Updated shared care protocol: melatonin for children and adolescents

Following approval by CRG and GMMMG, and the first meeting of the Greater Manchester ICS Clinical Effectiveness and Governance Committee on Thursday 22nd September, a shared care protocol for melatonin in children adolescents has been updated.

All of the currently active shared care protocols in Greater Manchester are available on the shared care page.

Formulary and subgroup decision updates

Following approval by CRG, GMMMG, and the Greater Manchester ICS Clinical Effectiveness and Governance Committee, the following decisions have been approved and published:

  • Ranibizumab biosimilar added to formulary as RED and made first choice anti-VEGF-A treatment for NICE-approved indications. An updated GM macular pathway is also expected.
  • Faricimab added to formulary as RED for diabetic macular oedema and wet age-related macular degeneration.
  • Adaflex tablets added to formulary as first choice option for melatonin.
  • Mexiletine capsules added to formulary as RED for life-threatening ventricular arrhythmias.
  • Filgotinib added to formulary as RED for moderately to severely active ulcerative colitis.
  • Diroximel fumarate added to formulary as RED for relapsing-remitting multiple sclerosis.
  • Teduglutide added to formulary as RED for short bowel syndrome.

The formulary has also been updated to reflect relevant NICE guidelines and safety alerts. For full details please see the formulary change log, which is available on the formulary page.

For more information on these and other decisions, please see GMMMG decision summaries.

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.

Voluntary Recall of Alimentum and Elecare Infant Formula Powders (Abbott)

Abbott have issued a voluntary recall of Alimentum Similac and Elecare Similac infant formula powders due to concerns of possible contamination with Salmonella Newport and Cronobacter sakazakii. Both products are used for special medicinal purposes, including the management of cow’s milk protein allergy (CMPA).

Anyone who has purchased or been prescribed Alimentum or Elecare should be advised not to feed it to their baby and to return it to the place they got it from. A suitable alternative feeding solution should be recommended.

The GMMMG CPMA guidance includes other infant formula powder options that may be considered as appropriate for individual patients.

Abbott can be contacted on 01795 580303 for information on how to return the product.

Further information:

Food Standards Agency recall

National Patient Safety Alert


The URL for the GMMMG RSS feed changed when the website refreshed, and can now be found at: https://gmmmg.nhs.uk/feed/.

RSS is a way to view any news items published on the site, directly in the RSS reader of your choice. To add an RSS subscription in Outlook 2016:

  • When viewing your email account, find the RSS Subscriptions folder in the left hand menu
  • Right click RSS Subscriptions, and choose “Add a new RSS feed”.
  • Paste or type in the address, https://gmmmg.nhs.uk/feed/ then press add
  • A dialogue box will pop up: “Add this RSS Feed to Outlook?”; click yes
  • The RSS feed should now be included as a folder in your Outlook menus, and will update when news items are published.

If you have any questions or problems, please contact us at nuth.enquires.gmmmg@nhs.net.

Consultation: actions from October meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the October 2021 CRG meeting.

Actions in this consultation include:

  • Inhaled colistimethate, dornase alfa and tobramycin for cystic fibrosis in children – RED. Repatriation should not be sought until a request to do so has been received from the specialist.
  • Bimekizumab for moderate to severe plaque psoriasis – RED.
  • Link to NG191, Managing COVID-19, to be added to formulary in chapter 2

To take part in this consultation, visit the consultations page. This consultation period is open until 5pm Tuesday 30th November 2021.

Formulary updates

Following the October meeting of GMMMG, the formulary and RAG list have been updated to reflect decisions made by the Clinical Reference Group (CRG) and Medicines and Guidelines Subgroup (MGSG).

For full details of the changes, please see the Formulary Change Log.

GMMMG website refresh

The GMMMG website has been refreshed with a new and updated design. The new design is a little clearer, and should make the site easier to navigate. All resources are still available in the same place; please use the search box or the menu bar at the top of each page to navigate as usual.

If you have bookmarks saved for frequently used pages of the site, please note that the web addresses for most pages have changed and you may need to create new bookmarks.

For any questions, problems, or suggestions, please email nuth.enquiries.gmmmg@nhs.net.