This aspect of Pharmacy Public Health deals with the planning for, and managed introduction of new medicines. The Scottish Medicines Consortium is responsible for providing advice on the clinical and cost-effectiveness of all new medicines and important new indications for existing medicines.
The NHS GGC prescribing website provides useful links to the local Medicines Formulary, medicines policies and associated resources.
The community pharmacist is a trusted source of information and advice for their patients. This is particularly important for those issues which can have high media attention e.g. introduction of a new vaccine or an outbreak of an infectious disease.
Further information and advice can be found in the Health Protection Topics section of this website. Examples of topics included are:-
Knowledge of infection control principles is important to protect yourself and your patients.
And
Advice on safe storage of vaccines which must be stored in the ‘cold chain’ between 2oC and 8oC at all times.
Pharmacists can recognise symptoms of a notifiable disease in order to appropriately refer patients
Understand how an outbreak is being managed to be able to offer appropriate advice and reassurance to the public.
Maintain Business Continuity Plans to ensure minimal impact on the delivery of patient care in the event of an emergency situation.
Pharmacists can encourage uptake of screening programmes against several cancers e.g. cervical, breast cancer and bowel. More information may be found on the Screening – Health topics – Public Health Scotland website.
For any enquiries regarding health protection please contact:
Three blood borne viruses are the main cause for concern in Scotland, Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.
There is an effective vaccine only for Hepatitis B. However, there are few effective treatments for Hepatitis C and HIV.
Public Health Protection Unit – NHSGGC in NHSGGC has a key role in monitoring and responding to the incidence of notifiable diseases e.g. meningitis.
The NHS GGC Community Pharmacy Infection Control Guidelines provide basic advice.
To reduce the incidence of infection due to antimicrobial resistance in the population, NHSGGC has launched https://handbook.ggc.medicines.org.uk/guidelines/infections/mrsa-eradication-policy/ to be followed in primary care and the prescribing support team has developed a non-prescription pad to encourage patients to seek non antibiotic remedies for viral infections.
The NHS GGC Public Health Screening is responsible for a range of health screening programmes.
Immunisation is one of the most effective health interventions.
There are several formal immunisation progammes in the UK. They are Childhood, Adult and Seasonal Influenza.
Public Health Specialists from NHS GGC Public Health Protection Unit – NHSGGC are involved in identifying and managing outbreaks of disease. They will liaise with infection control teams for example in the case of a norovirus outbreak in an institution or with local authorities if an outbreak is linked to a food supplier in an E. coli outbreak.
Local authorities and health boards are required to have plans in place to manage accidental events such as major oil or chemical spills or deliberate terrorist acts. For further detail see: Chemical, biological, radiological and nuclear incidents: recognise and respond – GOV.UK
Patient Group Directions (PGDs) are legal documents that enable suitably qualified healthcare professionals to administer and supply medicines (P or POM) in a defined clinical situation where the patient may not be individually identified before presenting for treatment. The individual using the PGD must have signed and been authorised to use the PGD prior to administering or supplying any medicines named in the document.
NHS GGC uses PGDs to allow nursing staff and Health Visitors to administer vaccines for the routine child immunisation programme and travel in specialist clinics.
Individuals are most likely to catch influenza in the winter months. The season runs from October to the end of February occasionally into March, peaking in December/January.
Seasonal influenza can affect anyone. It is an acute viral infection of the respiratory tract. There are three types of influenza virus: A, B and C. Influenza A and influenza B are responsible for most clinical illness.
It is difficult for an individual to develop long term immunity to influenza as the make up of the viral strains change slightly on a regular basis. So vaccination against seasonal influenza has to be undertaken annually.
The government resource Immunisation against infectious disease – ‘The Green Book’
In the United Kingdom immunisation for influenza for certain groups including ‘at risk’ patients is provided on the NHS and in Scotland the Chief Medical Officer (CMO) will send a letter detailing which groups are eligible for vaccination. Letters from the CMO are available here.
Egg allergy isn’t always an absolute contraindication for receiving flu vaccine. The British Society for Allergy and Clinical Immunology website advises on managing individuals with egg allergy
An e learning course for healthcare professionals undertaking immunisation is available. Registration is required to undertake this course.
NHS Inform has key patient information on all types of immunisation
NHS GGC: Immunisation – NHSGGC
Sandyford co-ordinates a wide range of sexual health services in NHS GGC.
The Free Condoms web-site provides, support for practitioners involved in condom distribution, information on how to sign up as a distribution point, where to find condom distribution points and general advice on condom use and products offered
It is important that pharmacists and their staff understand what they should do if they have any concerns about a child and sexual health issues. Access information at NHS GGC Child Protection Unit’s website
Pharmacists play an important part in providing information and advice about substances liable to misuse controlling the availability of medicines, and the associated risks and in providing harm reduction programmes e.g. methadone and the supply of injection equipment.
NaTHNaC gives the most up to date information for both public and professional use.
NHS GGC Guidelines on Vaccine Storage and Handling are available in the NHSGGC Guidelines Repository
For queries about the service please contact the Queen Elizabeth University Hospital Biochemistry Department on 0141 354 9060.
The Scottish Biologic Drug Monitoring Service is delivered by the Biochemistry Dept. within the Lab Medicine Building on the Queen Elizabeth University Hospital site, Glasgow.
The service currently delivers Infliximab and Adalimumab levels and their respective total anti-drug antibodies (ADA) for optimising care predominantly in gastroenterology patients with inflammatory bowel disease. The service uses both WHO standards for drug levels and a patient pool sample for ADA assay to monitor performance. It is involved in sample exchange with other laboratories.
The service employs a reflex ADA testing strategy based on drug level result. When a drug level result is within or higher than the therapeutic target range, and when ADA level has previously been undetectable, reflex ADA testing is not routinely performed. Since the introduction of reflex ADA testing approximately 50% adalimumab samples and 37% infliximab samples have not had a reflex ADA test performed.
There may be some clinical scenarios where ADA titres are desirable even when drug level results are therapeutic. Requests for additional ADA testing should be indicated clearly at the time of test request or can be arranged by contacting the lab directly.
During 2019 there were 2821 Infliximab and 2920 Adalimumab samples analysed from health boards across Scotland.
TDM tests should be requested according to local biochemistry/immunology laboratory requirements. The previously used paper request forms are no longer required. Local teams are encouraged to collate data related to TDM use and outcomes as this may be required to sustain future rounds of service funding.
Vedolizumab drug level testing is now available. The utility of testing drug and anti-drug antibodies for vedolizumab has yet to be fully ascertained. Target drug levels for vedolizumab have not been clearly established. The current evidence is covered in these articles:
Vedolizumab testing is not part of the nationally commissioned TDM service. The cost per sample is £20.
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Clyde Biochemistry Laboratories (those based at Royal Alexandra Hospital, Inverclyde Royal Hospital and Vale of Leven Hospital) has been accredited with UKAS to standard ISO 15189:2012 for much of our test repertoire. The certificate of accreditation is available online.
The scope of our accreditation includes the majority of the tests performed by our laboratories, with a small number of tests not falling within our accreditation status (for example, no fluid analyses (on fluids other than CSF, urine or blood / serum / plasma) are accredited) – see the link above for details of our accredited scope.
Specialist services including Protein Electrophoresis and less often requested endocrine assays are based at RAH.
All routine GP work within the Clyde Sector is also based at RAH.
Please accept our apologies for the behaviour of links on this webpage. This is due to a global setting which is outwith the Biochemistry Department’s control.
For routine issues with gas analysers or blood glucose meters and to arrange training / barcode for meters please email:
Cryoglobulin testing can also be arranged via this email address.
Both Primary and Secondary care professionals served by the Clyde Biochemistry Laboratory can obtain clinical advice by email:
We are committed to providing a quality service to users. If you wish to provide feedback on the Clyde Glasgow Biochemistry service, please contact our Quality Manager by emailing Pamela.craig6@nhs.scot
The most recent laboratory newsletters are available below:
Previous issues of the newsletter are stored in the Clyde Biochemistry Document Library:
Secondary Care
Previous memos can be found in the Clyde Biochemistry Document Library, linked above.
Ready to learn – the 30 month child health check ( English lanuage version) Ready to learn – the 30 month child health check (Arabic language version) Ready to learn – the 30 month child health check (Polish language version) Ready to learn – the 30 month child health check (Romanian language version) Ready to learn – the 30 month child health check ( Chinese language version) Ready to learn – the 30 month child health check ( Slovak language version) Ready to learn – the 30 month child health check ( Urdu language version) Ready to learn – the 30 month child health check (Punjabi language version) Ready to learn ( Traditional Chinese language version)The Human Fertilisation and Embryology Authority (HFEA) are the Government regulatory body for all fertility clinics in the UK. They collect data on all treatment cycles started and outcomes of those treatments, including success rates. They are currently updating their clinic data submission system and once complete in 2025, you will be able to see data on treatments from January 2020 to December 2023, and births from January 2019 to December 2022. In the meantime, you can visit their clinic profile for Glasgow Royal Infirmary ACS for the most recent inspection ratings, reviews and verified success rates.
Please note, not all patients will require all tests. Your nurse or doctor will advise on which ones you’ll need, depending on which treatment you’re having.
All patients having fertility treatment should have a transvaginal scan (TVS) as part of fertility investigations to assess the health of the uterus and ovaries. It can help identify potential issues like endometrial polyps, uterine abnormalities or ovarian cysts. It involves inserting a small, lubricated probe into the vagina. The probe emits high-frequency sound waves that create detailed images of the pelvic organs on a monitor. This allows us to see the uterus, ovaries, and fallopian tubes more clearly than with a transabdominal scan. While some individuals may experience slight discomfort, the procedure is usually well-tolerated and not painful.
It can:
Before the scan you will be asked to go into the toilet adjoining the scan room, empty your bladder and remove clothing from the bottom half of your body. You will be given a gown to cover your body. You may also have a TVS as part of a HyCoSy.
Semen analysis is a routine part of an infertility investigation. A few parameters are examined to determine the quality of semen. This includes the sperm concentration (the number of sperm), motility (how well the sperm are moving) and morphology (the shape of the sperm).
The results of the analysis help us to determine whether a ‘male factor’ plays a part in the reason why you have not conceived naturally. Several factors can influence the quality of the sample. You may be asked to provide more than one sample if the initial results are not within normal ranges. This is common and helps us to make an accurate diagnosis.
Initially, you should contact your GP to arrange referral for semen analysis.
AMH is produced in small ovarian follicles. Blood levels of this hormone are measured to assess the remaining ovarian reserve (egg supply) in your ovaries. This result will be used when deciding which treatment protocol you will have during treatment.
A full blood count (FBC) test is taken to look for abnormalities such as Anaemia – this means that you have fewer red blood cells than normal or have less haemoglobin than normal in each red blood cell.
This blood test offers Screening for sickle cell and thalassaemia – NHS. If the female partner is found to be a carrier of one of these diseases, the male partner will also be screened.
Cytomegalovirus (CMV) – NHS is a virus which can cause flu like symptoms. If you catch CMV while pregnant there is a risk to the baby. CMV can be present in body fluids, such as sperm. We test patients for immunity to CMV when using donor sperm. If you are immune to CMV, sperm can be used from a CMV positive or negative donor. If you are not immune to CMV the nurse or embryologist will advise on risks of using a CMV positive donor.
Chlamydia – NHS is one of the most common sexually transmitted bacterial infections and affects both men and women. It often does not cause any obvious symptoms. The disease can be spread during genital contact or unprotected sexual intercourse (including anal and oral sex) with an infected person or from an infected mother to her baby during childbirth. You will either be asked to provide a vaginal swab or sample of urine, depending on treatment type. Should your screening test show that you are infected with chlamydia, you will be offered antibiotic treatment to clear it and encouraged to take precautions to reduce the risks of passing it onto others.
You will be asked to provide a vaginal swab to test for infections such as thrush, bacterial vaginosis, trichomoniasis and group b streptococcus.
All women between the age of 25 and 60 are invited to attend for cervical screening. Cervical screening aims to detect and treat abnormal changes in a woman’s cervix (the neck of the womb). If left untreated, this may develop into cervical cancer. It is essential that prior to commencing your treatment you have an up-to-date cervical smear test.
If you have this done as part of NHS Scotland screening programme, we will be able to access your most recent result and advice. If you have had it done in a different country or privately, please bring a copy of your test result to your first appointment with the nurses. If you are over 25 and have never had a smear test, please arrange to have this done via your GP.
HIV attacks your immune system eventually stopping it altogether, at which point it becomes difficult to combat serious life threatening infections. The virus can be spread during unprotected sexual intercourse (including oral and anal sex) with an infected person and by sharing needles to inject illegal drugs. Infected mothers can transmit the virus to their baby before or during childbirth. Should your screening test show that you are infected with HIV, you will be offered treatment(s) designed to reduce the harmful effects of the virus and encouraged to take precautions to reduce the risks of passing it onto others.
Hepatitis B is a virus that can cause inflammation (swelling and tenderness) of the liver. It can take a long time for the symptoms to show. The virus can be spread during unprotected sexual intercourse with an infected person and by sharing needles to inject illegal drugs. Infected mothers can transmit the virus to their baby during childbirth. Should your screening test show that you are infected with Hepatitis B, you will be offered treatment(s) designed to reduce the harmful effects of the virus and encouraged to take precautions to reduce the risks of passing it onto others.
Hepatitis C is also a virus that can cause serious damage to the liver. It can take a long time for the symptoms to show. The virus is mainly spread through contact with the blood of an infected person. Rarely, the disease is passed through other body fluids. For example, during unprotected sexual intercourse with an infected person or from an infected mother to her baby before or during childbirth. Should your screening test show that you are infected with Hepatitis C, you will be offered treatment(s) designed to reduce the harmful effects of the virus.
Most clinic appointments are being carried out over the phone. At your first consultation a Specialist Fertility Nurse or a Doctor wil phone you, take a detailed medical history from you both and ask for your current BMI. This appointment will last around 30 minutes. They will recommend any further investigations, treatments or advise if you are not eligible for NHS treatment.
If your clinic appointment is in person please attend the ACS unit at Glasgow Royal Infirmary. We may weigh you, do an internal scan and take some blood samples.
Please note that to be eligible for NHS funded treatment you must meet the criteria set by the Scottish Government
Each treatment has its own waiting list, so times will vary depending on which treatment you’re having. The nurse or doctor at your clinic appointment will be able to let you know estimated waiting times for you.
When your name reaches the top of the treatment waiting list we will send you a letter with your first ART appointment, around 4-6 weeks later.
Before this appointment you will be sent information about:
Please ensure you have read all of the information provided and have started to prepare for the appointment. This will help to prevent delays to treatment starting. If you have a male partner and their semen analysis was more than 18 months ago, they should contact their GP to have this repeated.
Your partner is welcome to attend this appointment but we don’t need to see them at this stage.
At the ART appointment (which takes about 30 minutes to complete) You will meet with a Nurse who will:
Around 2 weeks after this, the 2nd part of your e-consents will be sent to you both separately and must be completed 24 hours before the post screen appointment to give the nurses time to check them before they speak to you.
This will be an attend anywhere video call. Please ensure you’re both present and have good data or WiFi connection. At the Post Screen appointment (which takes about 30 minutes to complete) you will meet with a Nurse who will:
