters

1 set

Small: 58202-015

Regular: 58201-015

£115.00 water bag 15 uses

catheter are single use Monthly

Rectal catheters x 10

1 pack

Small: 58302-010

Regular: 58301-010

£79.00 For an additional supply of

catheters Ad-Hoc

3. Ostomy Irrigation Systems – For Stoma Patients

Stoma manual irrigation system: This is for active independent patients requiring irrigation to maintain normal

bowel function. Both are first line systems following assessment and initiation from a specialist or stoma nurse ONLY,

which must be reviewed and monitored.

All requests for repeat prescriptions should be initiated by the patient; the preferred route is direct to the GP practice,

to enable a robust audit trail as per CCG recommendations.

Coloplast Assura Irrigation system

Irrigation bag (Coloplast)

Pack of 1

1 pack

Code: 1511

£14.86 Replace 2 to 4 times a year

Colotip (Coloplast)

Pack of 1

1 pack

Code: 1110 £7.85 Replace 2 to 4 times a year

Assura Irrigation Supporting

Plate

Pack of 5

1 Pack of 5

Code: 12820 £36.53 Replace 1 to 2 times a year

Brava Belt (Coloplast)

Pack of 1

1 pack

Standard: 0421 *please check correct

product with code*

£7.02 Replace 1 to 2 times a year.

Has a larger size if required (0422)

Assura Irrigation sleeve

Pack of 30

1 pack of 30

Code 60mm: 12836

40mm: 12834

£40.43 Maximum 1 per a month. Use once every 1-2 days

Dansac Irrigation System:

Water container (Dansac)

Pack of 1

1 pack

Code:95200-0000 £21.44 Replace 4 to 6 times a year

Clamp (Dansac)

Pack of 1

1 pack

Code:95210-0000 £9.28 Replace 2 to 4 times a year

Cone with tubing (Dansac)

Pack of 1

1 pack

Code:95205-0000 £13.78 Replace 2 to 4 times a year

Brush (Dansac)

Pack of 1

1 pack

Code:95220-0000 £2.34 Replace yearly

Tube (Dansac)

Pack of 1

1 pack

Code: 95215-0000 £1.64 Will require 2 per year

Irri-Drain with Ring Holder for

Silicone Ring

Pack of 20

1 pack

Code: 950-20 £27.41 Prescribe 1 to 2 a month

Irri-Drain Adhesive

Pack of 20

1 pack

Code: 950-35 £26.74 Prescribe 1 to 2 a month

Silicone ring (Dansac)

Pack of 1

1 pack

Code: 09547-0000 £5.50 Prescribe 1 to 2 a year

Restricted Products: Electronic pumps (e.g. Navina Smart Unit/Braun IryPump) are only to be issued following

specialist recommendation. This is for patients with poor dexterity or for specific patients groups where manual pumps

are unsuccessful or clinically inappropriate. Requests for prescriptions should only be accepted from a stoma specialist

nurse, hospital ward staff if a prior agreement has been made with the GP. This is usually a long term treatment.

Pathway considerations for Bowel and Ostomy Irrigation

Patients may be assessed and commenced on an irrigation system from the following settings:

Acute: Ipswich Hospital / West Suffolk Hospital

- Stoma Nurse Team

- Colorectal Clinic

When considering patient appliance overuse or changes in patient clinical need, patients should be assessed by their

GP and if required referred back to the clinic which commenced the treatment.

Useful Contacts:

Ipswich Hospital Trust Stoma Nurses Sharon Stopher, Sally Power 01473 703301

West Suffolk Hospital Stoma Nurses Katie Lloyd, Ann Hubble 01284 712697

East Suffolk GP Federation Community Stoma Nurses: Debbie Cooper, Sarah Skingley 01473 242168

West Suffolk Community Stoma Nurse: Bernadette Ambrose 07739 321369

Stoma Accessories

Product Quantity Price Comments Usual quantity to order

1. Barrier films (used with each bag/flange change)

3m Health Care Cavilon No

Sting Barrier Film Pump Spray 28ml £5.79

Used on skin that is broken,

sore or weepy to promote

healing.

For selected patients only

(diabetics, palliative patients

and difficult stomas)

1 box/bottle per month

StoCare Protect No-Sting

Protect Barrier Film Spray

*Higher Quantity*

50ml £7.90

StoCare Protect Barrier Wipes 30 £12.95

Salts Barrier Film Wipes 2nd Line 30 £16.17

2. Skin fillers

Hollister Adapt Paste

(contains alcohol) 60g £3.89

Used as a sealant for creases

and crevices 1-3 per month

Dansac Soft Paste

(contains alcohol) 50g £3.77

Oakmed Paste 2nd Line 56g £7.75

3. Sore Skin Accessories

Orabase paste S103 30g £2.17 Used to heal around stoma Not for regular use

Coloplast Brava Powder 25g £2.47

For wet skin, short term use

1-3 per month

Higher quantity tubes may

last longer

Convatec Orahesive Powder 25g £2.53

OstoMart OstoSEAL

Protective Powder

*Higher Quantity*

50g £4.96

Ilex Skin Protectant 2nd Line 57g £8.26

4. Discharge solidifying agents

Bullen Absorbian Sachets 30

sachets £7.88

Absorbs effluent Mainly for

ileostomies 1 per month

Opus Deogel 200ml £8.11

Opus Deogel Sachets

2nd Line

50

sachets £31.13

Respond Ostosorb 150

sachets £42.16 *Higher Quantity Option*

5. Flange extenders

Salts Flange Extender - Aloe 30 £13.52

Extends adhesion of bag.

Especially if patient has a

hernia

1-2 boxes per month

Coloplast Brava Elastic Tape 20 £13.29

UltraFrame Flange Extenders

*ultra-thin transparent film 20 £13.56

Dansac X-tra Strips 2nd line 30 £19.21

Ostomart Astoa 2nd line 30 £19.44

Product Quantity Price Comments Usual quantity to order

6. Mouldable washers

Salts Mouldable Seals

Thin/Aloe 30 £51.74 /

£51.32

Used on problem

stomas An adhesive

sealant to fill

creases/crevices around

stoma

1-3 box per month

Higher amount of packs may

be required when prescribing

lower quantity packs

Salts Mouldable Seals

Standard/Aloe 30 £52.56 /

£52.13

Hollister Adapt Barrier Rings 48mm 10 £18.34

Pelican Cohesive Slims Small 2nd Line 30 £58.55

Pelican Cohesive Seals Small 2nd Line 30 £59.69

Dansac TRE Seal 30mm 2nd Line 30 £68.22

7. Adhesive Removers (Sprays/Wipes) (used with each bag/flange change)

Peak Medical Offmate

Adhesive Remover Spray 50ml £5,10

Used each time

stoma bag is changed

Sprays are more cost

effective than wipes

1-3 cans per month

(depending on frequency

of bag changes)

StoCare Remove Adhesive

Remover Spray 50ml £5.60

Opus Lift Plus 360 /

with Citrus 360 50ml £5.99

Dansac Easy Spray

Adhesive Remover Spray 2nd Line

50ml £6.67

StoCare Remove Non-sting

Adhesive Remover Wipes 30 wipes £8.60

Salts Adhesive Remover

Wipes 2nd Line 30 wipes £8.72

8) Belts and Support

Coloplast Brava Belt (standard –

XL size) 1 belt

£7.02

Use to secure and support

ostomy pouches in position

Maximum quantity 3 per year Oakmed Adjustable Ostomy Belt

100cm £7.82

Restrictions

Stoma support garments and clothing - Level 3 Following specialist recommendation only (Level 1

and 2 garments are OTC items)

Deodourants, cleansers and soaps are not clinically necessary and prescribing of these products will not

be supported in Suffolk.

Please refer to CCG Website for ‘Ostomy Accessories List - Prescribing Indictor’ for further

prescribing guidance

Contacts:

Ipswich & East: Suffolk GP Federation Community Stoma Nurses:

Debbie Cooper, Sarah Skingley 01473 242168

West Suffolk Community Stoma Nurse: Bernadette Ambrose 07739 321369 Ipswich

Hospital Trust Stoma Nurses Sharon Stopher, Sally Power 01473 703301

West Suffolk Hospital Stoma Nurses Katie Lloyd, Ann Hubble 01284 712697

Skincare

(OTC) = Item is available for patients to purchase over the counter

Product

1. Soap Substitute

Emulsifying ointment (OTC)

Epimax®(OTC)

Zero AQS cream (OTC)

Dermol 500 Lotion (OTC) Only if infection present or frequent complication

2. Emollients (Leave on preparations)

Where required in Primary Care for patients with chronic skin conditions

e.g. psoriasis or eczema, prescribe larger tubs i.e. 450/500G only. Where use is intermittent, smaller packs are required

or simply dry skin - these are available to purchase.

Lanolin based products e.g. E45® or Exocream® are not routinely recommended for chronic skin conditions due to

allergy risk

First Line

Epimax®(OTC) This is equivalent to Diprobase® Cream. Can be used as a soap substitute.

Low fire risk

lsomol® gel (OTC) This is equivalent to Doublebase®. Low fire risk.

Zeroderm® ointment This is equivalent to Hydromol® ointment (lanolin free) and Epaderm®

ointment. High fire risk

White soft paraffin 50% / liquid

paraffin 50% ointment (OTC) High fire risk

Second Line

Ultrabase® cream (OTC) Low fire risk 2nd line

Emollient preparations - Restricted Use

Emollin® spray

Usually only on advice from specialist where:

Sore and inflamed skin so unable to spread cream/lotion

Where access to the affected site is difficult High fire risk

Dermol® cream (OTC) Only if infection present or is a frequent complication

Zeroveen® cream (OTC)

Usually only on advice from specialist Restricted to paediatric use where

they are unable to tolerate other emollients; ACBS borderline substance•

for patients with endogenous and exogenous eczema, xeroderma,

ichthyosis and senile pruritus associated with dry skin only

3. Emollients with urea

Emollients - Restricted Use

imuDERM® (OTC) Equivalent to Balnuem® cream

Balneum® Plus cream (OTC) Usually only on advice from specialist

Eucerin Intensive lotion Usually only on advice from specialist

Calmurid® cream (OTC) Usually only on advice from specialist

Dermatonics Once Heel

Balm® cream Inpatient use only on advice from specialist

4. Emollient bath and shower preparations

Soap substitutes available OTC include:

Epimax® ZeroAQS®

Dermol 600® bath emollient may be used if

recommended by a specialist for infected atopic eczema

for 14 days

Aveeno® bath oil may be recommended by a specialist

where there is an issue with paraffin based

products

There is a lack of good evidence to support the prescribing

of these items. These should only be prescribed at the

request of secondary care in exceptional circumstances.

Patients should be encouraged to wash with soap

substitutes

Usually only on advice from specialist Restricted to

paediatric use where they are unable to tolerate other

emollients; ACBS borderline substance- for patients with

endogenous and exogenous eczema,

xeroderma, ichthyosis and senile pruritus associated

with dry skin

5. Barrier Preparations

Barrier preparations: Please see CCG Skin Care Algorithm for indications of use and correct treatment depending on

level of moisture damaged skin

Barrier Cream – 1st Line

Conotrane® Cream (OTC) 100g tube £0.88 Primary Care only- use 1st line

For use on intact skin.

Sudocrem (OTC) Primary Care only

Barrier Cream – 2nd Line

Medi-derma S Barrier Cream - 2nd Line 90g tube £5.95 For use where Conotrane trialled and

failed - can be used on damaged skin.

Barrier Ointment and Incontinence Cleanser – Restricted use

Medi Derma-Pro Skin Protectant

Ointment (equivalent to Proshield) 115 tube £8.50 For severe moisture excoriation

Trial for up to 2 weeks

*When skin integrity restored return to

1st line barrier cream*

Medi Derma-Pro Foam & Spray

Incontinence Cleanser

(equivalent to Proshield) 250ml bottle £5.95

Barrier Films

Medi Derma Barrier film applicators

(for use on peri-wound skin)

1ml

Applicators (5) £3.70 For use on moisture damaged skin

around wounds, skin fold and creases. Medi Derma Barrier Film Pump Spray 30ml spray £5.35

6. Pressure sore prevention and low friction products

Pressure reducing gel or foam pads are not an alternative to appropriate pressure relieving equipment. Patients

will still require a skin and pressure relief assessment, undertaken by a clinician within this field of expertise.

Pressure reducing gel pads are not for use over broken skin.

Aderma Dermal Gel Pads

10x10x0.3 cm £4.43

Gel pressure relieving strips 10x10x1.2 cm £13.30

20x20x0.3 cm £17.70

30x5x0.3 cm £6.65

Not to be used over broken skin

Gel pressure relieving pads for

vulnerable intact skin

Does not replace appropriate

pressure relieving equipment

50x2.5x0.3 cm £5.55

Heel Standard £15.49

Heel Extra Large £17.66

Sacrum/Ankle Wrap

£17.40

Kerrapro Gel Pads

50x2.5x0.3 cm £5.39

Gel pressure relieving strips 30x5x0.3 cm £6.47

10x10x1.2M cm £12.95

Not to be used over broken skin

Gel pressure relieving pads for

vulnerable intact skin

10x10x0.3 cm £4.30

Heel £15.18

Sacrum/Ankle £17.09

Dyna-Tek Foam

Positioning Products

Foot & Heel protector (pair)

£3.99

Not for use as seating pressure relief

Devon Utility Pad £3.87

Process for Reviewing Formulary Products

NO YES

YES NO YES NO

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WEBSITES

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DOES THE PRODUCT NEED TO BE

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DOES THE PRODUCT NEED TO BE

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