As you know, the new NHS Steroid Emergency Card is an NHS-wide card supported by our recently published guidance. 

We know many GP and hospital appointments are operating as telephone clinics for the time being. Hence, community pharmacy teams will initially issue most of these cards, whilst we are working within COVID-19 contingency plans.

There will be 3 ways of obtaining a card:

• Through community pharmacies – for patients with known adrenal insufficiency who have had the necessary patient education, or need a replacement card; patients may wish to show a clinical letter or similar, but that is not essential.
• From GPs when having a routine review, if primary care is managing steroid replacement. We know many GP and hospital appointments are operating as telephone clinics for the time being. Hence, community pharmacy teams will initially issue most of these cards, whilst we are working within COVID-19 contingency plans.
• From hospital teams at next routine appointment.

The card can also be downloaded as a PDF, and added as a lock screen to mobile devices. Learn more from the Addison’s Disease Self-Help Group.

The new card can be ordered through the usual NHS ordering mechanisms:

• Secondary Care: Xerox online portal 
  You may need to raise a non-catalogue requisition in Oracle, selecting supplier as Xerox, and we can process the requisition by raising the order with NHS Forms. The cost is £2.65 (excluding VAT) for 100 cards (one unit is 100 cards).
• Primary Care: PCSE online portal 

Our adrenal crisis web page is a source of all the relevant information, including published guidance, a downloadable PDF of the card and links to patient educational resources. The QR code on the card goes directly to the adrenal crisis web page.

A National Patient Safety Alert¹ has been issued asking providers to ensure all eligible patients with adrenal insufficiency are issued with an NHS Steroid Emergency Card,² to support early recognition and treatment of adrenal crisis in adults. The alert requires that processes are put in place to check if a patient has a card ahead of any emergency treatment, elective surgery, or other invasive procedures.

Our teams will have a key role in ensuring there are processes and systems within their institutions to fulfil these actions and support organisations in implementing local policies to ensure the safety of our patients with adrenal insufficiency, as well as in providing teaching to other teams. Thank you for getting involved and thank you to all who have supported this work.

DR HELEN SIMPSON
Society for Endocrinology and RCP Patient Safety Committee

REFERENCES

1. National Patient Safety Alert
2. NHS Steroid Emergency Card