New consultation: communication standards for opioid medicines prescribed at discharge

On behalf of the GMMMG Medicines Safety Group, we now seek comments on draft Communication Standards for Opioid Medicines Prescribed at Discharge.

The draft document has been developed to support safe prescribing of opioids by improving and standardising the information communicated from secondary care to primary care when patients are discharged from hospital with an opioid medicine for pain management. The document has been developed by a task and finish group on behalf of the GM Medicines Safety Group. The document has been reviewed by members of the task and finish group, Medicines Safety Group, and has been circulated via the chief pharmacists group for comments.

This consultation will run for six weeks and closes at 5pm on Thursday 27th June 2024. To take part, visit the consultations page.


New consultations: asthma, tobacco, and paliperidone

Three new consultations have opened on the GMMMG website:

  • Asthma Guideline – update for 2024, to include AIR therapy
  • Medical Management of Tobacco Dependency guidelines – update for 2024, to include cytisine
  • Shared care protocol for paliperidone long-acting injection – update

All three consultations will run for six weeks, and close at 5pm on Wednesday 24th April. To take part in these or any other consultations, visit https://gmmmg.nhs.uk/consultations/.


Consultation: GM non-medical prescriber best practice guide

Following development by the GM NMP Leads Group and review by the GM Workforce Group, we now seek comments on the draft document: ‘Greater Manchester Non-Medical Prescribing Best Practice Guide’.

The consultation will run for six weeks and closes at 5pm on Thursday 2nd November 2023. To take part, visit the consultations page.


Consultation: updated HCD inflammatory bowel disease pathway

Following development by a clinical working group and review by CRG, we now seek comments on the draft update of the GMMMG High Cost Drugs Inflammatory Bowel Disease Pathway.

The consultation will run for 6 weeks, closing at 5pm on 30th August. To take part, please visit the consultations page.


Consultation: Safe management of medicines within GP practices

Following development by Wigan Borough locality and adaptation by the GM Medicines Safety Group, we now seek comments on the draft document: ‘Safe Management of Medicines within GP Practices, An Example of Good Practice’.

The consultation will run for 6 weeks, closing at 5pm on 30th August. To take part, please visit the consultations page.


Consultation: omalizumab for chronic inducible urticaria

The Greater Manchester Clinical Reference Group reviewed a request to add omalizumab to formulary for the unlicensed indications of severe chronic inducible urticarias (solar urticaria, cold and heat urticaria, symptomatic dermographism, delayed pressure urticaria and cholinergic urticaria). We now seek comments on this draft

The consultation will run for 6 weeks, closing at 5pm on 29th August. To take part, please visit the consultations page.


Consultation: wet AMD pathway

The Greater Manchester Medicines Value Subgroup have drafted a Greater Manchester High-Cost Drugs Commissioning Pathway for Wet Age-related Macular Degeneration in Adults and now seek comments on the draft.

Please note the download is a zipped folder containing two documents:

  • The draft pathway for comments
  • The pathway schematic diagram

The consultation will run for 6 weeks, closing at 5pm on Monday 21st August. To take part, please visit the consultations page.


GMMMG shared care consultation extended

Please note: the GMMMG consultation on the adoption of the suite of national shared care protocols has been extended.

The consultation will now run for 10 weeks, to facilitate gathering of feedback from across all sectors of the ICS. The consultation will now run until Monday 3rd October 2022. Please follow the link above for more information, and to submit comments.


GMMMG Consultation on the Adoption of the National Shared Care Protocols

On 8th July 2022 NHS England published a suite of 18 shared care protocols: https://www.england.nhs.uk/medicines-2/regional-medicines-optimisation-committees-advice/shared-care-protocols/.

These have been developed by the Regional Medicines Optimisation Committee (RMOC) North in conjunction with the Shared Care Working Group and the Regional Drug and Therapeutics Centre.

Before being published they underwent a national consultation and approval process by RMOC North and ultimately by the relevant NHSE National Clinical Directors and the Chief Pharmaceutical Officer. Further information on this process can be found on the NHSE website using the link above.

The GMMMG Clinical Reference Group (CRG) are now seeking comments from stakeholders on the potential barriers to implementation of these 18 shared care protocols. The clinical content has been approved nationally with representation from all regions including Greater Manchester, with input during the development, and via the consultation process undertaken by RMOC.

For this reason CRG are not seeking comments on the clinical content of the documents but are looking to the GM Integrated Care System to provide feedback on how these should now be used to replace the current shared care protocols.

GMMMG are keen to understand what barriers, if any, may prevent all GM localities from being able to adopt these national shared care protocols. These could include, but may not be limited to:

  • Specialist service design and capacity
  • Resource implications in both primary care and specialist clinics
  • Compatibility with current digital communication methods
  • Appropriateness of the listed indications for use of the medicine

Therefore CRG on behalf of GMMMG invite all GM stakeholders to submit comments using the link below before the closing date of 3rd October 2022. A downloadable copy of this text is also available via the link.

Comments submitted on clinical content of the documents are unlikely to be addressed at a GM level unless GMMMG agree that there are significant safety concerns. Any other comments will be collated and submitted to the NHSE Medicines Policy Team to inform future work to manage and update the documents.

Consultation comments can be submitted via the feedback form at https://gmmmg.nhs.uk/consultations/136-consultation-national-shared-care/.

* Please note: this news item was updated on 17th August 2022 to reflect the new closing date for this consultation. The consultation period has been extended from 8 to 10 weeks, and will now close on Monday 3rd October 2022.


Consultations: DOAC statement and hypersalivation pathway

Two new consultations have been opened on the GMMMG site; see details below. Both consultations will run until 5pm on Monday 1st August 2022. Comments can be submitted using the feedback forms on the GMMMG consultations page, and comments are invited from all stakeholders.

DOAC statement

CRG seek comments from Greater Manchester on this position statement regarding the prescribing of best value direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation. When developing the statement CRG carefully considered, amongst other things:

  • The financial savings associated with increased edoxaban use,
  • A clinician’s freedom to prescribe the treatment they think is most appropriate for their patient
  • The available evidence base to support (or not) the use of one medicine over another.
  • The Investment and Impact Fund indicators
  • The high court ruling that has invalidated the patent for apixaban, and may yet be subject to appeal.

CRG want edoxaban to be the first choice DOAC for use in non-valvular AF, and an alternative used where edoxaban would not be safe or appropriate. This position is still current at the time of publication of the draft statement, despite the legal issues surrounding apixaban.

GMMMG therefore seek feedback from a wide range of stakeholders regarding this statement.

Hypersalivation pathway

CRG seek comments from Greater Manchester on this draft pathway for the management of hypersalivation. It has been developed and approved by MFT and CRG are seeking to adapt it for use across GM, particularly in primary care.

It looks to provide evidence-based, cost-effective recommendations on the management of hypersalivation in a number of conditions.

GMMMG therefore seek feedback from a wide range of stakeholders regarding this pathway