Guidance to support primary care prescribers and pharmacists is available from the MLCSU Coronavirus guidance resource page. Links are provided to national resources and regional documents produced by MLCSU, RDTC, and SPS for use by Pan Mersey APC, LSCMMG, and GMMMG.
The list of resources will be updated as new material becomes available so please check back regularly for updates.
The Pan Mersey APC supports the use of COVID-specific guidance issued by NICE, and NHS England and NHS Improvement. During the COVID pandemic this will supersede any APC advice. In the absence of any COVID-specific advice then the usual Pan Mersey guidance and RAG rating will still apply unless otherwise indicated.
The Pan Mersey Area Prescribing Committee recommends the use of adalimumab, certolizumab pegol, etanercept, golimumab, infliximab and secukinumab▼ in the management of ankylosing spondylitis (AS), and adalimumab, certolizumab pegol, golimumab and etanercept in non-radiographic axial spondyloarthritis (NRAxSpA) in accordance with NICE TA383, NICE TA407 and NICE TA497.
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.
NICE Bites – Type 1 diabetes
Published 30th October 2015, updated 23rd July 2017 · North West Medicines Information Centre
NICE Bites – Type 2 diabetes
Published 4th February 2016, updated 23rd July 2017 · North West Medicines Information Centre
NICE Bites – Diabetes (type 1 and 2) in children and young people
Published 26th November 2015, updated 23rd July 2017 · North West Medicines Information Centre
Version 2 31 August 2017
A collaboration between:
St. Rocco’s Hospice,
Bridgewater Community Healthcare NHS Trust,
NHS Warrington Clinical Commissioning Group,
Warrington and Halton Hospitals NHS Foundation Trust
The Pan Mersey Area Prescribing Committee recommends the prescribing of biologic agents, by specialists only, for Juvenile Idiopathic Arthritis (JIA) as per NICE TA373 and TA238 in adult and paediatric services.
The Pan Mersey Area Prescribing Committee recommends the prescribing of anti-TNF (adalimumab, certolizumab, etanercept, golimumab, infliximab) by specialists only, for inflammatory monoarthritis or oligoarthritis as specified.
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, brodalumab, certolizumab, etanercept, guselkumab, infliximab, ixekizumab, 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.
The Pan Mersey Area Prescribing Committee recommends the prescribing of anakinra, etanercept, infliximab or tocilizumab in Adult Onset Still’s Disease.
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.