Updated shared care protocol: apomorphine for adult patients

Following approval by CRG and GMMMG, and by the Greater Manchester ICS Clinical Effectiveness and Governance Committee, the revised GMMMG shared care protocol for apomorphine for adult patients is now available.

The updated document can be found on the shared care page, along with all other currently active SCPs.


GMMMG charter

Following the first meeting of the Greater Manchester ICS Clinical Effectiveness and Governance Committee on Thursday 22nd September, the GMMMG charter has been approved and published.

The charter is available on the website by clicking here.


Updated shared care protocols

Following approval by CRG and GMMMG, and the first meeting of the Greater Manchester ICS Clinical Effectiveness and Governance Committee on Thursday 22nd September, the following shared care protocols have been updated:

  • GnRH analogues for breast cancer – now includes both goeserelin and leuprorelin, and applies to all adult patients
  • Somatropin for paediatric patients – updated to reflect the available products
  • DMARDs in dermatology, including azathioprine, hydroxychloroquine, oral methotrexate and mycophenolate – updated to reflect current contact details for dermatology clinic at MFT.

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


Consultation: actions from August meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the August 2022 CRG meeting.

Actions in this consultation include:

  • Famotidine added to formulary as GREEN, replacing ranitidine as first choice H2-receptor antagonist for adults
  • Risankizumab for active psoriatic arthritis added to chapter 10 as RED
  • Icosapent ethyl added to chapter 2 as GREEN (specialist advice)
  • Roxadustat added to chapter 9 as RED
  • Fenfluramine added to chapter 4 as RED
  • Imlifidase added to chapter 8 as RED
  • Setmelanotide added to RAG list only as RED

All links to MHRA drug safety updates will be added to formulary as appropriate.

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Wednesday 28th September 2022.


Consultations: GMMMG shared care protocols for Lokelma and Veltassa

On behalf of the GMMMG Clinical Reference Group, two GMMMG shared care protocols have been drafted for:

  • sodium zirconium cyclosilicate (Lokelma) for refractory hyperkalaemia
  • patiromer (Veltassa) for refractory hyperkalemia

We now seek comments on these drafts, which are available from the GMMMG consultations page. The consultation period is open until 5pm on Monday 12th September.


Consultation: actions from June meeting of CRG

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the June 2022 CRG meeting.

Actions in this consultation include:

  • Minoxidil foam to be DNP, and formulary updated to clarify that other topical minoxidil preparations are not prescribable
  • Lixisenatide to be removed from formulary following discontinuation of initiation packs
  • Romosozumab for severe osteoporosis to be RED, and added to formulary as a first line anabolic treatment alongside teriparatide
  • Selumetinib for symptomatic and inoperable plexiform neurofibromas to be RED
  • Links to NICE clinical guidance on baricitinib for COVID-19 to be added to formulary in chapters 10 & 13.

For information:

  • Epiduo gel: strength to be removed from formulary, to align with primary care dermatology acne pathway
  • Brand name and formulation for topical calcipotriol / betamethasone to be removed from formulary, and replaced with a statement that prescribers should choose the most cost-effective option.
  • Formulary restriction to macrogol 3350 to be removed, replaced with a statement that prescribers should choose the most cost-effective macrogol formulations.

To take part in this consultation, visit the consultations page. The consultation period is open until 5pm on Thursday 28th July 2022