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Clinical Guidance and Pathways

On this page you will find clinical guidance and treatment pathways that have been approved by GMMMG or its Subgroups.

The table headings below are active links; click a heading to sort in ascending or descending order.

Document Title Issue Date Review Date Status
HRT Guidance for Menopause Management 20230309 Mar 2023 20251209 Dec 2025
Hypersalivation and Sialorrhoea in Adult Patients 20230109 Jan 2023 20251209 Dec 2025
Inappropriate Polypharmacy Review and Treatment Optimisation: Resource Pack 20230209 Feb 2023 20241209 Dec 2024
Management of overactive bladder in adults 20190809 Aug 2019 20220809 Aug 2022
Trans-Anal Irrigation (TAI) Pathway 20171209 Dec 2017 20221209 Dec 2022
Tobacco Dependency Treatment Guideline 20220209 Feb 2022 20250109 Jan 2025

Antimicrobial guidelines
Antimicrobial Guidelines 20230509 May 2023 20230609 Jun 2023 This guideline is reviewed quarterly; comments will be accepted continuously
Dental Antimicrobial Guidelines 20200209 Feb 2020 20230209 Feb 2023
Guidelines on the management of outbreaks of influenza-like illness (ILI) in care homes 20201109 Nov 2020 External link to PHE guidance

Respiratory
Asthma Management Plan 20220409 Apr 2022 20250409 Apr 2025
Asthma Management Plan - Inhaler Guide 20221009 Oct 2022 20250409 Apr 2025
COPD Management Plan 20211109 Nov 2021 20230909 Sep 2023
COPD Management Plan - inhaler guide 20211209 Dec 2021 20230909 Sep 2023
Greener inhaler poster for patients 20220809 Aug 2022 20250409 Apr 2025
Greener inhaler poster for staff 20220809 Aug 2022 20250409 Apr 2025

Lipid management
Lipid management pathway (secondary prevention) 20230209 Feb 2023 20250209 Feb 2025 If prescribing inclisiran, please also click here for prescribing, ordering, and cost information.
Additional patient information is also available here.
PCSK9 inhibitors in the treatment of hypercholesterolaemia 20191109 Nov 2019 20211109 Nov 2021

Dermatology and allergy
Chronic urticaria in primary care for adults and children 20170909 Sep 2017 20190909 Sep 2019
Cow's milk protein allergy: prescribing infant formula for in primary care 20200409 Apr 2020 20230409 Apr 2023
Dermatology pathways: Management of acne in primary care 20190409 Apr 2019 20220109 Jan 2022 Under review
Dermatology pathways: Management of actinic keratoses in primary care 20190409 Apr 2019 20220109 Jan 2022
Dermatology pathways: Management of eczema in primary care 20190409 Apr 2019 20220109 Jan 2022
Dermatology pathways: Emollient ladder 20190409 Apr 2019 20220109 Jan 2022
Dermatology pathways: Management of psoriasis in primary care 20190409 Apr 2019 20220109 Jan 2022
Dermatology pathways: Steroid ladder 20190409 Apr 2019 20220109 Jan 2022
Dermatology pathways: Management of warts in primary care 20190409 Apr 2019 20220109 Jan 2022

CNS and pain
Benzodiazepine and Z-drug prescribing: Resource Pack 20210509 May 2021 20240509 May 2024
Benzodiazepine and Z-drug resource pack: editable appendices 20230409 Apr 2023 20240509 May 2024
Gabapentinoids - Prescribing for pain resource pack 20210709 Jul 2021 20230709 Jul 2023
Gabapentinoids - Prescribing for pain resource pack - editable version 20210709 Jul 2021 20230709 Jul 2023
Headache Pathway 20220609 Jun 2022 20250609 Jun 2025
Low strength antipsychotic prescribing in dementia: a resource for GPs 20151109 Nov 2015 20181109 Nov 2018
Neuropathic Pain in Adults - Guideline for Primary Care 20220509 May 2022 20250509 May 2025
Opioid Prescribing for Chronic Pain: Resource Pack 20180809 Aug 2018 20210909 Sep 2021
Palliative Care Pain and Symptom Control Guidelines for Adults 20191109 Nov 2019 20221109 Nov 2022 Developed in line with GMMMG process by the Greater Manchester and Eastern Cheshire Strategic Clinical Networks. Adopted for use by GMMMG

Gender dysphoria
Gender Dysphoria - Supporting information for GPs 20170409 Apr 2017 20200409 Apr 2020
The Royal College of Psychiatrists' Oct 2013: Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria 20131009 Oct 2013 RCPsych state that a review of this publication is planned and will take place in due course

High cost drug pathways
High Cost Drug Pathway for Axial Spondyloarthritis in Adults 20230209 Feb 2023 20250209 Feb 2025
High Cost Drug Pathways for Inflammatory Bowel Disease in Adults 20190609 Jun 2019 20191209 Dec 2019 Under review
High Cost Drugs Pathway for Psoriasis 20200109 Jan 2020 20221109 Nov 2022
High Cost Drug Pathway for Psoriatic Arthritis in Adults 20230209 Feb 2023 20250209 Feb 2025
High Cost Drugs Pathway for Psoriasis – outcomes & monitoring framework 20200109 Jan 2020 20210109 Jan 2021
High Cost Drugs Pathway for Rheumatoid Arthritis in Adults 20230209 Feb 2023 20250209 Feb 2025
Macular drugs pathways 20171109 Nov 2017 20191009 Oct 2019 Under review

Diabetes
Insulin Prescribing Aid for Adults with Type 2 Diabetes 20191109 Nov 2019 20221109 Nov 2022