Updated headache pathway

Following review and Greater Manchester-wide consultation, the GMMMG headache pathway has been updated and is now available on the Clinical Guidance and Pathways page. The formulary and RAG list have also been updated to reflect the guidance, including:

  • Additional options for simple analgesia and antiemetics
  • Clearer guidance on choice of triptan
  • Additional options for migraine prophylaxis in primary care, including metoprolol, amitriptyline, nortytipyline, candesartan. Zonisamide has also been added, for use following specialist advice
  • Flunarazine added as a RED drug
  • Additional options for acute treatment of cluster headache: zolmitriptan nasal spray, and oxygen.
  • Additional option for cluster headache prophylaxis: verapamil (following specialist advice)

Neuropathic pain guidance updated

Following technical review and Greater Manchester-wide consultation, the GMMMG neuropathic pain guidance has been updated and is now available on the Clinical Guidance and Pathways page. The formulary has also been updated to reflect the guidance.

Updated asthma pathway published

Following GM-wide consultation and approval by chief finance officers and directors of commissioning, an updated GMMMG asthma guideline is now available on the Clinical Guidance and Pathways page.

The guideline has been updated in response to a request from GMHSCP to produce an updated asthma management plan to support the move to lower carbon inhalers. This includes consciously reducing the propellants contained in metered-dose inhalers which is a significant contributor to enabling the Greater Manchester Combined Authority’s and Greater Manchester Joint Commissioning Board’s commitment to sustainability.

An updated inhaler guide to support the pathway is in production, and will be available in due course.