Author:
Andrew Heenan
RGN RMN BA(Hons) Introduction
In the UK, the availability of dressings for use in patients' homes is dictated
by the Drug Tariff[1]. This monthly publication defines what
may be prescribed in the community (and paid for by the National Health Service).
The Drug Tariff is not an arbitrary list; it contains only those products
that are tried and tested and therefore tends to exclude the latest products.
The exact criteria for selection are not published, but it may not be a coincidence
that products with a lower unit cost have, in the past, had a greater chance of
quick inclusion than more expensive products. This, it might be suggested, shows
a lack of understanding of the principles of wound management: a higher unit cost
might apply to a product which needs applying less frequently and/or requires
less time and skill to apply. Such a product might be more cost-effective over
a period of time. In recent years, the Drug Tariff has become more closely
related to the market place and to patients' needs. New products, and new sizes/formulations
of existing products, usually reach the Tariff more quickly. The Drug Tariff
matters, as products that are not included cannot be obtained on an FP10 prescription
(England and Wales; GP10 in Scotland); thus a dressing may be officially unobtainable
for NHS patients outside of hospital. Since hospitals are not bound by the Drug
Tariff, and are free to draw up their own lists of products, hospital staff need
to be aware of the Drug Tariff and its limitations in order to plan for continuity
of wound management as patients go home. With this in mind, a set of articles
has been produced to reflect information available in the Drug Tariff [1],
arranged in tables for convenience. They intentionally exclude obsolete dressings
and gauze swabs (used for cleansing purposes) as well as items such as paraffin
gauze, which are still available on community prescription, but are rarely the
dressing of choice [2], particularly those impregnated with
antibiotics. Colonisation and contamination are not an indication for topical
antibiotics, rather an imperative to effect wound healing as quickly as possible,
and any sign of significant wound infection is an indication for appropriate systemic
antibiotics. Each article should be used as a guide to dressing availability
in Great Britain and is not intended to provide advice on the suitability of a
particular dressing for a particular wound. The warnings and uses given are indicative
only, and are largely taken from the Drug Tariff [1] and the
British National Formulary [2], but any opinions expressed
are those of the author. These articles include most of the products in the
Drug Tariff that are used in wound care, and will build to a comprehensive resource
over the next few editions. Prices quoted are NHS basic prices, and should
be seen as no more than a rough guide, as contracts will vary. Readers are urged
to refer to manufacturers' information and published research before using any
dressing. The Drug Tariff is updated on a monthly basis and is available on subscription.
References 1. Prescription Pricing Authority, Department of Health. Drug Tariff. London:
The Stationery Office, May 2009. Article Updated: May 2009 Related Articles
2. British National Formulary. London:
BMA/RPSGB, September 2007. | 
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