News summary

Following the September meetings of GMMMG and CEGC, the following actions have been published to the GMMMG website.

Updates include:

• Tranexamic acid solution for injection added to formulary as RED, for management of head injuries as per NICE NG232.
• Valproate easy read leaflet for people who can become pregnant published.
• Minutes of the GMMMG August 2023 meeting published.

All outstanding actions will be actioned following approval by GM Executive.

Following development by a working group of healthcare professionals from Manchester and Trafford, we now seek comments on the draft document: ‘DOAC switch to edoxaban for NVAF patients – protocol’.

Please note that this consultation will run for 3 weeks; please visit the consultations page to take part. The consultation will run until 5pm on Monday 9th October 2023.

Following approval by CRG, the July meetings of GMMMG and the Greater Manchester ICS Clinical Effectiveness and Governance Committee, the following updates have been made to GMMMG guidelines, formulary, and RAG list:

• Tezepelmuab for treating severe asthma added to formulary as RED
• Fosofomycin for uncomplicated UTI updated to GREEN RAG status
• Greater Manchester Hypertension Medication pathway published, alongside supporting information and a medication table
• Greater Manchester Antimicrobial guidelines updated
• Ustekinumab dose-escalation in Crohn’s and ulcerative colitis – statement updated

The formulary has also been updated to reflect relevant safety alerts and NICE guidelines. For full details, see the GMMMG decision summary for August 2023, or the formulary change log available on the formulary page.

Following approval by the GM Executive, the following updates have been made to GMMMG guidelines, formulary, and RAG list:

• FreeStyle Libre 2 and Dexcom ONE added to formulary.

For full details, see the formulary change log available on the formulary page.

Following development by Manchester Royal Eye Hospital we now seek comments on the draft document: ‘Prescribing Information for Primary Care: Steroid Eye Drops for Ophthalmic Indications’.

The consultation will run for 6 weeks; please visit the consultations page to take part. The consultation will run until 5pm on Wednesday 27th September 2023.

Please note: the RAG status of the steroid eyedrops is currently undergoing a separate consultation, with a proposed change from RED to GREEN (following specialist initiation). Please see the proposed actions from the August 2023 meeting of the Clinical Reference Group for more details.

Following approval by CRG, the July meetings of GMMMG and the Greater Manchester ICS Clinical Effectiveness and Governance Committee, and review by the GM Executive, the following updates have been made to GMMMG guidelines, formulary, and RAG list:

• Finerenone for CKD in type 2 diabetes added as GREEN (specialist advice)
• Semaglutide for overweight and obesity added as RED
• Orodispersible morphine added as GREEN and GREY, only for use when specified criteria are met
• Eptinezumab for preventing migraine added as RED
• Hydrocortisone modified release capsules (Efmody) added as GREEN (following specialist initiation), only for patients not well controlled on standard release preparations and where specified criteria are met
• Dapagliflozin for CKD in children added to paediatric RAG list as RED
• Chloral hydrate and cloral betaine added to the RAG list only as RED
• Asfotase alfa added to the RAG list only as RED

The formulary has also been updated to reflect relevant safety alerts and NICE guidelines. For full details, see the GMMMG decision summary for July 2023, or the formulary change log available on the formulary page.