Transition of Commissioning Policies
On 1st July 2022 NHS Cheshire and Merseyside Integrated Care Board (ICB) became the new statutory body responsible for ensuring health care services are available to meet the reasonable needs of the people of Cheshire & Merseyside.
Until such time as a single suite of commissioning policies can be developed and adopted, NHS Cheshire and Merseyside will continue to adopt and operate the CCG policies it has inherited at Place/borough level, which means that there will be no immediate change in commissioning policy for local people resident in those Places/boroughs from what was in place prior to 1st July 2022.
The Pan Mersey Area Prescribing Committee recommends the use of adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab and ixekizumab in the management of ankylosing spondylitis (AS), and non-radiographic axial spondyloarthritis (NRAxSpA) in accordance with NICE TA383, NICE TA407, NICE TA497, NICE TA718 and NICE TA719..
NHS Cheshire and Merseyside APPROVED
This Guidance does not include prescribing advice to primary care from secondary care specialists e.g. oral medicine, special care dentistry or oral and maxillofacial surgery, regarding the management of complex conditions and patients with multiple co-morbidities.
The Pan Mersey Area Prescribing Committee recommends the prescribing of biologic agents, by specialists only, for Juvenile Idiopathic Arthritis (JIA) as per NICE TA373, TA238, TA 685 and TA735 in adult and paediatric services
The Pan Mersey Area Prescribing Committee recommends the prescribing of biological agents (adalimumab, certolizumab, etanercept, golimumab, infliximab, secukinumab and ustekinumab) by specialists only, for inflammatory monoarthritis or oligoarthritis as specified.
MONOARTHRITIS or OLIGOARTHRITIS pathway
Monoarthritis or oligoarthritis, inflammatory: biological agents (South Sefton and Southport and Formby CCGs)
Monoarthritis or oligoarthritis pathway (South Sefton and Southport & Formby CCGs)
If a private consultation identifies a long-term condition or a need for medication which is available as routine NHS treatment, this should be provided as such by the patient's usual primary care prescriber if they are satisfied it is appropriate, and the private provider issues the first prescription.
The Pan Mersey Area Prescribing Committee recommends the sequential use of biological agents, adalimumab, bimekizumab, brodalumab, certolizumab, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab and ustekinumab, in the management of psoriasis according to the attached flowchart.
The Pan Mersey Area Prescribing Committee recommends the sequential use of high cost agents, adalimumab, apremilast▼, certolizumab, etanercept, golimumab, infliximab, ixekizumab▼, secukinumab▼, tofacitinib▼ and ustekinumab in the management of psoriatic arthritis (PsA) in accordance with the recommendations below, and the accompanying flowchart.
PSORIATIC ARTHRITIS and PERIPHERAL SPONDYLOARTHROPATHY: high cost drugs pathway
The Pan Mersey Area Prescribing Committee recommends the prescribing of anakinra, etanercept, infliximab or tocilizumab in Adult Onset Still’s Disease.
STILL'S DISEASE, adult onset (AOSD): pathway for the management of
The Pan Mersey Area Prescribing Committee recommends that psychotropic drugs in people with a learning disability, autism or both should be reviewed and reduced in primary care in line with NHS England (NHSE) guidelines. Psychotropics should be initiated by a learning disability specialist.
Pan Mersey Area Prescribing Committee recommends that prescribers should NOT supply treatment durations in excess of THREE MONTHS for patients who are going to live or travelling abroad or otherwise absent from the UK. Patients should make local arrangements in their country of residence for on-going medical care.
This document is a good practice guide to support prescribers with prescribing unlicensed and “off-label” medicines. It describes the differences between licensed medicines, unlicensed medicines and “off-label” medicines. It advises prescribers on a stepped approach when considering what to prescribe, and highlights the prescriber’s responsibilities and best practice around patient communication.